What is dandruff?
What are the main signs and symptoms of dandruff?
The main signs and symptoms of dandruff are:
- Skin flakes on the scalp, hair, eyebrows, beard, or shoulders
- Itchy scalp
Dandruff can occur completely on its own, but sometimes is a symptom of other illnesses like HIV/AIDS, neurological disorders (e.g., Parkinson’s disease, tardive dyskinesia, epilepsy), hepatitis C, chronic alcoholic pancreatitis, and some congenital disorders like Down syndrome.[4]
How is dandruff diagnosed?
Dandruff is commonly diagnosed by simply examining a patient’s scalp.[1] It’s important to rule out other conditions that may initially appear similar, such as atopic dermatitis, tinea capitis, rosacea, and systemic lupus erythematous (SLE).[4]
What are some of the main medical treatments for dandruff?
Dandruff is mainly treated with hair and scalp products, such as shampoos. These products typically contain antifungals (e.g., ketoconazole, pyrithione zinc, selenium sulfide), corticosteroids (e.g., hydrocortisone or fluocinolone), or compounds that slow skin turnover or flake accumulation (e.g., coal tar, salicylic acid). Many of these products are available over-the-counter, but some require prescriptions.[1][5][4]
Have any supplements been studied for dandruff?
There is very little research on supplements for dandruff. However, vitamin A is known to reduce sebum production, so it may be beneficial for dandruff.[6]
Although the consumption of micronutrients such as biotin and vitamin B is often recommended, there isn’t much evidence to show that they directly improve dandruff.[7]
Some research suggests oral probiotics may improve dandruff.[4]
How could diet affect dandruff?
The connection between diet and dandruff isn’t well described. However, intake of dietary fats, glucose, and acetate can all increase sebaceous gland activity, so a diet lower in these nutrients might help dandruff. Similarly, caloric restriction can reduce sebum production, and thus may ameliorate dandruff.
Are there any other treatments for dandruff?
Shampoos containing tea tree oil have shown good effects against dandruff, but more research is required.[8]
What causes dandruff?
The causes of dandruff are not completely understood, although high levels of sebum secretion, the presence of the Malassezia genus of yeast (which feed on lipids present in sebum), and individual factors (e.g., skin barrier strength, immune response, genetics, neurological factors, and stress levels) are all thought to contribute to a person’s risk of having it.[4] It’s worth noting that Malassezia is also found on many healthy people, which suggests host (individual) factors contribute strongly to the development of the condition.[9]
Research FeedRead all studies
Frequently asked questions
The main signs and symptoms of dandruff are:
- Skin flakes on the scalp, hair, eyebrows, beard, or shoulders
- Itchy scalp
Dandruff can occur completely on its own, but sometimes is a symptom of other illnesses like HIV/AIDS, neurological disorders (e.g., Parkinson’s disease, tardive dyskinesia, epilepsy), hepatitis C, chronic alcoholic pancreatitis, and some congenital disorders like Down syndrome.[4]
Dandruff is commonly diagnosed by simply examining a patient’s scalp.[1] It’s important to rule out other conditions that may initially appear similar, such as atopic dermatitis, tinea capitis, rosacea, and systemic lupus erythematous (SLE).[4]
Dandruff is mainly treated with hair and scalp products, such as shampoos. These products typically contain antifungals (e.g., ketoconazole, pyrithione zinc, selenium sulfide), corticosteroids (e.g., hydrocortisone or fluocinolone), or compounds that slow skin turnover or flake accumulation (e.g., coal tar, salicylic acid). Many of these products are available over-the-counter, but some require prescriptions.[1][5][4]
There is very little research on supplements for dandruff. However, vitamin A is known to reduce sebum production, so it may be beneficial for dandruff.[6]
Although the consumption of micronutrients such as biotin and vitamin B is often recommended, there isn’t much evidence to show that they directly improve dandruff.[7]
Some research suggests oral probiotics may improve dandruff.[4]
The connection between diet and dandruff isn’t well described. However, intake of dietary fats, glucose, and acetate can all increase sebaceous gland activity, so a diet lower in these nutrients might help dandruff. Similarly, caloric restriction can reduce sebum production, and thus may ameliorate dandruff.
Shampoos containing tea tree oil have shown good effects against dandruff, but more research is required.[8]
The causes of dandruff are not completely understood, although high levels of sebum secretion, the presence of the Malassezia genus of yeast (which feed on lipids present in sebum), and individual factors (e.g., skin barrier strength, immune response, genetics, neurological factors, and stress levels) are all thought to contribute to a person’s risk of having it.[4] It’s worth noting that Malassezia is also found on many healthy people, which suggests host (individual) factors contribute strongly to the development of the condition.[9]
High levels of circulating stress hormones, which may be elevated by psychological or physical stress, have been shown to impair the function of our skin barrier known as the epidermal permeability barrier,[10] leading to dryness and irritation. More specifically, the hormone cortisol is secreted by hair follicles in response to high levels of stress [11] and may promote an immune response, increased sebum production, and irritation of the scalp and hair follicles — exacerbating the condition of dandruff.[12] Dandruff has also been linked to emotional disorders such as depression, suggesting a role for psychosocial stress in this phenomenon.[13]
The microbial yeast Malassezia feeds on oils (sebum) that are secreted by our scalp, leading to the production of another oil called oleic acid. High levels of certain hormones such as testosterone and progesterone increase sebum production from skin glands in the scalp,[14] meaning more sebum for Malassezia to feed on and more oleic acid production. Some individuals who are highly sensitive to the presence of oleic acid may experience dandruff or dandruff-like symptoms. One study found that directly applying oleic acid to participant’s scalps caused dandruff-like flaking, [14] although the role of hormones was not investigated.
While dandruff may run in families, there isn’t one gene that causes dandruff. However, predisposing factors like one’s individual sensitivity to oleic acid — which is produced when the microbe Malassezia feeds on naturally-occurring skin oils — can be inherited.[15] In addition, some gene mutations that are responsible for skin cell differentiation have been shown to exacerbate skin inflammation and oil production, two factors that contribute to dandruff.[4]
While there is some indication that presentation of dandruff increases in the winter, the cold seasons do not directly cause dandruff.[16] Rather, factors such as spending more inside in the presence of dry air and wearing a hat — which raises the temperature of one’s scalp — may promote conditions under which dandruff-promoting microbes thrive.
References
- ^Mayo ClinicDandruff
- ^The content of this page was partially adapted from MedlinePlus of the National Library of Medicine
- ^American Academy of Dermatology AssociationHow to Treat Dandruff
- ^Luis J Borda, Tongyu C WikramanayakeSeborrheic Dermatitis and Dandruff: A Comprehensive ReviewJ Clin Investig Dermatol.(2015 Dec)
- ^Sam Shuster, Jean Meynadier, Helmut Kerl, Siegfried NoltingTreatment and prophylaxis of seborrheic dermatitis of the scalp with antipityrosporal 1% ciclopirox shampooArch Dermatol.(2005 Jan)
- ^Esther Boelsma, Lucy P L van de Vijver, R Alexandra Goldbohm, Ineke A A Klöpping-Ketelaars, Henk F J Hendriks, Len RozaHuman skin condition and its associations with nutrient concentrations in serum and dietAm J Clin Nutr.(2003 Feb)
- ^Britta De Pessemier, Lynda Grine, Melanie Debaere, Aglaya Maes, Bernhard Paetzold, Chris CallewaertGut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin ConditionsMicroorganisms.(2021 Feb 11)
- ^Andrew C Satchell, Anne Saurajen, Craig Bell, Ross StC BarnetsonTreatment of dandruff with 5% tea tree oil shampooJ Am Acad Dermatol.(2002 Dec)
- ^Zrinka Bukvić Mokos, Martina Kralj, Aleksandra Basta-Juzbašić, Ines Lakoš JukićSeborrheic dermatitis: an updateActa Dermatovenerol Croat.(2012)
- ^Choi EH, Brown BE, Crumrine D, Chang S, Man MQ, Elias PM, Feingold KRMechanisms by which psychologic stress alters cutaneous permeability barrier homeostasis and stratum corneum integrity.J Invest Dermatol.(2005-Mar)
- ^Erling ThomStress and the Hair Growth Cycle: Cortisol-Induced Hair Growth DisruptionJ Drugs Dermatol.(2016 Aug 1)
- ^Limbu SL, Purba TS, Harries M, Wikramanayake TC, Miteva M, Bhogal RK, O'Neill CA, Paus RA folliculocentric perspective of dandruff pathogenesis: Could a troublesome condition be caused by changes to a natural secretory mechanism?Bioessays.(2021-10)
- ^Maietta G, Fornaro P, Rongioletti F, Rebora APatients with mood depression have a high prevalence of seborrhoeic dermatitis.Acta Derm Venereol.(1990)
- ^DeAngelis YM, Gemmer CM, Kaczvinsky JR, Kenneally DC, Schwartz JR, Dawson TLThree etiologic facets of dandruff and seborrheic dermatitis: Malassezia fungi, sebaceous lipids, and individual sensitivity.J Investig Dermatol Symp Proc.(2005-Dec)
- ^Turner GA, Hoptroff M, Harding CRStratum corneum dysfunction in dandruff.Int J Cosmet Sci.(2012-Aug)
- ^Dessinioti C, Katsambas ASeborrheic dermatitis: etiology, risk factors, and treatments: facts and controversies.Clin Dermatol.(2013)