Everything about Dandruff totally explained
Dandruff (also called
scurf and historically termed
Pityriasis capitis) is due to the excessive shedding of dead skin cells from the
scalp. As it's normal for skin
cells to die and flake off, a small amount of flaking is normal and in fact quite common. Some people, however, either
chronically or as a result of certain
triggers, experience an unusually large amount of flaking, which can also be accompanied by redness and
irritation. Most cases of dandruff can be easily treated with specialized
shampoos. Dandruff isn't an organism like
lice; it's just dead skin that accumulates in the scalp. Dandruff is unlikely to be the cause of
hair loss.
Excessive flaking can also be a symptom of
seborrhoeic dermatitis,
psoriasis,
fungal infection or excoriation associated with infestation of
head lice.
Dandruff is a global phenomenon and many people find that dandruff can cause social or self-esteem problems. Treatment may be important purely for psychological reasons.
Causes
As the
epidermal layer continually replaces itself, cells are pushed outward where they eventually die and flake off. In most people, these flakes of skin are too small to be visible. However, certain conditions cause cell turnover to be unusually rapid, especially in the scalp. For people with dandruff, skin cells may mature and be shed in 2 - 7 days, as opposed to around a month in people without dandruff. The result is that dead skin cells are shed in large, oily clumps, which appear as white or grayish patches on the scalp, skin, and clothes.
Dandruff has been shown to be the result of three required 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
Common older literature cites the
fungus Malassezia furfur (previously known as
Pityrosporum ovale) as the cause of dandruff. While this fungus is found naturally on the skin surface of both healthy people and those with dandruff, it was discovered that a scalp specific fungus,
Malassezia globosa, is the responsible agent. This fungus metabolizes
triglycerides present in sebum by the expression of lipase, resulting in a lipid byproduct
oleic acid (OA). Penetration by OA of the top layer of the epidermis, the
stratum corneum, results in an inflammatory response in susceptible persons which disturbs
homeostasis and results in erratic cleavage of stratum corneum cells.
Rarely, dandruff can be a manifestation of an allergic reaction to chemicals in hair gels/sprays, hair oils, or sometimes even dandruff medications like
ketoconazole.
There is no convincing evidence that food (such as sugar or yeast), excessive
perspiration, or climate have any role in the pathogenesis of dandruff. However, certain oily foods or excessive intake of 'junk food' can trigger the appearance of dandruff.
Seborrheic dermatitis
Flaking is a symptom of
seborrheic dermatitis. Joseph Bark notes that "Redness and itching is actually seborrheic dermatitis, and it frequently occurs around the folds of the nose and the eyebrow areas, not just the scalp." Dry, thick, well-defined lesions consisting of large, silvery scales may be traced to the less common
psoriasis of the scalp.
Seasonal changes, stress, and immuno-suppression seem to affect seborrheic dermatitis.
Treatment of fungal infection
There have been many strategies for the control of dandruff. Simply increasing shampooing will remove flakes. However, elimination of the fungus results in dramatic improvement. Regular shampooing with an anti-fungal product can reduce recurrence.
Anti-fungal/anti-dandruff shampoos containing
ketoconazole have been shown to be more effective than zinc pyrithione. Ketoconazole is the most effective antifungal agent according to one study.
Further Information
Get more info on 'Dandruff'.
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