Dandruff’s Microbial and Non-Microbial Causes
The stratum corneum, the epidermis’ outermost layer, is affected by the superficial disorder known as dandruff. Itching, shedding, and identifiable flax patches that are loosely adhered to the scalp or in the hair are the main symptoms of this non-inflammatory disorder. Dandruff causes severe psychological pain that is embarrassing and manifests as self-esteem loss and the creation of a bad social image.
It is a fairly prevalent condition that affects over half of the population, regardless of gender, age, or race. No one in any location would have freely moved through without being impacted by this disorder at some point in their lives. The intensity of dandruff might vary depending on the time of year; it can be worse in the winter than in the summer.
The dandruff scale is a collection of corneocytes that separate from the stratum corneum’s surface. The size and quantity of scales vary throughout time and location. The severity of the clinical indicators is inversely correlated with their number.
We should emphasize all of the known or reported causes of dandruff while talking about it and its etiology. There are both microbial and non-microbial triggers. It is exceedingly difficult to say which of the many recognized reasons, if any, or which combination of causes, if any, contributes to the development of dandruff.
Microbial etiology of dandruff
There may be several etiopathogenic pathways with intricate mechanisms that contribute to dandruff. Since 1846, it has been commonly acknowledged that the genus Malassezia, a type of lipophilic yeast, causes dandruff. The presence of this fungus in the condition pityriasis Versicolor was initially identified by Eichstedt. The scalp serves as a biocenosis for a variety of species, including Malassezia spp., Propionibacterium spp., and Staphylococci spp. These organisms range from 103 to 105 per mm2 in terms of density.
Malassezia concentrations increase by 1.5 to 2 times during dandruff. It has been argued that the quantitative microbiological evaluation of all kinds does not reveal the function of yeast; the abundance that may have been inversely related to the volume of scales it colonizes might be accountable for the changed desquamation. It’s interesting to note that the approach to dandruff treatment seems to depend on the specific relationship between two species of Malassezia.
The Malassezia population decreases in response to antifungal preparation use, while the bacterial population is rarely impacted. After stopping the medication, the clinical condition returns, and the Malassezia population rises to its initial level. The fact that dandruff responds well to various steroids as a treatment is another intriguing part of the microbiological origin of dandruff. The immune flare-up is known to be suppressed by steroids, and the microorganism will take advantage of this opportunity when the immune system is reduced.
The lengthy recovery period and positive treatment response with steroids, however, cast doubt on the dandruff-causing microbe. There is still no conclusive evidence as to whether the increased Malassezia count is the effect of abundant scales or whether numerous scales are the cause of the increased Malassezia population. Seven different Malassezia species, including M. globosa, M. resticta, M. obtuse, M. sloofiae, M. sympodialis, M. furfur, and M. pachydermatis, have been linked to the development of dandruff. But as of right now, none of the Malassezia species has shown to be a dandruff-causing pathogen per Koch’s postulates.
Non-microbial etiology of dandruff
It is commonly known that dandruff has a non-microbial etiology. Desquamation of the scalp is a known side effect of prolonged sun exposure. Dandruff can also be partially brought on by mild scalp irritation brought on by excessive shampooing, frequent combing, the use of specific cosmetic products, dust, and grime. The aforementioned assumptions, however, are not supported by enough experimental data.
According to reports, sun exposure causes dandruff. It’s interesting to note that Malassezia is said to be killed by sunlight. Scaling and a lot of Malassezia cells have always been present when there is dandruff. It is difficult to say whether abundant scaling promotes yeast cells or whether more yeast cells cause abundant scaling.
Final Words
Each patient should receive a personalized course of treatment for their particular case of dandruff. Before beginning any antifungal therapy, the fungus’ etiology must be established. To choose the right course of treatment, the type of disease must be determined as primary or secondary. Dermatologists must treat dandruff as promptly as possible to prevent the development of an unidentified “Tertiary” stage of the disease that could provide a greater burden to the medical community.
