Dandruff- Clinical Manifestations, Causes, and Treatment

According to our common understanding, dandruff is the flakes of skin that fall off the scalp. But do you know its inner mechanism? By what is dandruff triggered? How is dandruff formed in the first place? 

This very condition affects almost every individual, and to be precise, every 2 in 5 individuals have dandruff now! Now, these are quite the numbers. So knowing the actual clinical manifestation also makes sense, and this is what we will be discussing in this blog.

Clinical Manifestation of Dandruff

When the homeostasis of cell formation and its deterioration is disrupted, specifically on the scalp, dandruff occurs. Dandruff is commonly defined as increased scalp scaling, which represents the more aggressive end of physiological desquamation. What causes such physiological/clinical manifestations? 

The postulate of fatty acid metabolism by the commensal lipophilic yeast of scalp skin – Malassezia – is losing its luster because scaling occurs in many cases without the organism present. The question is, what causes the quick scaling and what keeps the state in a continuous state? What should the treatment strategy be? 

Is it better to treat the clinical indications and symptoms or to eliminate the cause? Dandruff is a major problem in a series of physiological scaling disorders, including dandruff, seborrheic dermatitis, and psoriasis, and the condition is exacerbated by the commensal flora, Malassezia. We believe that when there is an abundance of food and water, the commensal organism transforms into a saprophyte.

When this transformation occurs, there is a rapid increase in the formation of dandruff. 

What triggers dandruff formation?

The internal causes of dandruff are-

1. Sun exposure: This tends to make skin oily and, in some cases, dry, which leads to scaling of the scalp.

2. Dry scalp: In this case, there is an impairment in the barrier that affects intracellular lipid levels in the scalp and causes dandruff.

3. Frequent combing and over-shampooing: Both frequent combing and over-shampooing are known to weaken the scalp stratum corneum barrier, so this hypothesis has some merit. No organism can develop its adherence to undamaged skin.

4. Unhygienic scalp: Due to the accumulation of dirt on the scalp, it is more likely that the pores get clogged with oil and dirt in it. This may also cause dandruff.

5. Fungus: Dandruff is frequently caused by Malassezia, a fungus that resides on the scalp and feeds on the oils released by hair follicles. Malassezia is usually not an issue, but in certain people, the immune system reacts excessively to it. This might irritate the scalp and lead it to create additional skin cells.

As these dead skin cells fall off, they combine with the oil in the hair and scalp to cause dandruff.

7. Other factors: 

1. Extreme cold temperatures in the winter, and maybe a combination of cold weather and overheated rooms 
2. Hair brushing, as brushing helps remove dead skin cells 
3. Stress
4. Age, as dandruff is more common between the ages of adolescence and middle age (though a type of dandruff known as cradle cap is also common with babies)
5. Alcohol does more than just dehydrate your hair; it also creates itchy scalp, which contributes to dandruff.
6. hormonal factors

Tips To Treat Dandruff

Treatment for dandruff necessitates a logical approach and understanding, and it should be individualized for each patient. Before beginning any antifungal treatment, the etiology of the fungal infection must be determined. To determine the best course of treatment, the condition must be classified as primary or secondary.

The tips are-

1. Use anti-dandruff shampoo containing either of the mentioned below-

1. Ketoconazole
2. Selenium sulfide
3. Zinc pyrithione
4. Coal tar
5. Salicylic acid
6. Tea tree oil

2. Use shampoo gently and adequately such that cleanses the scalp properly.

3. Prefer gentle combing to remove loose scales and then wash with medicated shampoo

4. Go on a healthy diet routine that maintains homeostasis in the body

Summing Up

While being a simple condition in its form, dandruff is much more complicated. There are various ways of dealing with it, but basic steps like hygiene, deep scalp cleansing, good shampooing habits, and much more help in treating dandruff. 

We hope that the blog was useful. To continue reading more about dandruff, you may visit here.