Dandruff: Causes And Treatments For Oily And Dry Types

Diseases A-Z

Dandruff can represent an unsightly and at the same time annoying problem, able to cause unpleasant sensations in the scalp, such as itching and burning. The much publicized anti-dandruff shampoos often contain active substances suitable to counteract it present only in small quantities. For this reason they can prove to be ineffective. Best Home Remedies has prepared highly informative materials on dandruff, its signs, causes, risk factors, types and treatments.Dandruff

What is dandruff?

Dandruff is a pathology of the scalp which occurs macroscopically as white and dry flakes at the base of the hair. It affects about 40 percent of people between 18 and 45 years, both women and men. Does not compromise the health of the hair or cause their fall. Normally the epithelial cells of the scalp are replaced regularly and the elimination of dead cells as desquamation of the upper parts of the epidermis occurs without problems, and a very slight presence of desquamation is physiological. However, when the presence of whitish and dry scales is rather high, it is called dandruff, which may be a symptom of seborrheic dermatitis, therefore it has a chronic recurring pattern.

Causes:
Dandruff can be due to different causes, even if sometimes those affected are simply more predisposed than other people: An excess of epithelial cells that causes a continuous and large-scale desquamation; very often the change is so fast that the cells not yet fully mature are pushed into the superficial corneous layer; It may be due and accompanied by scalp dryness and / or excessive production of sebum, then a glandular irregularity; Malassezia furfur and / or Malassezia globosa, yeast normally present on the skin, but that some conditions such as excessive production of sebum proliferate; Increased sebum secretion due to androgenic hormones, including testosterone; Stress, predisposition; Reaction of the skin to hair products such as gel or spray; Seasonality: during the winter season, the dandruff tends to increase, as well as when the seasons change, while it reduces during the summer months.

The improvement is due to the beneficial effects of the sun and to the favorable modifications of the bacterial flora. Use soothing and emollients based on oil to facilitate detachment of scales, associated with shampoos and anti-inflammatory solutions. The products based on ketoconazole and climbazole are very useful in this regard. In important cases, locally applied steroids are used. A supplement based on polyunsaturated fatty acids can also prove useful.

When dandruff has been eradicated, it is good to let the hair breathe, washing with other types of shampoo more delicate and ph physiological. Anti-dandruff solutions do not have a preventive effect on the appearance of dandruff.

Dandruff symptoms and clinical signs

A symptom that usually accompanies dandruff is itching, which can amplify the detachment of the scales (if it yields to the necessity of scratching). Another event may be irritation of the scalp, which is flushed, particularly fatty or dry.

Several causes can contribute to the problem: predisposition, physical or emotional stress, hormonal changes, dry or oily skin, increased sebum secretion and wrong eating habits (eg excessive consumption of fats, alcohol abuse and poor diet in foods rich in zinc, B vitamins, etc.). Dandruff can be helped by the irritation caused by some hair care products (shampoo, gel or other cosmetics): if they cause contact dermatitis, they can trigger the mechanism at the base of dandruff. There are also yeasts normally present on the skin (Malassezia furfur and / or Malassezia globosa), which thrive on the lipids produced by the scalp producing an irritating effect that can accentuate or cause the disorder.

Dandruff, generally, affects men and manifests more often in adulthood; It can be a symptom of seborrheic dermatitis or psoriasis (when it affects the scalp).

Contact allergy
Seborrheic dermatitis
Dermatophytosis
Ichthyosis
Tinea capitis

What is oily dandruff?

Oily dandruff – or pityriasis steatoid – is a particular type of dandruff characterized by the presence of yellowish scales. Oily dandruff is generally linked to seborrheic dermatitis and to the presence of scalp seborrhea. The underlying causes of the appearance of pityriasis steatoid, however, are not due exclusively to the excessive production of sebum, but – as we will see in the course of the article – seem to be multifactorial. Although difficult to eliminate, the phenomenon of oily dandruff can be kept under control thanks to the use of special detergent products (anti-dandruff shampoos), lotions or, possibly, drugs.

oily dandruffOily dandruff is a disorder affecting the scalp which is found to be covered by thick scales (residues of dead cells) and by an abundant and excessive layer of sebum. In fact, some argue that pityriasis steatoid is more than a disease, but the debate is still open. However, greasy dandruff affects mainly the adult subjects, but it can also occur in adolescents, with a greater incidence in males than in females.

Oily dandruff, however small a disorder may appear, can greatly affect the aesthetics of the individual and, consequently, the quality of his life. In fact, those affected by this disorder may feel uncomfortable when they are in public and this could also negatively affect the individual’s social relationships. Oily dandruff should not be confused with dry dandruff, another type of dandruff characterized by the production of whitish whitish scales. In this regard, it is interesting to note that seborrheic dermatitis has been proposed as a possible cause also for the appearance of this type of dandruff.

As mentioned, oily dandruff is characterized by the formation of thick and yellowish scales, having a waxy / pasty consistency. This characteristic is due to the excessive production of sebum by the scalp that accumulates outside the hair follicles, also covering the scaled flakes. As a consequence, individuals suffering from oily dandruff present, therefore, greasy hair with a classic greasy appearance and a ‘dirty’ effect.

Due to the presence of the sebum, the scales that make up the oily dandruff tend to adhere to the scalp and detach with greater difficulty than the flakes that form in the case of dry dandruff. Often, oily dandruff is accompanied by symptoms such as itching and irritation and inflammation of the scalp and its presence in an individual is associated with a high risk of hair loss.

What are the causes and risk factors of oily dandruff?

The causes of fat dandruff have not yet been precisely defined, but it is believed that there are several factors that compete with each other to give rise to the disorder. Among these we find:

  1. Increased speed of cellular scalp replacement;
  2. Excessive production of sebum (seborrhea, seborrheic dermatitis, etc.);
  3. Presence and excessive proliferation of Malassezia furfur (or Pityrosporum ovale), a yeast that normally lives on the scalp but which, in certain situations, behaves as an opportunistic pathogen.

This fungus feeds on the substances contained in the sebaceous secretions produced by the scalp which, by reflex, is irritated by secreting even more sebum. The excessive production of sebum, in turn, favors the development of Malassezia furfur, thus giving rise to a vicious circle. At the same time, the uncontrolled proliferation of this yeast causes an increase in cell turnover, thus favoring scalp desquamation.

In the light of what has been said so far, it would seem that the only person responsible for oily dandruff is the Malassezia furfur mushroom. In reality, although this yeast is actually considered to be one of the main culprits and although its excessive and uncontrolled proliferation may increase sebum production and may promote desquamation, these phenomena can also have other root causes.

Risk factors:
In this regard, among the factors that seem to be involved or which may predispose to the appearance of oily dandruff, we find: Use of very alkaline and excessively degreasing detergents, too frequent washing and use of poor quality hair products; Conditions of anxiety and stress; Endocrine or hormonal imbalances (may favor the excessive production of sebum); Lowering of immune defenses (this situation may favor the excessive replication of Malassezia furfur and other microorganisms); Genetic predisposition.

Moreover, according to some authors, among the possible causes of oily dandruff there could also be the excessive proliferation of other opportunistic microorganisms of bacterial origin, such as, for example, some types of staphylococci and bacteria belonging to the genus Propionibacterium.

Nutrition also appears to play an important role in the formation of oily dandruff. In fact, some eating disorders and an unregulated diet rich in sugars, fats and alcohol, could promote the appearance of the disorder. Therefore, the problem of oily dandruff should be mitigated by the adoption of a more balanced diet, rich in fruits, vegetables and fatty acids of the omeoga-3 and omega-6 series.

Cosmetic and dermocosmetic treatments against oily dandruff

In the milder cases of oily dandruff, the use of a shampoo with a purifying action that is, at the same time, delicate and suitable for frequent washing, can help remove excess sebum and promote the elimination of yellowish scales from the scalp.

Cosmetic and dermocosmetic treatments against oily dandruffIt is a common opinion that the use of frequent washing can increase the production of oily dandruff and dandruff in general. However, this is not always the case. Frequent washing, in fact, can be useful to keep the scalp cleaner, favoring the elimination of excess sebum. This practice, however, must be performed with delicate products and not excessively degreasing and the washing must be done with light massages. Very aggressive shampoos and a too energetic wash, in fact, would provoke the opposite effect, since they would further irritate the scalp, pushing it to produce new sebum in an attempt to defend itself from the ‘aggressions’ suffered.

Also the use of anti-dandruff shampoos based on zinc pyrithione or selenium sulfide, associated with dermopurifying and sebum-regulating substances, can be useful to combat oily dandruff. Zinc pyrithione, in fact, has antibacterial and antifungal properties, useful to counteract the action of bacteria and yeasts involved in the formation of oily dandruff. Selenium sulfide, on the other hand, in addition to exerting mildly antimycotic activity, is also able to reduce the speed of cellular scalp replacement, thus reducing desquamation. However, it should be used carefully as it also exerts a lightening activity on the hair. Likewise, vegetable tar-based shampoos can also be useful. This product, in fact, is able to slow down the speed of cellular turnover of the scalp; but it can be irritating and can dry your hair.

Finally, we remember the presence of shampoo based on salicylic acid, a compound that is normally used in anti-acne products. Thanks to its keratolytic action, however, salicylic acid is also used in case of oily dandruff to promote the elimination of scales and excess sebum.

Although the above compounds are found in cosmetic products or dermocosmetics sold freely, before resorting to their use for the treatment of oily dandruff, it would be good to seek advice from your doctor or your dermatologist.

Pharmacological treatments

Recommendations:
Pharmacological treatments1

In particularly severe cases of oily dandruff, however, it may be necessary to resort to the use of specific drugs that should be prescribed by the doctor. In these cases, we usually resort to the use of medicated shampoos based on ciclopirox (Sebiprox) or ketoconazole (Nizoral, Triatop), both antimycotic active ingredients also used in the treatment of seborrheic dermatitis and useful to counteract the excessive proliferation of Malassezia furfur. The use of the aforementioned shampoos must be carried out at least 2-3 times a week and it is necessary to let them act on the scalp at least 3-5 minutes before rinsing them.

Ketoconazole shampoos, in most cases, are framed as drugs for sale of which it is not necessary to submit the prescription. However, since the Malassezia furfur yeast is not considered solely responsible for the onset of oily dandruff, the use of ketoconazole or other antifungal shampoos remains the subject of controversy among dermatologists. In addition to this, we must not forget that, even if purchased freely, these shampoos contain an antifungal medication for all purposes. For these reasons, before resorting to the use of antifungal products, it is always good to ask for a doctor’s prior consultation.

If the above mentioned treatments (pharmacological or otherwise) are not effective in the control of oily dandruff, the doctor may decide, finally, to resort to the use of corticosteroids for topical use (generally, using corticosteroids in the form of gel, lotion or cream).

What natural remedies can be used to combat oily dandruff?

For the treatment of oily dandruff certainly does not lack the possibility of resorting to the use of natural remedies of various kinds. Among the various natural alternatives that can be used to combat oily dandruff we remember the extracts of nettle leaves to which are attributed dermopurifying, sebum-regulating and anti-dandruff properties. In addition, essential oils are also used in the tough fight against oily dandruff. Among the most commonly used, we find without a doubt the essential oil of lemon, with astringent, antibacterial and skin-purifying properties, and the essential sage oil to which antifungal, antibacterial and astringent properties are attributed.

Essential oils

Lemon essential oilEssential oils should never be used pure, as they are potentially irritants. In the specific case of the treatment of oily dandruff, it is usually recommended to add 10-20 drops of essential oil to a mild and neutral shampoo (ie, a shampoo that contains no other active ingredients) and to proceed with the normal washing.

Homeopathy

HomeopathyThe alternative medicines also propose different remedies to combat oily dandruff, whose usefulness, however, has not been demonstrated or confirmed by any type of study. In case of oily dandruff, homeopathy suggests using the Thuia (or Thuja) plant remedy, in particular, to be used at 9CH dilution. The usually recommended doses are three granules to be taken four times a day.

Schussler biochemical therapy

Schussler biochemical therapySchussler’s biochemical therapy involves the administration of the homonymous salts. In detail, the remedies indicated in case of oily dandruff are number 6 (Kalium sulfuricum) and number 9 (Natrium phosphoricum).

To combat oily dandruff, such salts can be taken either orally (classical method of administration), or they can be dissolved in water and used to make compresses on the hair to be left on for a few hours.

The practices described above to combat oily dandruff are not accepted by medical science, have not been subjected to experimental tests conducted with scientific method or have not passed them. Such practices, therefore, could be ineffective or even dangerous for health. The information shown is for illustrative purposes only.

What are the characteristics of dry dandruff?

Dry dandruff is manifested in the form of small and fine scales of greyish-white color that can remain on the hair or – as more frequently happens – can fall on clothes, giving rise to the so-called ‘snow effect’. The small scales that form dry dandruff are nothing but residues of desquamated dead cells belonging to the stratum corneum. The desquamation of the superficial cells of the stratum corneum is part of the normal physiological process of cell turnover, however, when its speed increases exponentially, there is the appearance of the disorder.

dry dandruffFortunately, unlike what happens in oily dandruff, normally dry dandruff is not associated with inflammation of the scalp and its presence does not increase the risk of hair loss. This disorder, however, is very often associated with even very intense itching. Finally, remember that the manifestation of dry dandruff tends to get worse during the winter, while it improves during the summer months.

What are the causes and risk factors of dry dandruff?

Although the exact causes that lead to the formation of dry dandruff are not yet completely clear, it is believed that the main responsible is to be found in the increase in the speed of cell turnover. Increase that, in turn, can be caused and / or exacerbated by the uncontrolled growth of Malassezia furfur (or Pityrosporum ovale). This micro-organism is a yeast that lives on the scalp of most people but, under certain circumstances, can act as an opportunistic pathogen. Malassezia furfur feeds on the substances contained in the sebaceous secretion of the scalp; when the situation allows it, this yeast starts to replicate excessively and uncontrollably, favoring scalp desquamation with acceleration of cell turnover.

Risk factors:
Among other factors that may favor, exacerbate or contribute to the formation of dry dandruff we find: Dry skin, this condition can favor the formation of this type of dandruff because a dry and dehydrated skin gets desquamed more easily; Stressful situations; Use of shampoos and hair products of poor quality, too aggressive and / or unsuitable for your skin type; Use of alcohol-based products or lotions (in fact, alcohol dehydrates the scalp favoring the desquamation); Lowering of the immune defenses (this condition can favor the replication of Malassezia furfur and other microorganisms on the scalp)

According to some, in addition, dry dandruff could be caused by a mild form of seborrheic dermatitis. However, in most cases, this type of dermatitis is associated with the appearance of oily dandruff.

Dandruff and nutrition

Dandruff and nutritionAs with oily dandruff, even when it comes to dry dandruff many people say that its formation can be connected to poor diet and unbalanced diets. Without prejudice to the importance of following a varied and balanced diet, this hypothesis is not accepted by all dermatologists and, therefore, remains today the subject of several debates.

Regarding the research of the cause triggering dry dandruff, the hypothesis has been suggested that this disorder may derive from the presence of liver dysfunctions and disorders, such as, for example, liver failure. In truth, this theory still raises several doubts and, for this reason, is rejected by several doctors.

Cosmetic and dermocosmetic treatments against dry dandruff

In cases of mild dry dandruff, the simple use of anti-dandruff shampoos may be sufficient to keep the problem under control.

Recommendations:

Generally, such shampoos contain such ingredients as:

  • Zinc pyrithione is a compound with antibacterial and antifungal properties, useful to counteract the action of Malassezia furfur and any other microorganisms that can develop on the scalp.
  • Selenium sulfide: it is a substance able to slow down the speed of cellular turnover which is also attributed to mildly antifungal properties. However, this compound should be used carefully, as it is able to lighten the color of the hair.
  • Vegetable tar: it is a compound able to decrease the speed of cell turnover of the stratum corneum, thus reducing desquamation. However effective, however, tar is not well tolerated by all skin types and can also cause dry hair.
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