Dandruff is a mild form of seborrheic dermatitis that is characterized by a flaky, itchy scalp; it affects approximately 50% of adults worldwide. It commonly begins during puberty and is more prevalent in men and boys, with no link to poor hygiene.
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]
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Frequently asked questions
What is dandruff?
What are the main signs and symptoms of dandruff?
The main signs and symptoms of dandruff include skin flakes on the scalp and other areas, as well as an itchy scalp. Dandruff can occur independently or may indicate underlying health issues such as HIV/AIDS, neurological disorders, or congenital disorders.
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 typically diagnosed through a visual examination of the scalp. It is essential to differentiate it from other similar conditions like atopic dermatitis, tinea capitis, rosacea, and systemic lupus erythematosus.
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 primarily treated with hair and scalp products, particularly shampoos that contain antifungals, corticosteroids, or compounds that reduce skin turnover and flake accumulation. Many of these treatments are available over the counter, but some may require a prescription.
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 limited research on supplements for dandruff, but vitamin A may help by reducing sebum production. Although micronutrients like biotin and vitamin B are often recommended, evidence of their effectiveness is lacking, though some studies suggest that oral probiotics might improve 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 relationship between diet and dandruff is not clearly defined, but reducing intakes of dietary fats, glucose, and acetate may help decrease sebaceous gland activity and improve dandruff. Additionally, caloric restriction could lower sebum production, potentially alleviating the condition.
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 with tea tree oil have demonstrated positive effects on dandruff, although further research is needed to confirm these findings.
Shampoos containing tea tree oil have shown good effects against dandruff, but more research is required.[8]
What causes dandruff?
Dandruff is thought to be caused by a combination of factors, including high sebum secretion, the presence of Malassezia yeast, and individual characteristics such as skin barrier strength, immune response, genetics, and stress levels. The fact that Malassezia yeast is also found on individuals without dandruff indicates that personal factors play a significant role in the condition's development.
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]
Can stress cause dandruff?
Quick answer:
High levels of stress hormones, particularly cortisol, can impair the skin's barrier function, which leads to dryness and irritation that may worsen dandruff. Additionally, dandruff has been associated with emotional disorders like depression, which indicates that psychosocial stress may contribute to the condition.
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]
How do my hormones affect dandruff?
Quick answer:
Hormones like testosterone and progesterone increase sebum production in the scalp and provide more food for the yeast Malassezia, which can lead to increased oleic acid production. Individuals who are sensitive to oleic acid may experience dandruff or dandruff-like symptoms as a result.
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.
Can dandruff be inherited?
Quick answer:
Dandruff can run in families, but it is not caused by a single gene. Instead, inherited factors such as sensitivity to oleic acid and certain gene mutations that affect skin cell differentiation may contribute to its development.
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]
Why does my dandruff get worse in the winter?
Quick answer:
Dandruff may appear worse in winter due to factors like spending more time indoors with dry air and wearing hats, which create conditions that favor dandruff-promoting microbes. However, the cold weather itself does not directly cause dandruff.
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.