Shed

Synonyms in a broader sense

dandruff, pityriasis simplex capillitii, head borrhoea, pityriasis simplex capitis

  • On the one hand there are the dry scales. They occur in very dry scalps and occur more frequently in winter, e.g. due to the heated room air.
  • The oily scales, on the other hand, are found in oily hair, i.e. excessive sebum production, where the scalp is often reddened and the skin itches.

    This can also be an indication of seborrheic dermatitis.

Among the complaints that occur with increased dandruff are varying degrees of itching (pruritus), as well as reddening of the scalp or small skin lesions due to increased scratching. But also weeping skin areas, pustules (accumulations of pus in the skin) and hair loss, which can be caused by scratching or can be the result of a hormonal disorder (alopecia androgenetica) or increased sebum production (alopecia sebborrhoica), can be counted among the symptoms. The diagnosis can be made by a comprehensive interview (anamnesis) and clinical examination by the dermatologist (dermatologist).

This includes a family and social anamnesis. But also the so-called vegetative anamnesis must not be neglected, which asks for connections between the occurrence of dandruff and the season or the consumption of certain foods. In addition, it should be clarified whether there are previous illnesses, a pregnancy exists or whether certain stress situations such as an operation have preceded it.

An inspection of the entire skin and hair is also necessary. Laboratory diagnostics can also be consulted, including a differential blood count, a histopathology after taking samples, allergy diagnostics and microscopic detection of fungi in the tissue. To prevent or reduce dandruff it is helpful to eliminate behavioral risk factors.

These include a moderate diet, little alcohol and stress. Often, relief can be achieved by appropriate hair care with an anti-dandruff shampoo, avoiding sharp combs, as well as permanent waves or hair dyes. If there is no improvement, a dermatologist should be consulted after four weeks at the latest, who can rule out an intolerance of ingredients in shampoos or food.

Anti-dandruff substances such as selenium and coal tar, or even anti-dandruff substances such as salicylic acid, sulfur, head oils or urea are often contained in anti-dandruff shampoos or can be prescribed by a doctor. In addition, anti-inflammatory substances such as steroids e.g. cortisone creams, as well as itch-relieving drugs can be prescribed. If a fungal infection is present, an antimycotic can be prescribed.

These are usually locally (topically) applied drugs such as clotrimazole or ketoconazole. These “anti-fungal agents” impede the further reproduction of the fungus by killing the pathogens that are in the reproduction phase and preventing further fungi from entering the reproduction phase. These are shampoos that must be applied twice a week.

Another possibility are hair solutions with the antimycotic bifonazole, which are only applied to the scalp and do not need to be rinsed out. Zinc pyrithione and selenium disulfide also have an antimycotic effect. If the cause of dandruff is severe bacterial inflammation, antibiotics can be used to inhibit the growth of the bacteria or to kill them. If neurodermatitis or psoriasis are the trigger, the disease must first be treated as such.