Health - Conditions
By: - at June 7, 2013

What Really Causes Dandruff and How Can You Treat the Symptoms

Dandruff in hair and scalpDandruff in the scalp can cause discomfort and embarrassment with the irritating flaky white shedding of dead skin. Although dandruff is not usually a serious condition, it can become chronic and has a potential to lead to secondary infections like fungal and bacterial infection. Dandruff has no known cure but the condition can be controlled using different treatment options depending on the underlying factors that trigger it. The symptoms of dandruff may come and go.

What may be effective in treating symptoms of dandruff in one person may not be so in another patient and therefore the right treatment option has to be identified. Dandruff affects more men than women and is also more prevalent in people with oily skin. A flaky scalp does not necessarily mean that you have dandruff since there are other skin conditions that present similar symptoms of dry flaking and itchy scalp such as eczema, psoriasis, rosacea, and seborrhea.

What is dandruff?
Dandruff also known as pityriasis simplex capillitii is a condition of the scalp. Dandruff is a white flaking scalp that occurs as the dead skin cells are shed from the scalp. Although it is normal for the scalp to shed its matured cells, the rates at which these cells are shed may increase leading to more accumulation of cells that die and flake off. This condition is characterized by itching scalp and its severity may change with season and exposure to trigger factors. Dandruff may also be confused with dry skin that can lease white flakes of dead cells.

What really causes dandruff?
Malassezia may contribute to dandruff on headThe cause of dandruff is not clearly understood but the condition occurs when skin cells grow and die fast that they are supposed to, causing accumulation of dead skin that is shed off. Although it is not clear why this happens, it is thought that a common fungus known as malassezia may contribute to the dandruff. The exact cause of overgrowing malassezia that triggers formation of dandruff is not well known. However, it is believed that the presence of too much oil on the scalp, hormonal changes, neurological disorders like parkinson's disease, stress, illnesses, not shampooing regularly, suppressed immune system, as well as extra sensitivity to the malassezia fungus are some of the contributing factors to the increased growth of the yeast-like fungus (malassezia) on the scalp.

Malassezia fungus lives on the scalp of many healthy adults and does not cause any serious problems. Nevertheless, if the immune system of patients with dandruff overreacts to the fungus, it makes the dandruff symptoms worse. Dandruff also tends to worsen when a person is stressed. Environmental conditions like cold and dry winter are also likely to exacerbate or trigger dandruff flare ups. Exposure to sunís ultraviolet rays may also induce the condition.

Another condition that may lead to dandruff is seborrhea or seborrheic dermatitis. Seborrhea is a chronic inflammatory disease that affects the skin and is characterized by dry, greasy or moist scale with yellow crusted patches on the scalp. Seborrheic dermatitis may appear as small scaly patches on scalp and it progresses to involve the entire part of your scalp leading to excessive exfoliation of dead skin cells or dandruff.

How does dandruff form?
Research has linked keratinocytes, the predominant cells in epidermis with immunological reactions that lead to formation of dandruff. Keratinocytes form a barrier on the skin, which protects the body from damages caused by things like bacteria, viruses, fungi, parasites, ultraviolet rays, and water loss on the skin. Keratinocytes are part of the cells that form the stratum corneum (SC) layer of the skin.

The SC covers many parts of the body with extremely thin and soft biological membrane that offers high efficient barrier for prevention of water loss from the tissue. The stratum corneum is made up of tightly overlapping corneocytes, and these corneocytes are composed of lipid-depleted and fully keratinized epidermal keratinocytes.

Anatomy of hair:
Anatomy of hair

Desquamatory enzymes in stratum corneum aid in daily individual exfoliation of corneocytes, something that helps maintain the right thickness of the SC layer. The time needed for the epidermis to proliferate and differentiate may be shortened if the skin function is influenced by proinflammatory stimuli factors that may be inflicted from inside or outside the body.

Such stimuli may lead to a stack of incompletely differentiated corneocytes that have a less stratum corneum turnover compared to that of a normal skin. The immature or incompletely differentiated corneocytes may be released to eliminate harmful agents from the skin thus leading to accumulation of a mass of stratum corneum layer. This layer forms the dry scales that are noticed in inflamed skin lesions.

When there is quick turnover of the stratum corneum, it means that the slow desquamatory process of stratum corneum does not take place and therefore a formation of dry clumps of undifferentiated but firmly attached corneocytes occurs on the skin surface. This way, dandruffs are formed.

The epidermal inflammatory reaction initiated to fight against Malassezia, the fungus found in the sebum-rich skin surface may lead to formation of dandruff. When the Malassezia globosa, a specific fungus found in scalp of both healthy people and those affected by fungus, metabolizes triglycerides from the sebum by expressing lipase, it results to release of oleic acid, a lipid by product.

This oleic acid can cause the stratum corneum on the top layer of epidermis to initiate inflammatory response, something that results to disturbances in homeostasis thus causing an irregular cleavage of stratum corneum (SC) cells. With dandruff, new cells are formed faster than they die resulting to more of the skin being shed and therefore the white flaky scales are noticed on the skin.

How can you detect that you have dandruff
Dandruff on ClothesIt's not difficult to tell if you have dandruff because you can see the flaking skin cells.  However, the symptoms could mimic other skin conditions. The common sign of dandruff is the presence of white flakes that come out of the scalp and could attach to your hair. In persons wearing dark clothes, these flaking dead cells can be noticed when they fall on their shoulders.

A personís head feels tight and itchy. The head of a person with dandruff may feel tingly and sore. The signs of dandruff may also vary from person to person depending on the triggering factors such as seborrheic dermatitis. If dandruffs are occurring due to a condition known as seborrheic dermatitis, a person may have the white flakes of skin accompanied by red, flaky and greasy patches on skin.

Because there are other conditions that mimic dandruff, this could lead to misdiagnosis of the condition. The diagnosis of dandruff may be done by examining the healthy history of a patient, the symptoms, and physical examination of the scalp. If you have self-diagnosed yourself of dandruff and applied treatment and it does not improve the symptoms such as shampoos, you need to consult a dermatologist. A biopsy may be performed to help diagnose the exact cause of the dandruff symptoms such as eczema, psoriasis, ringworms, head lice, and possibly contact dermatitis.

How can you treat dandruff?
One thing for sure, there is no cure for dandruff but the most interesting thing is that the symptoms can be managed thus making the condition subside or even disappear. The treatment of dandruff will vary depending on its severity and the causal factor. The most commonly used treatments are shampoos and creams.

Using shampoos with ingredients like tar, salicylic acid, zinc pyrithione, and ketoconazole may help treat this condition. If after using these shampoos, the symptoms disappear, you can switch to regular non-medicated shampoos to help cleanse the scalp and the follicles of dead cells and oils deposited on the skin surface.

Similarly, if one shampoo does not work, you may try a different one. Treating dandruff may take time and at times a trial and error approach may be applied to determine the right treatment product that works for you. It is important to consult a medical care practitioner or dermatologists when seeking for treatment of the dandruff. This is because an underlying cause may be worsening the symptoms for example, psoriasis or eczema.

Cortisone use in hairIf dandruff is being induced by seborrhea, you may need to use creams such as cortisones that help reduce inflammation and can be used together with medicated shampoos. Although shampoos are the easiest to use in treating dandruff, the limited contact time with the skin makes them less effective and may only be used for mild cases of dandruff.

Steroid solutions may also be used to treat inflammation but then again there might not help in removing large scales of the dead skin. Creams and lotions can help because they are left over the scalp for sometime or overnight thus being able to dissolve the scales. Antifungal creams appear to be more effective since they are able to reduce the number of the yeast-like fungus- malassezia, which triggers episodes of dandruff.

Antifungal creams with 1% clotrimazole and 2% miconazole may be applied once or twice a day to treat the condition. The tar shampoos can help reduce the cell division, inflammation and itchiness. The salicylic acid shampoos help in dissolving the dead keratinocytes and cleansing the follicles of the scales faster. Steroid is suitable for cases of seborrhea dermatitis and psoriasis that may be triggering dandruff.

Sulfur, ketoconazole, zinc pyrithion, and selenium sulfide found in shampoos, creams and lotions helps in reducing the number of fungus that trigger the formation of dandruff.

Besides the medicated shampoos, lotions, solutions, creams and ointments there are also natural remedies that can help fight dandruff.

Natural remedies for treatment of dandruff
As said, treating dandruff may require different options and diet cannot be eliminated from the treatment. The foods people eat can determine how well they are able to manage dandruff formation. Eating foods that are rich in omega 3 fatty acids like fish can help fight the condition. Vegetables and fruits are also good in dealing with this condition. You can control dandruff by taking vitamin B and zinc diet supplements. Probiotics are good bacteria that you can find in foods like yogurt and they can help in treating dandruff.

Natural remedies for treatment of dandruffThere are also remedies that you can apply on scalp to treat dandruff symptoms such as vinegar, honey, and tea tree oil. By mixing one part of apple cider vinegar with one part water, it can provide a solution, which you can apply on your hair and massage on the scalp. Remember that concentrated vinegar can sting your scalp and you should ensure that it is diluted with water.

Lemon juice may also be squeezed from the fruit and applied onto the scalp. You may also need to dilute the juice with water to prevent burning your sensitive scalp. Honey may also help in treating dandruff and what you need to do is mix it with water and apply it on your scalp allowing it to rest for about 10 to 15 minutes.

One reason why medicated shampoos may not be the best is because they are made with ingredients that may be toxic to the body. The coal tar, which is a common ingredient found in dandruff shampoos is essential in slowing the division of cells but then again, when used in high dozes, it can lead to serious health complications because it is carcinogenic or has the ability to cause cancer.

Other ingredients like sulfur, selenium sulfide and salt found on the shampoos can irritate sensitive scalp and lead to hair loss and dryness. There are non-toxic anti-dandruff medications such as the green tea shampoos that can help fight the condition without posing other health problems.

Before you use any medication, discuss with your doctor on the possible side effects and determine if there are any natural remedies that you may use before you opt for the medicated shampoos and lotions. Green tea contains polyphenols that help in promoting skin metabolic equilibrium. These polyphenols also help in shielding the skin against autoimmune disease and microbial infections. Green tea is both an antioxidant and anti cancer.

Dandruff can be discomforting with the irritating and itchy flaky scalp and may require testing different products to treat it. It is recommended that you try using natural remedies for treatment of the condition because they may alleviate the symptoms. However, if the symptoms persist, you need to seek medical attention to determine the exact cause of dandruff and get appropriate treatment. Brushing your hair with firm and steady strokes from the scalp down can help remove the oil from the scalp and hair strands. Dandruff may also cause self esteem and social complication calling for a psychological treatment approach too.





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