Skin Condition Series, Dandruff

Dandruff also referred to as Pityriasis simplex capillitii or scurf is a chronic and common condition of the scalp. Dandruff can usually be controlled; however, some cases may be difficult to treat. Mild cases may require nothing more than shampooing daily with a gentle shampoo. More severe cases may respond to shampooing with medicated shampoos.

What is Dandruff?

Dandruff is a chronic and common disorder of the scalp that is characterized by flaking of the skin of the scalp. It is often associated with itching. It can become embarrassing in some cases and treatment can be difficult. However, dandruff is not serious or contagious. Moreover, a large number of individuals find that dandruff improves with age. According to estimates around 50% of individuals in North America and Western Europe have dandruff.

What are the symptoms of Dandruff?

For majority of the adults and teenagers, symptoms of dandruff can be easily spotted-oily, white flakes of dead skin, which cover your shoulders and hair and a scaly, itchy scalp. Dandruff may aggravate during the winter and fall months when dry skin can occur due to indoor heating and get better during the summer months.

Babies can be affected by a type of dandruff referred to as cradle crap. This condition, which is characterized by a crusty, scaly scalp, is common in newborn babies; however, it can occur in infants too. Although the parents may be alarmed by the condition, it is not dangerous and generally gets cured on its own.

When to visit a doctor?

Majority of the cases of dandruff don’t need care by a doctor. However, if OTC (over-the-counter) dandruff shampoos don’t help, or if redness or swelling occurs on your scalp, visit a dermatologist. You may be suffering from seborrhoeic dermatitis or other condition that is similar to dandruff.

What are the causes of Dandruff?

There are several causes of dandruff, such as:

• Oily, irritated skin (seborrhoeic dermatitis). This is one of the most common causes of dandruff and is characterized by greasy, red skin covered with white or yellow flaky scales. This condition affects not only your scalp but also other areas that have oil glands including eyebrows, sides of nose, breastbone, and back of ears, groin area, and armpits.
• Not shampooing your hair frequently. If you don’t wash your hair regularly, there is a build up of skin cells and oils on your scalp, resulting in dandruff.
• Malassezia (yeast like fungi): Malassezia is found on the scalp of majority of the adults. However, in some, it causes irritation of the scalp and leads to overgrowth of skin cells, which die and fall off, appearing as flaky and white scales on your clothes and in your hair. It is not known as to why the fungus causes irritation of scalps of some people.
• Dry skin: Dry skin leads to flakes that are less oily and smaller in comparison to those caused due to other causes. Moreover, it is unlikely to be associated with inflammation or redness. You will also have dry skin on other areas of your body such as arms, legs etc.
• Contact dermatitis (Sensitivity to products of hair care): Sometimes you may be sensitive to some ingredients present in certain products of hair care or hair dyes that can result in itchy, red, scaly scalp.

What are the risk factors of having Dandruff?

Dandruff can develop in anyone; however, certain risk factors exist that make you more susceptible:

• Age: Dandruff usually improves with age. However, for some persons the condition can persist for the entire life.
• Being Male: Males are more prone to develop dandruff than females.
• Oily scalp and hair: Malassezia thrives on oils present in your scalp. Hence, dandruff is more common in individuals who have oily hair and skin.
• Certain diseases: Adults suffering from neurological disorders such as Parkinson’s disease, or those suffering from HIV or have compromised immunity due to other diseases are more prone to develop dandruff.
• Certain skin disorders: Persons who suffer from eczema, psoriasis etc. are more prone to get dandruff.
• Not brushing your hair enough and often: Persons who do not brush or comb their hair regularly are more prone to develop dandruff-since they are not helping the shedding of dead skin that brushing or combing provides.
• According to certain studies, diets rich in sugary, spicy, or salty foods and taken along with alcohol may aggravate dandruff.

Lifestyle changes to stop Dandruff

There are various lifestyle changes that you can make to prevent dandruff:

Manage stress

Your overall general health is affected by stress, making you prone to various illnesses and diseases. It can even trigger dandruff or aggravate existing symptoms. Hence, learn to manage your stress to prevent dandruff. Try short walks, yoga, massage therapy etc. to relax.

Shampoo your hair regularly

Persons who have an oily skin or scalp can benefit from regular shampooing of their hair. You can use over-the-counter anti-dandruff shampoo to clean your hair.

Get little exposure to sun

Getting a little sunlight is good for dandruff. However, ultraviolet light exposure may increase your risk of getting cancer of the skin; hence, you should avoid prolonged exposure to sunlight. Instead, spend some time outdoors in the sun and don’t forget to apply sunscreen to your body and face.

Stay hydrated

Dry skin is one of the causes of dandruff, which may be caused due to dehydration. Drink enough water to stay hydrated.

Use coconut oil on your scalp

Coconut oil has strong antimicrobial, antifungal and antiviral properties; hence, its application can help you get rid of dandruff.

Dietary changes and supplements to improve Dandruff

The various dietary changes that you can make to improve dandruff include:

Limit your intake of sugar: Eating a diet rich in simple carbs and sugar may promote inflammation, thereby, eating a diet low in sugar and high in anti-oxidants could help in controlling the flares of dandruff. A hormonal link may also exist. Diets rich in processed foods, sugar and bad fats can result in spikes of insulin, which stimulates hormonal surges that may trigger the secretion of oil. Hence, an overall restriction of fried and fatty foods, processed foods, refined sugars and gluten may reduce the flaking.

Eat a diet rich in fresh vegetables and fruits: Add more vegetables and fruits to your diet as they are rich in fibre and nutrients. Eating foods rich in salt, sugar and fat cause poor digestion which in turn can lead to multiple health problems including dandruff.

Yeast Link? A theory connects yeast in diet to dandruff. According to Alan J. Bauman, MD, and a hair-restoration physician in Boca Raton, Fla, overgrowth of yeast has been implicated in multiple conditions, one of them being dandruff. Fungal growth is promoted by sweets and foods that contain yeast such as bread, beer, and wine. According to some health experts it is recommended to cut back on alcohol and bread.

Include healthy fats in your diet: Eating foods rich in omega-6 and omega-3 fatty acids help support healthy skin and hair in general. They have anti-inflammatory properties. Include tuna fish, salmon, flaxseeds, canola oil, extra virgin olive oil, peanut butter, walnuts, avocado and fortified eggs in your diet.

The supplements that you can take to improve dandruff include:

B Vitamins

Riboflavin of Vitamin B2 aids in the elimination of dandruff. It plays a vital role in maintaining the health of scalp by facilitating the uptake of oxygen in the skin of the scalp. Dandruff can indicate a deficiency of vitamin B6. According to studies, persons suffering from dandruff usually have low levels of vitamin B6. Dandruff can also be caused due to deficiency of biotin, which is another member of B vitamins. Biotin also promotes growth of hair. Vitamin B12 deficiency can result in dryness of the scalp. It also increases scaling of the scalp skin. Since, vitamin B12 is naturally found in dairy products and meat, the risk of having dandruff due to deficiency of vitamin B12 is higher in vegans and vegetarians. Highly preliminary studies done in the 1950s and 60s suggest that folate when taken orally or vitamin B6 when applied topically may relieve some symptoms of dandruff.

Vitamin E

It is a fat soluble vitamin. It is a potent antioxidant; it reduces oxidative stress by scavenging free radicals and preventing them from oxidising tissues. Vitamin E is usually applied topically to decrease the dryness of scalp, which results in dandruff.

Omega oils

As already mentioned, omega-6 and omega-3 fatty acids help support healthy skin and hair in general. They have anti-inflammatory properties. According to a study done on dogs, oral supplementation of omega-3/omega-6 fatty acids relieved seborrhoea in them. According to a review, essential fatty acids have been suggested as treatment for seborrhoeic dermatitis, but there is no real evidence as yet that they work.

Selenium

Selenium is a trace element that is required by the body for multiple functions. It is used for maintenance of normal hair. It also acts as an antioxidant. According to one study, published in the journal JAMA, topical application of selenium sulphide shampoo has been found useful in relieving dandruff.

Zinc

Zinc is a trace element. It is present in almost all cells of the human body and acts as vital co-factor of multiple enzymes. It is used in beauty products as it is very effective in maintaining the health of hair, skin and nails. Zinc has been suggested as treatment for seborrhoeic dermatitis but there is no real evidence as yet that it works. According to one study published in Dermatologic Clinics, zinc deficiency has been associated with rough and dry skin, which is a risk factor for the development of dandruff.

Copper

Copper is found in trace amounts in the body but still it is considered an essential nutrient. It helps in the improvement of pigmentation of hair and skin. Natural food sources of copper are shellfish, oysters, nuts (pistachio and Brazil nuts), lamb, split peas and liver.

Dandruff is a chronic and common disorder of the scalp that is characterized by flaking of skin. There are various causes and risk factors for dandruff. You can make a few lifestyle and dietary changes to prevent and relieve dandruff. You can also take various supplements such as copper, zinc, b vitamins, selenium, omega oils and vitamin E to relieve dandruff.

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