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Dandruff

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Refers to a skin condition that mainly affects the scalp.

Symptoms include flaking and sometimes mild itchiness.

The severe dryness of scalp results in dandruff.

Dandruff scale is a cluster of corneocytes, which have retained a degree of cohesion with one another and detach as such from the surface of the stratum corneum.

The size and abundance of scales are vary from one site to another and over time.

Red and greasy patches of skin may be present.

Some experience a tingly feeling on the skin.

Tends to worsen in the winter.

Males are more often affected than females.

Dandruff prevalence is 81–95% in African Americans, 66–82% in Caucasians, and 30–42% in Chinese.

Rates decrease after the age of 50 years.

The underlying pathophysiology involves the excessive growth of skin cells, and is not due to poor hygiene.

Normally skin layers continually replace itself, and cells are pushed outward where they die and flake off.

It is suggested that with dandruff, skin cells may mature and be shed in 2–7 days, as opposed to around a month in people without dandruff.

Generally, these flakes of skin are too small to be visible.

With dandruff dead skin cells are shed in large, oily clumps, which appear as white or grayish flakes on the scalp, skin and clothes.

I can result in social or self-esteem problems.

Usual onset is at puberty.

Occurs in 50% of adults.

Caused by genetic and environmental factor.

Diagnosed clinically.

Differential diagnosis includes:

Psoriasis, atopic dermatitis, tinea capitis, rosacea, systemic lupus erythematosus.

It has no known cure, but it is typically treated with an antifungal cream such as ketoconazole.

In a 2016 study, bacteria, especially Propionibacterium and Staphylococcus are more important to dandruff formation than fungi.

It is suggested a clear link between the dandruff an seborrheic dermatotis exists, that it is the mildest form of the clinical presentation of seborrhoeic dermatitis.

Treatments:

Shampoos use a combination of special ingredients to control dandruff.

Antifungal treatments including ketoconazole, zinc pyrithione and selenium disulfide have been found to be effective.

Ketoconazole is a broad spectrum antimycotic agent that is active against Candida and M. furfur.

Ciclopirox is also widely used as an anti-dandruff agent in most preparations.

Coal tar causes the skin to shed dead cells from the top layer and slows skin cell growth.

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