The cause

Many things can cause dandruff, but one of the most common, and surprising to many, is not washing here in the right manner. As a medical practitioner I find that most of my patients believe that using shampoo will result in hair damage. Not true! However, I would also like to state that inadequate rinsing of the hair after shampooing may actually do more harm than good. 

Some patients also do not realise that they may be sensitive to hair products being used, which can eventually cause irritation of the scalp, leading to scaling and dandruff.

Seborrheic dermatitis, is a common cause of dandruff. This happen in areas, which are rich in sebaceous glands. Once inflamed they result in yellowish-white scales on scalp, and even eyebrows, sides of the nose and the ears, chest area and back. Sometimes the problem affects the groin and the armpits too.

Psoriasis is another condition, which is similar to dandruff. A yeast like fungus, known as melasezzia, is often present on the scalp and causes irritation on oily, skin covering our head. This aggravates the production of dandruff.

We have seen that some people are more prone to having dandruff than others, for instance, males are more affected than females, young adults are more prone than the elderly; people with oily scalp are the most common sufferers. 

Some babies develop a scaly crusty layer on their scalp known as cradle cap. This usually occurs in new-borns and clears up as the baby grows older.

Patients suffering from immune-compromised diseases may also suffer from dandruff.

Treating dandruff 

Dandruff can be treated relatively easily, but it may need some trial and error to find the perfect solution that's suits an individual. The general rule to cure and prevent dandruff is to keep the scalp and hair clean. Using a gentle shampoo regularly will help to keep the scalp oil free. It will also prevent drying of the scalp and build up of dead skin. If the condition aggravates, one may choose antidandruff shampoos, available over the counter.

Shampoos like Head & Shoulders and Jason Dandruff Relief 2-in-1 contain the antibacterial and antifungal agent, zinc pyrithione. These work well to reduce the growth of fungus on the scalp, which leads to causing dandruff. 

Tar-based shampoos such as Neutrogena T/Gel use coal tar, a by-product of the coal manufacturing process and helps in conditions such as dandruff, seborrheic dermatitis and psoriasis. It slows down the death of cells and eventually, the flake off. 

Shampoos containing salicylic acid (such as Neutrogena T/Sal) work as 'scalp scrubs' and help eliminate scale, but they may eventually leave your scalp dry; using a conditioner after shampooing can help relieve dryness.

Selenium sulfide shampoos (such as Selsun Blue) slow your skin cells from dying and may also reduce malassezia. As they can discolour blond, gray or chemically coloured hair, be sure to use them only as directed, and rinse well after shampooing.

Ketoconazole shampoos (such as Nizoral) are a broad-spectrum, antifungal agent that may work when other shampoos fail. It is available over-the-counter, as well as by prescription.

If dandruff still persists after trying out some of these shampoos; it is then time to consult a specialist. If not treated properly and in time, chronic dandruff can lead to drastic and irrecoverable hair loss.

Photo: LS Archive/Sazzad Ibne Sayed