Dandruff is a relatively common condition, and most people would find that they have at least a few dandruff flakes if they looked closely. But while it may be a simple annoyance for most people, up to 25% of adults may have enough dandruff flakes to consider it troublesome. There is also an increased awareness of dandruff through advertisements in stores and on television.
Scientists know that dandruff is caused by a micro-organism named Malassezia. This yeast grows at the hair root and eventually spreads over the entire scalp. Since the scalp is irritated by Malassezia, it responds by overproducing new skin cells and shedding the old ones. This is known as increased cell turnover and results in thin white or greyish flakes called scales. People with dandruff may also find their scalps very itchy.
There are two types of dandruff: oily flakes and dry flakes. Oily flakes are bigger in size, and may stick to the oil on the scalp. People with oily dandruff may have visible flakes near the hair root on the scalp, but may not have a lot of dandruff on their clothes. Dry flakes are smaller, and tend not to stick to the scalp. People with dry dandruff may find that they have more flakes in their hair and on their shoulders.
Dandruff is also affected by a person's lifestyle and environment. Some people with dandruff have fewer flakes in the summer and when they are older. Dry weather and inadequate hair-washing may cause more flakes.
The best way to stop dandruff is to prevent it from happening. Dandruff treatment is aimed at removing flakes, relieving the itchiness and controlling the proliferation of Malassezia. As a start, people should wash their hair with a nonmedicated shampoo at least three times a week, gently massaging the scalp and rinsing well. If this does not work, medicated anti-dandruff shampoos can be used. In most cases, shampoos that do not require a prescription will be effective for dandruff. Different brands of non-prescription shampoos may contain a variety of ingredients (either as a single ingredient or as a combination), including selenium sulfide, salicylic acid, ketoconazole, coal tar, or soaps. Some brands have two versions of anti-dandruff treatments – one for oily flakes, and one for dry flakes. Ask your pharmacist to help you pick the right shampoo for you.
People with dandruff should continue to use nonmedicated shampoo for routine hair-washing before using the anti-dandruff shampoo. Anti-dandruff shampoos should be applied to the scalp for at least 5 minutes for best results. In general, anti-dandruff shampoos can be used up to a few times a week to control flakes; however, some brands may have specific recommendations on how they should be used. After the flakes are under control, anti-dandruff shampoos should be used less often. People who do not notice an improvement in two weeks should contact their doctor.
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