Dr. Satish Kumar Gupta
Dandruff is the shedding of dead skin cells from the scalp in the form of white coloured thin scaly flakes.
It is technically known as'pityriasis simplex' or'pityriasis capitis'
Greasy dandruff or seborrhoeic dermatitis occurs when oily and yellow flakes or scales form on your scalp and stick to your head and hair.
Dry dandruff occurs when dry, white and loose flakes or scales form on your scalp and fall from your head and hair.
Other symptoms can include itching, redness, and a greasy or dry scalp.
As skin cells die, a small amount of flaking is normal.
About 487, 000 cells/cm2 get released normally after detergent treatment.
Some people experience an unusually large amount of flaking either chronically or as a result of certain triggers, up to 800, 000 cells/cm2, which can also be accompanied by redness and irritation and even by loss of hair.
Dandruff is a common scalp disorder affecting almost half of the population at the post-pubertal age and of any sex and ethnicity.
Dandruff is rare before puberty, peaks in the teens and early twenties, and declines with age thereafter.
It often causes itching.
The signs and symptoms of dandruff are an itchy scalp and flakiness.
Red and greasy patches of skin and feeling tingly on the skin are also symptoms
It has been well established that keratinocytes play a key role in the expression and generation of immunological reactions during dandruff formation.
The severity of dandruff may fluctuate with season as it often worsens in winter.
Dandruff can have several causes, including dry skin, seborrhoeic dermatitis, not cleaning/scrubbing often enough, shampooing too often, psoriasis, eczema, sensitivity to hair care products, or a yeast-like fungus.
Skin hyperproliferation is triggered by malassezia globosa.
Dandruff has been shown to possibly be the result of three factors:
Skin oil commonly referred to as sebum or sebaceous secretions.
The metabolic by-products of skin micro-organisms (most specifically malassezia yeasts)
Individual susceptibility and allergy sensitivity.
According to 2016 study bacteria (mainly prionibacterium and staphylococcus) are more important to dandruff formation than fungi.
Bacteria presence was in turn influenced by water and sebum amount.
Older literature cites theclaims the fungus malassezia furfur (previously known as pityrosporum ovale) as the cause of dandruff.
While this species does occur naturally on the skin surface of both healthy people and those with dandruff, it was discovered in 2007 that the responsible agent is a scalp specific fungus, malassezia globosa that metabolizes triglycerides present in sebum by the action of lipase, resulting in a lipid byproduct oleic acis.
During dandruff, the levels of malassezia increase by 1.5 to 2 times its normal level.
Androgenic excess enhances dandruff as androgens inrease sebum production.
Oil enhances dandruff by increasing oiliness of scalp.
Hairloss is due to dandruff and associated fungal infection.
Dandruff can be triggered by a variety of factors, including:
Genetic predisposition dandruff tends to run in families
Climatic conditions e. G. Sun exposure, cold, heat, wind
Physical or emotional stress
Hormonal changes: incresed by androgen
Lifestyle factors, such as diet or alcohol intake
Dandruff scale is a cluster of corneocytes, which have retained a large degree ofcohesion with one another and detach as such from the surface of the straitum corneum.
A corneocyte is a protein complex that is made of tiny threads of keratin in an organised matrix.
The size and abundance of scales are heterogeneous from one site to another and over time.
Parakeratotic cells often make up part of dandruff.
Those affected by dandruff find that it can cause social or self-esteem problems, indicating treatment for both psychological and physiological reasons.
Most cases of dandruff can be easily treated with specialized shampoos and vitamin-a supplementation.
A number of antifungal treatments have been found to be effective including: fluconazole, ketoconazole, zinc pyrithione and selenium disulfide ciclopirox.
These antifungals are widely used in anti-dandruff shampoos.
Vitamin-a is he strongest inhibitor of sebum production and can control seborrhoic dermatitis. It also stimulates rapid growth of skin layers resulting into shedding off of old unhealthy layers and creation of new healthy epitelial layers. It also assists in rapid clearing of fungus if added with antifungals.
Dandruff treatment' is firstly aimed at:
Improving the health and condition of your scalp and hair.
Reducing any flaking and irritation to your scalp.
Clear any flaking and irritation to your scalp.
Prevent any further build up of flaking and irritation to your scalp.
Providing and maintaining you with a flake free, irritation free, healthy scalp and a healthier head of hair.
The best treatment is outlined below:
Take fluconazole 150 mg once weekly (every sunday) for fungus.
Once weekly shampooing with selenium sulfide (selsun) shampoo+ which is antifungal as well as specific treatment of dandruff.
Shampooing by fluconazole shampoo on other days
Local use of clotrimazole (candid) lotion
Aquasol10 000 iu twice daily for 5 days and then on every sunday.
Take high protein diet
Take at free diet free from triglycerides which are precursors of sebum.
Don't eat egg as it has avidin which antogonises hair-growth promoting vitamin biotin or take egg with biotin
Take green vegetables, salad and fruits
Take biotin 1/2 twice daily with antifungals for 1 year for loss of hair.
Vitamin-a causes inhibition of sebum production and promotion of growth of health scalp skin, thus removing dandruff.
Excess of vitamin a may cause hairloss while optimal dose increses hair growth.