Not all people are given a dense and and strong hair and a healthy scalp. Unsightly impairments of the scalp and hair coat, which include the annoying and recurring dandruff (head dandruff), make some people almost despair.
What is dandruff (dandruff of the head)?
Schematic diagram showing the anatomy and structure of human hair with dandruff layer. Click to enlarge. Scalp dandruff is visible irregularities of the scalp. These phenomena appear in individually varying manifestations and are not always visually similar. In the context of dandruff, which can also affect other parts of the body, head dandruff is limited to the hairy head. In dermatology, head dandruff, as well as other types of dandruff that can affect the skin of the person, certainly represent phenomena that require treatment. Hair or head dandruff occurs with specific accompanying symptoms and is characterized as dead skin cells. There are thereby dry and greasy head dandruff.
Causes
Like all body cells, the skin cells of the head regularly die and detach from the scalp in the form of dandruff. As causes for the, either permanently and in large extent or only occasionally recurring, head dandruff quite different causes come into question. One of the most common triggers for the increased formation of dandruff on the head is a fungus called Pityrosporum ovale. This fungus occurs primarily on oily scalps due to an overproduction of sebaceous glands, leading to head dandruff. In addition, dandruff can also be triggered by various other skin diseases, such as atopic dermatitis, psoriasis or so-called contact allergies. The skin fungus Pityosporum ovale is considered the causative agent of small fungal lichen, which manifests itself as head dandruff. This type of fungus is a yeast fungus and finds optimal living and reproduction conditions especially on oily scalps.
Symptoms, complaints and signs
Dandruff is noticeable when hair or scalp is touched with the hands. Also when combing or brushing, the small white skin scales, which detach from the scalp, are noticeable. Dandruff is dead skin cells. Mostly it is a cosmetic problem, which can be solved with appropriate care products. However, dandruff can also indicate diseases. A distinction is made between dry and greasy dandruff. If the scalp is too dry due to dry heating air or incorrect care, small white dandruff flakes off. Dry dandruff can also be an indication of psoriasis. If too much sebum is produced, greasy dandruff develops. These skin scales are larger, yellowish and sticky. Before the actual formation of dandruff, itching usually occurs. If the scalp is inflamed due to frequent scratching, the formation of dandruff is additionally promoted. If the scalp is dry and reddened, there is a feeling of tension. Untreated dandruff leads to severe redness and swelling of the scalp. Scabs and incrustations can form. The encrusted areas burn and weep. Hair loss can also be a consequence of scalp dandruff. Dandruff can occur not only on the scalp, but also on the eyebrows. The symptomatology is similar.
Diagnosis and course
The fungus is always located on the normal scalp. It does not overproduce dandruff until the sebaceous glands secrete more fat. The fungus absorbs these fats and metabolizes them. Substances are formed, which are represented in an unpleasant itching and burning on the scalp with the head dandruff. Scratching can cause the scalp to become inflamed and infections to develop. This in turn causes a renewed replication of inflamed scalp cells, which leads to an increased occurrence of scalp dandruff. In some cases, specific hair care products are considered causative factors in classic dandruff.
Complications
Complications are rather not to be expected with ordinary dandruff on the head. It should be determined at the dermatologist or cosmetician only whether it is too dry scalp or the result of inappropriate hair care measures. Head dandruff is usually a cosmetic rather than a medically relevant problem.However, head dandruff can also occur in neurodermatitis and psoriasis or as a result of mercury poisoning from dental materials. As an expected complication of psoriasis or contact eczema, dandruff belongs in the hands of a dermatologist. He can determine the cause of the aggravated symptoms and then initiate specific treatment. Amalgam-related sequelae may need to be treated by an environmental physician through detoxification measures. Head dandruff can also indicate seborrheic eczema in need of treatment. Here, self-treatment with conventional anti-dandruff shampoos can lead to complications such as inflammation of the scalp. The aggressive anti-dandruff shampoos can dry out the irritated scalp even more. This can lead to inflammatory processes and skin irritations caused by bacteria. In the case of seborrheic eczema, special antifungal and anti-inflammatory hair care products are useful. A pronounced tendency to dandruff can also lead to psychological secondary problems. Those affected develop inferiority complexes. They become depressed if there is no improvement. Affected individuals feel uncomfortable in the company of others because their condition is so obvious and appears unsavory to others.
When should you see a doctor?
If conventional remedies such as anti-dandruff shampoo do not work, it is worth going to the doctor. After all, there may be something serious behind a few dandruff. The hair may start to fall out and more severe scarring may occur. If nothing is done about it for a long time, the hair will remain permanently gone. Increased itching, weeping spots or pustules on the scalp are clear warning signs that a doctor should be consulted. In the doctor’s office, it can be clarified what the cause of the dandruff infestation is. Whether an allergic reaction or, for example, a fungal infection is behind it, the doctor examines with the help of a tissue sample. Often it does not help to try a variety of products to get rid of the dandruff. If greasy hair is the cause, for example, and a moisturizing product is used against it, this could only worsen the symptoms. Therefore, a visit to the doctor would be quite appropriate. Only the doctor can prescribe appropriate medication. At the beginning or for the normal clarification of the symptoms, a visit to the family doctor is sufficient; however, if necessary, a dermatologist is also necessary, which can treat the dandruff more specifically.
Treatment and therapy
To reduce dandruff on the head, quite different treatment options come into question. In particular, as part of a self-therapy, the affected women or men can use effective drugs from the pharmacy, which curb a development of dandruff on the head. These drugs are called antifungals or antimycotics and act mainly against a skin fungus that causes the formation of dandruff. These active substances are used in the form of medicinal shampoos and are applied when washing the hair. Besides, products containing salicylic acid, selenium disulfide and substances containing tar are also suitable against head dandruff. After the fungicidal agents from the antifungal product are absorbed into the scalp, it can be rinsed well. As a result, there is a significant reduction in fungal growth on the scalp, which leads to a decrease in scalp dandruff. This treatment is usually carried out for four weeks and can be replaced by conventional shampoos until the scalp dandruff reappears. If it is the development of head dandruff due to other causes, then a deviating treatment is carried out. In addition to the use of cortisone, an omission of allergy-causing hair care products as allergenic substances, as well as the therapy of other causative skin diseases come into question.
Prevention
Prevention against the development of dandruff is basically feasible. This can already begin with the fact that a gentle and careful hair care is carried out. Permanently scalp-irritating substances such as hair dyes and perms should also be paused every now and then to prevent the formation of dandruff. Furthermore, as part of the preventive measures against dandruff, it makes sense to use ph-neutral hair shampoos and to rinse out residues well after washing. Hair care products with a high alcohol content stimulate the sebaceous glands to secrete more oil. These should therefore be avoided in the case of dandruff.After washing the hair, it is advisable not to blow dry them too hot and not to use too degreasing washing substances.
Aftercare
Head dandruff is usually not a serious condition that requires a visit to the doctor. The typical symptoms can usually be remedied without problems with the help of an anti-dandruff shampoo. Since there is subsequent freedom from symptoms, no scheduled follow-up care is necessary. In case of a recurrence, patients can again resort to a commercially available hair shampoo. As a preventive measure, adequate hair hygiene is sufficient. Affected individuals should care for their scalp hair once a day. Washing too frequently can trigger dandruff formation in a healthy person, as can insufficient care. Some patients complain frequently about dandruff. If they are present for months and commercially available shampoos do not work, a visit to the doctor is necessary. In this case, other diseases may cause the dandruff. The doctor will try to eliminate the causes. Scheduled follow-up examinations are arranged until the symptoms subside. In addition to an interview, a blood test, an allergy test and obtaining a pathogen culture play a significant role. Overall, head dandruff can be prevented primarily with preventive measures. However, these are mainly the responsibility of the patient. Especially the use of commercially available shampoos leads to good results. In contrast, scheduled follow-up examinations are usually only necessary in the case of skin diseases.
What you can do yourself
Dandruff is usually harmless. Nevertheless, they are perceived as a burden by those affected. However, there are some home remedies and measures with which the white residues can be treated without medical assistance. Typical triggers of dandruff should be avoided. These include strong sunlight, hot blow-drying and an unbalanced diet. If the hair is regularly dyed or straightened, this can also lead to dandruff. A yogurt or curd pack can also be effective. Carefully massaged in, the cure helps with severe dandruff and provides the scalp with the necessary moisture. If the dandruff does not subside or even becomes stronger, a visit to the dermatologist is recommended. Occasionally, the complaints are based on serious causes. The doctor can also prescribe suitable medicines and suggest further measures to reduce dandruff. Dandruff should disappear quickly with good skin care and a healthy lifestyle. However, in some people they are genetic. If there is a genetic predisposition, sufficient care with suitable anti-dandruff products will help. The targeted use of home remedies supports the care of the hair.
