Dandruff is an excessive flaking of skin on the scalp, with some skin flakes caught amongst the hair. Shedding of surface skin cells is normal, as they are gradually replaced by cells formed at the base of the epidermis which then move towards the surface. This process takes about a month. An increase in the number of cells being shed, which tend to clump together, is called dandruff.
If the scalp is excessively dry, the dandruff will appear as dry, flaking skin. Seborrhoeic dermatitis (red, itchy, scaly reaction of the scalp) differs from a dry scalp as it includes oiliness, severe flaking with redness, itching and inflammation. Other conditions, such as psoriasis and eczema may also affect the scalp. For further details, see also psoriasis, atopic eczema.
Treatment of dandruff involves removal of the scales from both the scalp and those that are adhering to the hair shaft. In many cases the scalp is itchy so an anti-pruritic (helps to relieve itching) is indicated to help prevent scratching which may lead to secondary infection.
An anti- fungal agent is necessary to help reduce the fungus on the scalp that can cause dandruff and seborrhoeic dermatitis.
Advice for the Patient
As with all skin conditions that involve pruritus, it is important to advise the patient not to scratch. Scratching can introduce secondary infection to the area leading to a more complicated condition to treat. Scratching will also increase the inflammation. As dandruff is a condition that tends to recur, the patient should be made aware of this and advised to use a maintenance shampoo to help prevent recurrence.