Pathophysiology and Pathogenesis of Dandruff

Dandruff is the most common condition of the scalp and affects almost every individual. The white flakes falling off the head are what dandruff looks like. The causes are many in number, but their initiation and progression occur in fixed phrases. A complete understanding of these phases becomes important when the progression of dandruff leads to complications like intensive scalp rashes, redness, eczema, etc.

This blog serves the purpose of elaborating on the pathophysiology and pathogenesis of dandruff. But before that, do you know the difference between these two terms?

Pathogenesis – How does a disease infect an individual?

Pathophysiology – How does the disease lead to symptoms?

So basically, we shall cover “how it occurs” to “what happens after it occurs” in terms of dandruff in this blog.

Phases of Pathophysiology of Dandruff

Dandruff is progressed via four stages-

1. Interaction of the scalp with the Malassezia (dandruff fungus) ecosystem

2. Initiation and propagation of inflammation on the scalp

3. Disruption of the epidermis (layer of skin) proliferation and differentiation processes

4. Disruption of the normal functioning of the skin

Initially, the symptoms seen are very usual

• Flakes of skin
• Itchiness
• Tight sensation
• Hair loss

All these symptoms originate from an impairment in the stratum corneum barrier function and skin dryness. The main culprit is the dandruff fungus – Malassezia, which tends to release fatty acids that cause inflammation and hyperproliferation. Furthermore, due to the presence of the fungus, the hair becomes thin and brittle, which leads to weak hair and hair loss symptoms. 

At a deep tissue level, this condition causes epidermal structural and functional disruption. The epidermal layer of the skin is highly proliferative, and hence, a significant increase in the amount of dandruff becomes evident. This is due to the fact that the cells are parakeratotic cells, which increases the turnover rate of their formation. This increase leads to changes in the irregular moisture-holding capacity and protein composition of the scalp.

Furthermore, the significant lamellar structure formed by ceramides is replaced by wider and unstructured lipid material. This serves as the primary mode of inflammation. The inflammatory activity includes leukocytic infiltration in dandruff. This results in SC barriers. This means that the ability of a normal scalp to eliminate moisture and exogenous material is decreased. 

The more moisture in the scalp, the more dandruff is formed. The steady and slow progression of this disruption elevates the amount of dandruff formed. Thus, the dandruff removal process should be accompanied by the cleansing of these wide ducts that contain moisture. This is done by a deep cleansing of the scalp.

If I have to sum up with a more precise version of the above data, I would say-

A dandruff scale is a cluster of corneocytes that have kept a high degree of cohesiveness with one another and detach from the stratum corneum’s surface as a result. A corneocyte is a protein complex composed of small keratin threads arranged in an organized matrix. Scale size and abundance vary from one location to the next and across time. Dandruff is frequently composed of parakeratotic cells. Their numbers are proportional to the severity of clinical signs, which may be altered by seborrhea.

Dandruff Reasons Decoded- (Precise & Segmented)

1. Skin that is irritated and greasy

2. Inadequate cleanliness and washing, which causes skin cells to collect and cause flakes and itching

3. An immunological response to Malassezia globose, a form of yeast that resides on the skin.

4. Because dandruff is most common in young adults after puberty, hormonal factors may be at play.

5. Hair care product sensitivity (contact dermatitis)

6. Other skin disorders include psoriasis and eczema.

Dandruff Symptoms (Precise & Segmented)

1. Dandruff is distinguished by an inflamed and itchy scalp, followed by white skin flakes. These white, greasy flakes build up in your hair and on your shoulders during cold weather when the air is dry.

2. If you are stressed, the indications and symptoms may be more severe, and they tend to worsen during cold, dry seasons.

3. A red rash caused by itching can also be observed around the scalp, forehead, and ears or forehead if you have dandruff.

4. In cases of dandruff, constant hair loss is a common sign.

Wrapping Up

Dandruff is a condition that is unavoidable. It appears simple in nature, but at an internal level, it disrupts the normal structure of the epidermal layer of the skin. If that structure becomes permanent, dandruff becomes permanent. Hence, to eliminate this loop of dandruff and structural change, keeping the scalp healthy is the key.

If you wish to read further about dandruff, just scroll through our blogs.