For those who don’t suffer from dandruff, the condition can seem like no big deal. But those who do suffer can have cases that range from the occasional and annoying to the chronic and humiliating.
The itchy scalp and telltale flakes that are the hallmarks of dandruff can have several causes or influences, according to the Mayo Clinic. You can develop dandruff if your scalp is simply too dry. Dandruff can also be caused by skin that’s too oily, for example if you don’t shampoo often enough to rid your scalp of excess oil and dead skin cells. You can also have dandruff if you have a case of psoriasis or eczema that affects your scalp.
Some people develop a condition called contact dermatitis—irritation resulting from exposure to hair care products. And for some, dandruff is caused by a common fungus (malassezia) gone out of control.
The majority of women and men with dandruff can control it for the most part by shampooing often with a gentle product. Some need to use a medicated shampoo to keep the flakes under control.
Other dandruff sufferers aren’t so lucky. Seborrheic dermatitis is another common cause of dandruff—a condition arising where oil glands are dense: on the scalp as well as areas of the face, ears, chest and sometimes the groin and armpits. Skin in the affected areas is often red and irritated, and flakes shed, particularly by the scalp, can be large and greasy or powdery. The exact mechanisms behind seborrheic dermatitis are not thoroughly understood, though the American Academy of Family Physicians reports that the malassezia fungus can be a factor, as well as oil (sebum) production, general health and cleanliness and environmental triggers.
Experienced physicians can usually spot the reason for a stubborn case of dandruff without extensive testing, and many doctors will take a hierarchical approach to the treatment plan, just as they do for other non life-threatening conditions. This means less aggressive measures will be tried first, and if they aren’t effective the physician will recommend stronger treatments until a solution is found.