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Dandruff

Dandruff is a very common form of scalp irritation. It is actually a disease in itself, but most people describe a scalp that is shedding copious quantities of skin scale as dandruff.

Over a period of a few weeks, the skin totally replaces itself. New cells are produced deep in the skin, slowly move out as new cells are produced beneath them, thin out to form a hard scaly layer, and eventually slough off. Dandruff is an acceleration of this natural process in which the rate at which cells are produced on the scalp is increased, so that the excess cells produced form a scale on the skin. The underlying skin may become inflamed and itchy. It is thought that a mild fungal infection of the scalp causes this increased rate of cell loss. Emotional stress, overworking, hot climates and a poor diet all aggravate dandruff.

Dandruff must be differentiated from other skin diseases such as psoriasis, dermatitis, eczema, neurodermatitis and other fungal infections. A biopsy is sometimes necessary to make the diagnosis.

Seborrhoeic dermatitis is an inflammation of the scalp that is more common in babies, when it is known as cradle cap.

Good scalp hygiene, and an antidandruff lotion or shampoos are the main treatments, but excessive use of shampoos or soap may aggravate the problem by further drying and irritating the scalp. Resistant cases may be helped by steroid scalp lotions and antifungal lotions or gels.

Most patients have recurrences, with bad and good periods, often for no apparent reason, but reasonable control is normally possible.