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Dandruff 

Dandruff is a common scalp disorder affecting almost half of the post pubertal population of any ethnicity and seen in both men as well as women.1

The condition is generally characterized by the presence of flakes on the scalp and in the hair, associated with scalp pruritis (itching).

The symptoms may vary and the severity can range from mild to severe scaling. In some individuals, recurrent and chronic dandruff represents a difficult-to-treat condition which may subsequently lead to an excessive hair shedding and diffuse alopecia.2

Causes of Dandruff

Dandruff is frequently associated with seborrhea and seborrhea is the precursor of seborrheic dermatitis. Seborrheic dermatitis is a more severe condition than dandruff characterized by the presence of erythema and flaking of the skin in the affected areas.3

The lesions are mainly located in areas containing more number of sebaceous glands such as the scalp, face and certain areas of the trunk.

Dandruff is a consequent of at least three etiologic factors:

  • The yeast,
  • Pityrosporum ovale (Malassezia fungi),
  • Increased sebaceous secretions and individual sensitivity.

Pityrosporum ovale feed on the dermal lipids and proteins and aids the lipase activity, which in turn releases proinflammatory free fatty acids causing dermal inflammation and tissue damage. Of the three etiologic factors implicated in dandruff, Malassezia are the easiest to control.

The exact cause for the overgrowth of these organisms is not known.

The disorder is commonly aggravated by

  • Changes in humidity,
  • Seasonal changes (severe during winter and mildest during summer as ultraviolet rays from sunlight counter acts P. Ovale),
  • Hormonal fluctuations,
  • Emotional stress,
  • Suppressed immune system,
  • Poor diet
  • Infrequent shampooing.4 

Management of Dandruff

Dandruff is a natural process, which cannot be eliminated and can only be managed and controlled. In general, mild scaling can often be managed by daily cleansing with a gentle shampoo. When regular shampoos fail, over-the-counter dandruff shampoos may be helpful.

Currently available treatment options for the management of dandruff include

  • Therapeutic use of zinc pyrithione
  • Salicylic acid
  • Imidazole derivatives
  • Glycolic acid
  • Sulphur
  • Tar derivatives
Present anti-dandruff agents primarily have an antimicrobial mode of action and inhibit growth of P. Ovale. It’s been shown that shampoos containing a proven antifungal compound were the most effective in controlling the yeast causative of dandruff.5  
 
Recent developments in shampoo technology have led to increased efficacy of anti-dandruff agents which allows shorter contact time and reduces irritation effectively.6


Written by: Healthplus24 team
Date last updated: July 18, 2011
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References 
  1. Piérard-Franchimont C, Xhauflaire-Uhoda E, Piérard GE. Revisiting dandruff. Int J Cosmet Sci. 2006; 28(5): 311-318.
  2. Piérard-Franchimont C, Xhauflaire-Uhoda E, Loussouarn G, Saint Léger D, Piérard GE. Dandruff-associated smouldering alopecia: a chronobiological assessment over 5 years. Clin Exp Dermatol. 2006; 31(1): 23-26.
  3. Peyrí J, Lleonart M; Grupo español del Estudio SEBDERM. Clinical and therapeutic profile and quality of life of patients with seborrheic dermatitis. Actas Dermosifiliogr. 2007; 98(7): 476-482.
  4. Nowicki R. Modern management of dandruff. Pol Merkur Lekarski. 2006; 20(115): 121-124.
  5. Bulmer AC, Bulmer GS. The antifungal action of dandruff shampoos. Mycopathologia. 1999; 147(2): 63-65.
  6. Trüeb RM. Shampoos: ingredients, efficacy and adverse effects. J Dtsch Dermatol Ges. 2007; 5(5): 356-365.
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