Dandruff – causes and treatment

Dandruff consists of small flakes of epidermal skin that shed and remain on the scalp. Almost everyone encounters this unpleasant condition at some point. These tiny flakes form due to the accelerated growth of primary epidermal cells during the skin’s natural renewal process.

Dandruff is considered a mild manifestation of seborrheic dermatitis. It is non-contagious, most commonly occurs in individuals aged 15–25, and is rare in the elderly.
Although some believe it results from poor hygiene,  dermatologists generally recognize dandruff as a symptom of an underlying condition.

Causes and Triggers

Dandruff does not appear spontaneously—it always has specific causes. The primary cause is often a yeast-like fungus of the genus Malassezia furfur (also known as Pityrosporum ovale), which thrives in areas of the scalp rich in sebum.

Contributing factors include:

• Heredity: If family members have dandruff, children are likely to develop it.
• Increased sebum production: Particularly during puberty due to hormonal changes.
• Seborrhea: Excessive sebum production.
• Nervous system disorders.
• Certain medications: Especially those used to treat psychiatric conditions.
• Emotional stress.
• Intestinal dysbiosis.
• Gastrointestinal diseases.
• Vitamin deficiencies.
• Diabetes mellitus.;
• Chemical and thermal damage: Overuse of harsh products and heat on the scalp.

What else can cause dandruff? Dandruff can also result from the use of low-quality shampoos containing aggressive surfactants, or from improper hair washing frequency—either too often or too infrequently.

In young children, dandruff may stem from allergic reactions or the wrong choice of scalp care products.  In adolescents, it is linked to hormonal changes and is often accompanied by oily skin and acne.

Symptoms of Dandruff

The symptoms of dandruff are easy to identify. It doesn’t go unnoticed and becomes a genuine aesthetic issue for people dealing with it. Excessive washing and combing of the hair, as well as the use of hair dryers, chemical treatments, and heat styling tools, only worsen the existing problem.

Dandruff is particularly noticeable in people with dark hair, as the white flakes stand out prominently against such a background, both on the scalp and along the length of the hair. Key symptoms include oily hair shine and flaking of the scalp, accompanied by the shedding of a large number of skin flakes. Patients also report severe itching, redness, and increased skin sensitivity. In some cases, hair loss begins.

A significant amount of flakes in the hair and on clothing is a clear sign that regular shampoos are not addressing the problem. Moreover, these flakes tend to accumulate not everywhere but specifically in areas of increased pressure and around the forehead.

Complications

If left untreated, dandruff can lead to complications such as:

• Sebopsoriasis: Flaky plaques extending to other areas of the body.
• Hair loss: Blocked hair follicles can lead to oxygen deprivation and permanent follicle damage, causing bald spots.
• Pyoderma: Scratching itchy areas introduces infections, potentially causing boils and abscesses.
• Sebaceous cysts: Blocked sebaceous glands can fill with sebum, forming cysts.

These complications cause significant emotional distress, often leading individuals to avoid social interactions. Even with daily hair washing, the problem remains unresolved.

Treatment

How to Get Rid of Dandruff Unfortunately, there is no universal cure for dandruff. The first step is to identify and address the underlying cause.

Treatment usually involves medicated shampoos, which should be purchased from pharmacies.  Use these shampoos twice weekly, applying them to the scalp, massaging gently, and leaving them on for 5–10 minutes before rinsing.  Medicated anti-dandruff soaps, containing the same medicinal components as shampoos, can also be effective. Most often, doctors recommend using tar and sulsen.

If no improvement is seen after three weeks of treatment, consult a dermatologist.

Additional measures Balanced diet: Reduce fatty and sugary foods.  Include fermented dairy products, fiber, and vitamin-mineral complexes.

Prevention

There are no guaranteed methods to prevent dandruff. While it is easy to manage the symptom of flakes, identifying and addressing the root cause is essential. Dermatologists recommend:
Regular washing with suitable shampoos.
Maintaining a healthy diet.
Managing stress effectively.
Treating underlying medical conditions. Avoid harmful habits.
If untreated, dandruff can escalate into more severe conditions, such as dermatitis.