Introduction
Dandruff, which is also known as pityriasis simplex capillitii, is a common, recurrent scalp disorder characterized by scalp flaking or shedding of dead skin cells from the scalp in the form of white or yellowish, fine or coarse flakes; oily or dry scalp, depending on sebum production; and scalp itching or mild pruritus that worsens with stress, sweating, or dryness (Rudramurthy et al., 2014). Dandruff is a mild form of seborrheic dermatitis which is usually non-inflammatory and does not lead to significant hair loss (Thomas & H. Khasraghi, 2020). While dandruff is not contagious, it can cause psychological distress and social embarrassment (Chan et al., 2024).
Prevention
There are certain factors that need to be taken into account if dandruff is to be prevented. These include environmental and dietary modifications, which consists of maintaining a diet rich in omega-3 fatty acids, zinc, and B vitamins, and reducing exposure to pollution, dry air, and cold temperatures; routine scalp care, with regular use of mild, pH-balanced shampoos and avoidance of excess hair styling products that lead to oil buildup; and long-term maintenance therapy, which includes addressing underlying factors that could trigger flares, such as hormonal imbalances and stress and continuing the use of once-weekly anti-fungal or medicated shampoo after symptoms resolve (Piérard-Franchimont et al., 2006; Wei et al., 2020).
Management
In order to manage dandruff, the first-line treatment is the use of medicated shampoos, twice or thrice weekly, with visible improvement in two to four weeks (Thomas & H. Khasraghi, 2020). Second-line treatment of dandruff includes the use of topical corticosteroids for cases with mild inflammation, the use of topical calcineurin inhibitors as an alternative for steroid-refractory cases, and oral anti-fungals for severe or refractory cases (Ibid, 2020). Another means of managing dandruff is adopting certain supportive lifestyle measures, which include good scalp hygiene, regular washing with mild shampoo to remove oil and flakes; minimizing the use of hair sprays, gels, or chemical treatments; and stress management (Mohamed et al., 2014).
Complications
Even though dandruff is chronic but manageable, it could lead to a number of complications, such as secondary bacterial infection, such as impetigo, due to excessive scratching; progression to seborrheic dermatitis, characterized by greasy scaling lesions; and psychological distress, including embarrassment and low self-esteem (Mohamed et al., 2014; Borda & Wikramanayake, 2015; Silindelo Minenhle Zondi, 2017).
Conclusion
Dandruff is chronic but with proper care and treatment, it can be effectively managed, though it may require long-term maintenance therapy. Dandruff can also be prevented with routine scalp care and environmental and lifestyle modifications.
References
Borda, L. J., & Wikramanayake, T. C. (2015). Seborrheic Dermatitis and Dandruff: A Comprehensive Review. Journal of Clinical and Investigative Dermatology, 3(2).
Chan, C., Smith, T., He, Z., & Garter, C. (2024). The Sequelae and Moderators of Influence of Dandruff on Mental Health Among Mainland Chinese Adults. Clinical, Cosmetic and Investigational Dermatology, Volume 17, 1333–1346.
Mohamed, H. S., Farahat, N. H., Megallaa, N. G., & Elhaleem, M. A. (2014). Nursing Guidelines on Hair Dandruff Symptoms for adult patients. Semantic Scholar.
Piérard-Franchimont, C., Xhauflaire-Uhoda, E., & Piérard, G. E. (2006). Revisiting dandruff. International Journal of Cosmetic Science, 28(5), 311–318.
Rudramurthy, S. M., Prasanna Honnavar, Dogra, S., Yegneswaran, P. P., Handa, S., & Chakrabarti, A. (2014). Association of Malassezia species with dandruff. The Indian Journal of Medical Research, 139(3), 431.
Silindelo Minenhle Zondi. (2017). The efficacy of a topical application comprising Calendula officinalis Ø and Olea europaea in the management of seborrheic dermatitis of the scalp (dandruff). [Master’s dissertation, Durban University of Technology]. Openscholar DUT.
Thomas, L. M., & H. Khasraghi, A. (2020). Topical Treatment of Seborrhoeic Dermatitis and Dandruff: An Overview. Annals of Tropical Medicine and Public Health, 23(18).
Wei, S., Zhang, H., Yin, Y., Ma, L., Li, L., Dong, Y., & Yi, F. (2020). Factor analysis approach unveils the influencing factors of dandruff in the normal teenage population. Dermatologic Therapy, 33(4).
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