For a normal person, skin cells form and rise to the surface in about 25-30 days.  With dandruff however, the skin cells on the scalp go through this process about twice as fast, causing an accumulation of skin cells on the scalp. Itching can cause the patient to scratch violently, resulting in embarrassing flaking, swelling and breaking of the skin, compounding the problem if an infection sets in. This is more common at the top of the head, although for some people the entire head might be affected.

Signs & Symptoms

  • Flaking of the scalp, which is more apparent on dark clothes. These flakes should be relatively easy to comb out. If there are tiny white specks firmly glued to your hair, consider checking for lice.
  • Itchy scalp
  • Red patches of scalp
  • Hair loss, although this is not permanent

When to Seek Medical Attention

  • If over-the-counter treatments do not work well for you
  • If hair loss occurs
  • If your condition is worsening or affects your daily activities
  • If your scalp is red and tender


Dandruff is considered to be a mild form of seborrheic dermatitis on the scalp. It is not quite known why exactly dandruff occurs. However, some factors associated with dandruff are:

  • Elevated amounts of Malassezia furfur, a fungus that is found on the scalp and skin
  • Weak immune system
  • Production of excess oil
  • Genetic predisposition (i.e. the condition runs in your family)
  • Seborrheic dermatitis

Some factors that can make your dandruff worse are:

  • Overly harsh shampoos
  • Stress
  • Increased oil production

Lifestyle Modifications

  • Try washing your hair every other day, or every day if feasible.
  • Do not apply conditioner onto your scalp.
  • Try to minimise use of hair products such as hair spray or wax.
  • You can try having more foods and supplements containing probiotics, also called “good bacteria”. This might be of help to control the balance of fungus causing your dandruff.

Treatment options

Dandruff is not a dangerous condition, and patients can attempt to treat it themselves. When using medicated shampoos, remember to leave the shampoo on your hair for three to five minutes before rinsing off.

Cetrimide is an antiseptic that can help to kill germs and clean your scalp. Combination shampoos with anti-itching ingredients are also available.

Zinc pyrithione is available as a shampoo, and helps to kill fungus and reduce the rate at which cells multiply.

Selenium Sulphide is an ingredient found in many shampoos indicated for dandruff. This ingredient might help to control germs on the scalp, and helps to slow down the growth of skin cells.

It is not known exactly how coal tar works although it is believed to loosen scales, ease itching, bring down swelling and kill germs. This ingredient has been used for ages to treat dandruff. Some people get skin irritations related to coal tar, and get more sensitive to the sun. Be careful of staining from coal tar, especially if your hair is bleached.

Salicylic Acid is used to draw water into skin cells, hence softening them and aiding in their removal.

For more persistent and serious dandruff, fungal involvement is considered. Hence, antifungal shampoos containing Ketoconazole and Ciclopirox are used twice a week or as directed. These shampoos work by controlling the fungus on your scalp.

For recurrent sufferers, these medicated shampoos might need to be used on a regular basis.

Topical corticosteroids are used to help control itch and bring down swelling. Corticosteroids available from the pharmacy are hydrocortisone and desonide, while the more potent ones like mometasone and betamethasone are under prescription.

If these treatments do not bring you relief, go to a doctor for an evaluation and if necessary, prescription medications.


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