As anybody who’s wardrobe is bereft of black t-shirts knows, there’s nothing quite like a bout of dandruff to ruin your self-confidence. Those unsightly skin flakes that you brush off your shoulders are mostly harmless, but they are embarrassing, and can be accompanied by a red and itchy scalp at the worst of times.
To put it simply: dealing with dandruff bloody sucks.
Around 50 per cent of the global adult population deals with dandruff at some point in their lives—it can happen to literally any of us. However, in most cases, dandruff is easily treated, and prolonged symptoms are more likely to cause social (or psychological) problems than medical ones.
And in case you’re dealing with a co-worker suffering from a scaly scalp, don’t stress; dandruff is not contagious.
What causes dandruff?
Dandruff is dead skin that forms on your scalp as a result of relapsing dermatitis or eczema.
Skin cancer expert Dr Ryan Harvey says dandruff occurs following an oversupply of Malassezia—the yeast that occurs in the gland-rich areas of your scalp: “It’s not completely understood why the body creates an excess of Malassezia.
“Although the yeasts can start to behave differently, metabolising our normal oils in a different manner which results in the inflammatory reaction of the skin and scalp.”
Yeast in your hair sure sounds disgusting but is perfectly normal. Everyone has it, whether you suffer from dandruff or not.
When Malassezia is overabundant, your body then reacts to the yeast by replacing dead skin cells at an overly fast rate.
You might regularly exfoliate to remove dead skin, but when dandruff occurs, the process has accelerated to the point where you’re going to need some form of treatment.
Dandruff could be the result of Seborrheic Dermatitis, a nasty form of eczema that can inflame the chest, arms, behind the ears and leave scaly, flaky, red patches scattered within hair-bearing areas of the scalp.
It’s also sometimes associated with the chronic skin condition Psoriasis which affects two to four per cent of the population and can be hereditary.
“There is a genetic component to inflammatory skin conditions and people with dandruff may have other family members with the same problems,” adds Dr Harvey.
“This would be other family members with conditions such as Seborrheic Dermatitis or Psoriasis.”
If you’re diagnosed with one of these skin conditions, a GP may prescribe topical anti-fungal creams for inflamed areas around the face and body. For the scalp, medicated shampoos can be used in conjunction with steroids to reduce the itching and coal tar cream to reduce the scaling areas.
If you’re looking at Psoriasis, mild cases can be treated with topical steroids, salicylic acid, and coal tar. Severe cases may require phototherapy, which is exposure to ultraviolet radiation in combination with topical treatments.
What are the best dandruff treatments?
If you’re experiencing dandruff for the first time, you should start by trying an anti-dandruff shampoo. “The usual treatment involves medicated shampoos which contain an active ingredient that works on the yeasts that live on the scalp,” says Dr. Harvey.
You’ll find it at the chemist and supermarket easily enough, but it’s also worth noting that dandruff is the most commercially exploited skin disease.
This means you’re going to be faced with an abundance of products making all sorts of bold claims, but there’s one simple combination of ingredients to look out for to get rid of dandruff.
Read the back of the bottles and look for a shampoo containing a combination of ketoconazole, selenium sulphide, and zinc pyrithione.
Zinc pyrithione is particularly important for its fungistatic and bacteriostatic properties (that means it goes straight to the root of the problem and treats the cause, rather than just cleanses and removes the flakes).
You may have to try several different products before finding one that works for you, and you’ll also need to keep using the shampoo for at least a month to clear up dandruff.
Dr Harvey points out that some dandruff sufferers may need to use the shampoo twice a week indefinitely. It may sound excessive, but it’s a small price to pay to reduce the itching (not to mention the unsightly shoulder flakes).
If an anti-dandruff shampoo doesn’t fix the problem, dandruff may be the result of an underlying medical condition, and a GP or dermatologist should be consulted.
He or she may be able to identify the problem on sight. In rare cases, a skin biopsy could be used.
Is there a cure for dandruff?
There’s no cure for dandruff, only treatments.
A medicated shampoo may clear up the flakes for good, while topical solutions can be required to take care of infrequent flare ups from here on out.
A great way to stay on top of dandruff is to keep track of changes in your life and environment. We’re talking shifts to carbs and sugar-heavy diets, increased stress and smoking, new medications, moving house, and even the changing of the seasons can all affect your skin.
Something as simple as using a new shampoo or not washing your hair often enough can result in a flaky scalp.
If dandruff coincides with any of the above, see if that detail can be removed, substituted, or improved in some way. You can’t go avoiding the shift into winter, so if the colder weather results in a flare up, you’d best consult a GP or dermatologist to help find a treatment.
Does shaving your head fix dandruff?
Shaving your head will not fix dandruff. In fact, this will only make your flaking scalp more obvious. Using hair product may conceal the flakes, but any leftover product can also be a cause of increased Malassezia, and hence isn’t much of a fix after all.
Living with dandruff can be a real pain in the arse. It’s itchy, uncomfortable, unsightly, and can cause a pretty serious knock to your confidence.
It’s also one of those conditions that, because it isn’t intrinsically threatening to your general health, gets ignored or avoided all too easily (and let’s be honest: most of us do have more pressing issues than dealing with a flaky scalp).
Luckily, nobody has to suffer it alone: it’s a very common condition, and with a switch to the right shampoo and conditioner (and a regular hair care routine), most people who have dandruff can say goodbye to the flakes and the itching, and hello to a healthier scalp (and the confidence that comes with it) for good.