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What’s the deal with dandruff?

What is dandruff, exactly?

Dandruff is a chronic scalp disorder that is more common than you may realise. It causes white ‘flakes’ on the scalp and is difficult to get rid of. Those suffering from it may get quite embarrassed, feeling like they constantly need to wash their hair – however it’s important to remember that if you do suffer with dandruff, the majority of others won’t even notice, as the flakes are too small to be seen from any distance. On some occasions, the flakes will be more noticeable, but there are ways of dealing with it, as we’ll explain later on.

What causes dandruff?

Your skin is constantly ‘renewing’ itself, growing new cells and shedding old ones in order to stay healthy. A flaky scalp can be caused when this process speeds up; and this process could be sped up by a variety of things, including:

  • Eczema
  • Psoriasis
  • Tinea capitis
  • Contact dermatitis
  • Seborrhoeic dermatitis


There are several different types of eczema, however they all tend to cause dry, irritated skin that becomes very itchy. It is most common in young children, and often develops before their first birthday; however the condition can develop at any time in adulthood too. The most common form of eczema is atopic eczema, which can affect any part of the body, although it most commonly occurs on the inside of the elbows, the backs of the knees, the hands and often the face and scalp in younger children.


Psoriasis is a long-term condition which is caused by an overproduction of skin cells, thought to be due to a problem with the immune system.  The skin (often around the elbows, knees, lower back and scalp) becomes red, patchy and crusty. It usually develops in adults younger than 35, however, like eczema, can appear at any time. This only affects roughly 2% of the population.

Tinea capitis

This is a form of the fungal infection known as ringworm. Although ringworm can generally affect anywhere on the body, tinea capitis is the form that affects the scalp. It is estimated that around 10%-20% of the population will suffer from some form of ringworm; however it is more common in children that haven’t yet reached puberty. Symptoms of tinea capitis include scaly patches of skin on the scalp, which may be itchy and sore. This condition can often be treated using antifungal tablets and an antifungal shampoo.

Contact dermatitis

Contact dermatitis is a reaction that causes skin to become dry, cracked and blistered, and often looks like eczema. It occurs from being exposed to allergens or irritants, so the root cause of it is usually different in different people. For example, one person may not be able to use scented bath products, as it irritates the skin. Another person may be allergic to the product in a hair-dye, which is one of the more publicised contact dermatitis reactions due to its severity. For many, the symptoms will be much milder. Patch tests are often carried out to determine the cause of the problem.

Seborrhoeic dermatitis

It is reported that only 4% of the population suffer with seborrhoeic dermatitis, which is a skin complaint that affects the more oily areas of skin, such as the face and scalp. However, most people who do suffer with the condition aren’t even aware that they have it. In severe cases, the individual may have a red, weeping rash; however this is less common than the main symptom: dandruff. Dandruff is a mild form of seborrhoeic dermatitis. This condition is thought to be caused by an over-production of harmless yeast that lives on the skin, and the immune systems reaction to this. It’s usually treated with creams and shampoos, however initially a mild steroid cream may be prescribed by your GP to deal with the symptoms.

Treating dandruff

Anti-dandruff shampoos are the most common way of managing this complaint. Unless your scalp is inflamed, severely itchy or you have a weakened immune system, there’s no need to see your GP. You want to look out for shampoos that contain coal tar, salicylic acid, ketoconazole, selenium sulphide or zinc pyrithione, as these will benefit you the most. Regular use of these shampoos will bring your dandruff under control; however it will return should you stop using them completely. If you’ve used solely anti-dandruff shampoos for more than a month and the condition hasn’t gotten any better, let your GP check for any other skin conditions.

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