Are You One Of The 350 Million With Dandruff?

At one time or another, we have all noticed small white flakes in our hair or on our shoulders, sometimes accompanied by an itchy scalp.

Pityriases capitis is the medical name for dandruff, and is a skin condition where skin flakes and white scales become excessive, and causes itchiness and irritation. Dandruff is extremely common (about 2-5% of the population has this condition).

For those who have chronic or severe dandruff, this can be an embarrassing condition due to visible shedding on surfaces as well as clothing, and habitual scratching.

Dandruff is the result of excessive shedding of dead skin cells from the scalp. There may be minor itching, but no redness or scabbing occurs. It usually gets worse during the fall and winter and improves in the summer. Since dandruff is a natural process, it cannot be eliminated and can only be controlled or managed.

Previously, it was thought that dandruff was caused by dry skin, oily skin, shampooing too often or not often enough, a poor diet, stress, and the overuse of styling products. Although some of these factors can worsen or contribute to excess flaking, research has implicated the real offender, a fat-eating, yeast-like fungus called malassezia.

This micro-organism lives on the scalps and skin of most healthy individuals without causing problems, but sometimes it grows out of control (owing to scalp conditions), feeding on the sebum (oils) secreted by your hair follicles and causing irritation that leads to increased cell turnover.

Medicated shampoos are the most common treatment for dandruff, and can be found at a local pharmacy without a prescription. Since one of dandruffs most persistent triggers is a fungus, a medical ingredient like pyrithione zinc can effectively kill this yeast. Clinical studies indicate that the use of a shampoo and conditioner with this medical ingredient provides an enhanced and improved antidandruff effect by doubling the dose of the active agent received by your scalp.

Anti-yeast shampoos will often contain salicylic acid, coal tar, and antifungal solutions. Many of these shampoos have become more pleasant than in the past to use, and are far more effective due to recent developments in zinc pyrithione shampoos. These shampoos should be used daily until the condition is controlled, and then applied one to three times as necessary.

Some effective dandruff shampoos:

  • Head & Shoulders (antifungal)
  • Nizoral (antifungal)
  • Selsun (antifungal)
  • Sebcur (salicylic acid)
  • T-Gel (coal tar)

Conditioners containing pyrithione zinc help to maximize dandruff control by exposing the scalp to an extra dose of the key ingredient.

Unlike traditional conditioners, the product needs to be massaged into the scalp, then distributed evenly from hair root to tip. Clinical studies indicate that the use of a shampoo and conditioner with this active ingredient provides an improved anti-dandruff effect.

If your dandruff is severe, you may notice rashes in the following areas:

  • Between the eyebrows
  • Inside and around the ears
  • On the sides of the nose
  • On the back and chest
  • On the under armpits or breasts

Similar to Dandruff, seborrheic dermatitis is a skin condition that causes itchiness and flaking, along with inflamed red patches of skin. In addition to the scalp, the central face around the sides of the nose and eyebrows are often affected and upper body, particularly on the central front of the chest.

These patches of irritated skin can be red to salmon pink with greasy looking scales and occur on parts of the skin that are rich in oil glands. Neurological conditions from Parkinsonism, HIV-AIDS, or the use of antipsychotic drugs can all increase the risk of or aggravate seborrheic dermatitis.


Anti-yeast shampoos can treat seborrheic dermatitis. Applying the shampoo on the scalp, face, and chest for a minute, and then washing it off is all that is required. If this does not improve your condition after several weeks of trial, you may wish to consult a doctor for a prescription medicine.

Some other treatments are listed below:

  • Hydrocortisone cream
  • Ketoconazole cream or pill
  • Lithium succinate ointment with 15% propylene glycol in water
  • Zinc pyrithione shampoo

For severe or persistent cases, the following medications may be needed:

  • Betamethasone valerate solutions (Betnovate)
  • Clobetasone shampoo (Clobex)
  • Flucinonide gels
  • Pimecrolimus cream (Elidel)
  • Tactrolimus ointment (Protipic)

If your seborrheic dermatitis does not heal, see your physician for a proper diagnosis. Seborrheic dermatitis can often be confused with other skin conditions like scalp psoriasis, atopic dermatitis, tinea capitis, facial rosacea, intertrigo, or erythrasma.

Similarly for dandruff, if it is severe or difficult to control with over the counter anti-dandruff shampoos, see your doctor for a proper diagnosis and treatment.

(edited from the article: What is Dandruff Really?)