Brief overview
- Origin: dandruff develops when larger clusters of dead skin cells are shed
- Causes: often hereditary, but also possible are skin diseases (such as psoriasis), hormonal fluctuations, incorrect hair care, certain climatic conditions, stress
- What helps? Many sufferers can help themselves, e.g. with anti-dandruff shampoos, proper hair care and a healthy diet, as well as sun protection. However, if there are underlying conditions, treatment by a doctor may be necessary (such as medication).
- When to see a doctor? In case of persistent or recurring dandruff, suspected skin disease, hair loss, redness, inflammation, itching and/or oozing of the scalp.
What helps against dandruff?
There are several products that have proven effective in the fight against dandruff. Some of them can only be prescribed by a doctor, others are available over-the-counter. To find the right remedy for the individual case, the reason for the dandruff must be known. In principle, however, there are, for example, the following possibilities to get the dandruff trickle under control.
Dandruff: What the doctor does
Especially against psoriasis, which often manifests itself in annoying head dandruff, there are various therapy options for the dermatologist (dermatologist):
- Vitamin D3 analogs: These are derivatives of vitamin D that have an anti-inflammatory effect. They also slow down and normalize the process of dandruff formation. The preparations are suitable for longer-term therapy of up to one year.
In the case of greasy dandruff and fungal infestation, the dermatologist can resort to antifungal agents as dandruff shampoos. These contain active ingredients such as ketoconazole or clotrimazole.
Dandruff: What you can do yourself
The light dandruff is usually harmless, but annoying to unpleasant. With the following “anti-dandruff measures” many affected people can help themselves:
- Use anti-dandruff shampoo correctly: Dandruff shampoos can prevent the formation of new dandruff. They often also contain fungicidal active ingredients (e.g. zinc pyrithione). But be careful: dandruff shampoos are usually not suitable for daily or long-term use. Otherwise, they can dry out the scalp and then intensify dandruff instead of alleviating it. Apply them only once or three times a week and not for longer than a month.
- Proper care for dry scalp: Do not wash your hair daily. Rinse hair thoroughly with clean water after washing. Refrain from hot blow-drying to prevent dry scalp from developing in the first place. In general, use mild shampoo for dry, sensitive scalp.
- Hair care products: conditioners, mousse, hairspray and hair gel can additionally irritate the scalp and promote dandruff. Therefore, use only a few hair care products and then only those that are coordinated with each other.
- Olive oil: For a smooth scalp, you can massage in a small amount of olive oil, leave it on for some time (overnight, for example) and then wash it out. This is good for dry scalp, which is often heavily stressed by shampooing.
- Sun protection: You can prevent too much sun exposure on the head with a light, airy head covering. However, sun in moderation does not harm skin and hair.
- Proper nutrition: Alcohol, wheat flour, sugar and coffee are unfavorable because they promote the food supply for microorganisms on the skin. Also avoid high-fat diets because they can increase sebum production on the skin. Instead, your diet should provide adequate amounts of the “skin vitamins” vitamin A, vitamin E and biotin. These provide beautiful skin and hair from the inside and can thus help with dandruff.
How does dandruff develop?
Only larger clusters from a number of about five hundred cells are visible as scales. They form when the skin repels the flakes too quickly and they clump together. A typical sign is an itchy scalp. It indicates that the scalp is irritated, for example by an aggressive shampoo or too frequent washing and blow-drying.
Most of the time, the dandruff that trickles down is harmless and is merely perceived as aesthetically unattractive, especially on dark clothing. But dandruff can also be an indication of a disease such as psoriasis or neurodermatitis.
Dry and greasy dandruff
Dandruff can be divided into two categories:
Dry dandruff:The dry, white dandruff is mainly caused by dry scalp, heating air in winter, drying shampoos and care products, blow-drying or hot, dry climate. Women are affected just as often as men. Dry dandruff also occurs with certain diseases, for example psoriasis vulgaris.
Dandruff: Causes and possible diseases
In most cases, the causes of dandruff are harmless. However, diseases can also be behind it. Common dandruff triggers include:
- Hormone fluctuations: Sebum production is influenced by hormones and can become an annoying problem during puberty, for example. The skin becomes oily, which promotes the formation of blackheads and pimples as well as yellow, stuck dandruff on the scalp. Dry dandruff, on the other hand, is often an accompanying symptom of menopause in women.
- Incorrect hair care:Frequent hair washing with aggressive shampoos and hot blow drying can lead to dry scalp and dandruff.
- Unfavorable climate:Heat and dry air cause a dry scalp, which promotes itching and the formation of small, white dandruff. Oily dandruff, on the other hand, tends to develop in high humidity.
- Hereditary predisposition: Experts assume that heredity also plays a role in the development of dandruff. In fact, dandruff occurs more frequently in some families, which supports this theory.
- Stress: Psychological stress affects the metabolism of the cornea – dandruff is the result. Since the skin’s defense barrier is also disturbed, skin fungi can also colonize more easily.
- Malassezia furfur: This yeast fungus is part of the normal skin flora and feeds particularly on fatty acids in sebaceous skin. If the scalp’s sebum production increases, its growth can skyrocket and cause inflammation. Itchy scalp and greasy dandruff are typical symptoms of this. Bacteria can also settle on the scratched skin areas.
- Atopic eczema: This disease, also known as neurodermatitis, often occurs in early childhood. It manifests itself as scaly, very itchy skin rashes. In an atypical variant, atopic eczema can also affect only the head and neck and lead to scaling due to a very itchy scalp.
- Seborrheic eczema: This non-contagious, chronic inflammatory skin rash particularly affects the face and scalp. Typical symptoms are itching and yellowish scales.
- Contact allergies: Some people react to ingredients such as hair care or cosmetic products with itching, scaling, scabbing and crusting of the skin.
Dandruff: When do you need to see a doctor?
Dandruff is a cosmetic problem for many sufferers, but it can usually be managed without medical help with anti-dandruff shampoos, proper hair care and a healthy diet. However, in the following cases you should go to the dermatologist (dermatologist):
- severe itching, redness or swelling of the scalp
- hair loss
- burning or inflammation of the scalp
- weeping or crusted areas on the scalp
Initial consultation and examinations
In order to get to the bottom of the cause of the dandruff, the doctor will first take your medical history (anamnesis). He will ask, for example:
- How long have you had dandruff?
- Have you already tried different remedies (e.g. anti-dandruff shampoo)? With what success?
- Do you suffer from severe itching?
Then he looks at the skin of your body. Skin changes on other parts of the body can provide the doctor with decisive clues. Skin diseases often manifest themselves differently on the scalp than on the less hairy parts of the body.
It is also important to distinguish between dry and greasy dandruff. Particularly in the case of inflamed scalp, a pathogen test can show whether there is a fungal infestation, a bacterial infection or a parasite infestation. If necessary, the dermatologist can also take blood and/or tissue samples.
If it is finally clear what is causing the dandruff, the doctor can suggest a suitable therapy.
