Dandruff basically occurs when small dry skin flakes come off the scalp. You may see these flakes in your hair or on your shoulders. Dandruff can cause itching on your scalp. Dandruff is a common problem, but not as simple as it seems. Defining dandruff is actually very difficult because it overlaps with seborrheic dermatitis (a chronic form of eczema) and other skin conditions that lead to flaking of the scalp.

Symptoms of Dandruff

An important sign that someone may have dandruff is the presence of distinct white flakes on the scalp, which are formed from dead skin on the hair. Other symptoms include:

• Sometimes, the scalp may itch.

• Oily or dry flakes on the scalp

• Yellow to red bumps along the hairline (in severe cases)

Causes and Risk Factors of Dandruff

Dandruff can occur for various reasons.

Seborrheic Dermatitis

According to the American Osteopathic College of Dermatology, if you have a severe case of dandruff, you probably have a mild case of seborrheic dermatitis (SD). The National Eczema Association states that seborrheic dermatitis is a chronic form of eczema that affects areas of the body that produce the most sebum or oily secretion.

People with oily skin are often prone to dandruff.

Reason: A yeast called Malassezia globosa feeds on the oils on the scalp. Dr. Amy McMichael, a dermatologist, professor of dermatology, and chair of the dermatology department at Wake Forest, notes that some people's bodies perceive this breakdown of oil as an irritant, causing the scalp to react by speeding up skin cell turnover, leading to dandruff. According to the Winston-Salem Medical School in North Carolina, for those without dandruff, it takes a full month for new skin cells to mature, die, and shed on the scalp, but for those with dandruff, this process occurs in only two to seven days. However, it is important to note that while it was long believed that M. globosa was the main culprit for dandruff, a July 2019 report in the journal Experimental Dermatology indicated that a cause-and-effect relationship has not yet been firmly established.

Contact Dermatitis

Contact dermatitis is a skin irritation caused by an allergen or irritant, resulting in itchy, sometimes painful rashes, which in the case of dandruff, occur on the scalp. According to the American Academy of Dermatology, this can happen due to hair care products or dyes.

Dry Skin

If the cold winter air dries out your skin, including your scalp, dry skin may be the cause of your dandruff. When dry skin leads to dandruff, the flakes are usually smaller and less oily than those caused by seborrheic dermatitis. (Additionally, according to the Cleveland Clinic, cold and dry weather can worsen seborrheic dermatitis.)

Almost anyone can develop dandruff, but the following factors can make you more susceptible.

Shampooing Habits

Dr. McMichael says: For those at risk of dandruff, frequent washing can worsen the condition. Prolonged intervals can also lead to oil buildup and dandruff.

Age

According to a study published in the Clinical and Investigative Dermatology journal, dandruff often starts in adolescence, peaks around age 20, and is less common in individuals over 50 years old.

Gender

Sex hormones like androgen stimulate sebaceous gland activity. Increased oil production means a higher likelihood of inflammatory reactions and dandruff. Men are more prone to dandruff than women.

Weak Immune System

Seborrheic dermatitis is more common in individuals with organ transplants and those with HIV, AIDS, hepatitis C, or alcoholic pancreatitis. For example, 30 to 83% of HIV patients report seborrheic dermatitis.

Neurological and Psychological Disorders

Parkinson's disease, Alzheimer's disease, epilepsy, traumatic brain injury, and spinal cord injury are conditions that increase the risk of seborrheic dermatitis, including dandruff. For example, individuals with Parkinson's disease have a weakened autonomic nervous system that helps control factors such as sebum secretion, which can lead to excessive oil production that can cause dandruff.

History of Skin Disorders

Eczema, rosacea, psoriasis, or acne can trigger or worsen seborrheic dermatitis.

Oily Skin

If you naturally have oily skin, you are at risk of developing seborrheic dermatitis.

Scalp Medications

Dr. McMichael advises: "Specific oils applied to the scalp can cover the scalp, but they can worsen flaking and itching."

How is Dandruff Diagnosed?

A dermatologist can usually diagnose dandruff by simply looking at your scalp. According to the Cleveland Clinic, if your dandruff does not respond to treatment, they may recommend a skin biopsy to rule out other possible issues.

Duration of Dandruff

Dandruff resulting from seborrheic dermatitis is a chronic condition that requires repeated or long-term treatment. In the case of dandruff caused by contact dermatitis, dry skin, or shampooing habits, changing skin habits can resolve the flakes in less time.

What is dandruff?

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