Dealing with dandruff

Dandruff is a common condition marked by flaking of the skin on your scalp.

Although it is neither contagious nor harmful to your health, it can be intensely itchy, embarrassing and difficult to treat.

Is it due to dirty hair?

The white flaky appearance of hair afflicted with dandruff often makes people associate it with poor hair/scalp hygiene. This is, however, not true. Dandruff really isn’t about how clean your hair is—even people who wash their hair regularly can get it. Instead, it’s about changes happening to the skin on your scalp.

What exactly causes dandruff?

Dandruff is thought to be caused by a common skin fungus known as malassezia. Under normal circumstances, skin regularly sheds off dead cells. In some people, this fungus starts to feed on the excess oil and dead skin cells on the scalp, causing the skin cells to shed more frequently and clump into flakes.

Is scalp dryness associated with dandruff?

Although the skin of the scalp appears flaky, dandruff is not caused by dryness. It is thought that the scalp in people with dandruff may instead be too oily. The oil and dead skin cells result in a conducive environment for fungus to thrive.

Dandruff can affect your face and body

It is not unusual to have dandruff on one’s eyebrows, beard and chest hair. This can be managed the same way as scalp dandruff.

Dealing with dandruff

Wash your hair regularly with an anti-dandruff shampoo: Often ordinary shampoo will not manage to clear dandruff. If you wish to buy an effective shampoo, ensure that it has one of the following ingredients:

Zinc pyrithione: This has some antifungal properties and can reduce the fungi on your scalp that cause dandruff

Selenium sulphide: These shampoos are also thought to reduce the fungi on your scalp and help slow the turnover of skin cells.

Salicylic acid: These shampoos help eliminate scaly patches on your head but they may leave your scalp dry. To help prevent this, use a conditioner after shampooing.

Coal tar: These shampoos reduce the flaking of skin on your scalp. They, however, can cause discolouration of white, grey and blonde hair.

Ketoconazole: This is a strong antifungal agent that is often prescribed by your doctor when over-the-counter anti-dandruff shampoos fail.

Tea-tree oil: For people who prefer more ‘natural’ products, tea tree oil has been found to have some benefit in fighting dandruff. Care should be taken when using it because some people are allergic to it.

It is important to leave the shampoo in your hair for at least five minutes before washing it out.

Give the shampoo time to work:

Use the shampoo for a month to see if your dandruff improves. If it does not improve, try a shampoo with a different anti-dandruff ingredient.

You might be able to use the medicated shampoo less often once your dandruff improves, but be aware that your dandruff will probably come back if you stop using it completely.

Wash your hair regularly and use a light moisturiser after cleaning it.

It might not be dandruff

A flaky, itchy scalp does not always mean that you have dandruff. If none of the anti-dandruff products are working for you, it is important to consider that you might be having a different scalp problem.

• Allergic contact dermatitis: Some hair treatments and products with harsh chemicals can create an allergic reaction or sensitivity that may cause your scalp to become flaky

• Psoriasis: This is a skin condition that causes flaky, crusty patches of skin covered with silvery scales. Often, it affects other parts of the body in addition to the scalp.

• Scalp ringworm (also known as tinea capitis): this is a highly contagious fungal infection of the scalp,

When to see a doctor

You rarely need to see a doctor because of dandruff. However, the following may warrant a visit to either your GP or a dermatologist.

•Dandruff that does not improve with prolonged use of anti-dandruff shampoo (you might be dealing with another cause of scalp flakiness other than dandruff).

• Dandruff that appears to be very severe and is associated with hair loss.

• If you develop red, swollen or painful spots on your scalp.

Hair products

If you are prone to dandruff, avoid using hair products that contain harsh chemicals, like bleach and alcohol. In addition, try and buy hair products that have been designed for people with dandruff prone scalps. Avoid very oily hair products that can build up on your scalp.

‘Dandruff’ in babies

Babies can sometimes have yellow, greasy, scaly patches on their scalp. This is known as ‘cradle cap’. It often appears in the first two months of life.

Although it can be unsightly, it does not harm your baby and it is not a reflection of poor hygiene. It tends to last only a few weeks or months and clears on its own without any special treatment.

If your baby has cradle cap, gently wash the scalp with a mild shampoo. This can be followed by massaging baby oil or a natural oil, such as olive oil, unto their scalp to help loosen the crust.

Do not subject the baby to painful hair scrubbing (or brushing) sessions in an attempt to remove the crusts. These will fall off with time.