Dandruff: Symptoms, Causes, Risks, Complications, Diagnosis, Treatment, Prevention and Outlook



It’s annoying to have dandruff, which can be embarrassing and hard to treat. Dandruff is a condition of the scalp wherein it becomes dry or greasy that it produces white flakes of dead skin.

The exact cause of the condition is still unknown but there are many factors that may heighten the risk. Many people believe that it’s related to hygiene but it’s actually a condition seen even in those who take a bath daily. However, the condition may appear worse in people who do not wash the hair often or comb it regularly.

The most annoying and uncomfortable side effect of having dandruff is itching.


For most adolescents, the symptoms of dandruff are easy to detect. There are white flakes that are oily-looking of dead skin that dots the hair and shoulders. The scalp is oily, itchy and scaly. The symptoms of the condition may improve during the hot season or the summer and worsen during the winter or rainy season in some countries.

Among babies, the presence of dandruff on the scalp is called cradle cap. The condition causes a scaly and crusty scalp that can be annoying for the parents. This condition clears up on its own and will disappear after a few weeks.


The skin sheds and is replaced constantly. This includes the skin on the scalp. Usually, the dead skin is washed away during bath or if they are rubbed off by the clothes. The skin is also covered with millions of microorganisms called “flora”. The secretions of the skin like sebum or sweat, create a protective layer that helps prevent the microorganism and bacteria to multiply on the scalp.

However, in some instances, triggered by diet, hormonal changes, illness, and stress, the bacteria can proliferate, leading to the excessive shedding of the skin on the scalp.

Possible Causes

Not shampooing properly and often enough – People who do not regularly wash their hair may have dandruff because the dead skin cells and oils on the scalp start to build-up, leading to dandruff.

Oily and irritated skin (seborrheic dermatitis) – This condition is one of the main causes of dandruff. Seborrheic dermatitis is a condition that can affect the skin, even in the scalp. The areas most affected are those with many oil glands like the side of the nose, the eyebrows, the breastbone, the armpits, the back of the ears and the groin area.

Dry skin – Dry skin may trigger the production of dandruff. The flakes from dry skin may resemble dandruff and if it’s severe, dandruff may indeed form.

Malassezia – Malassezia is a yeast-like fungus that thrives on the scalps of most people. In some instances, the organism may irritate the scalp, leading to excessive skin cell growth. The excess skin cells would die and shed off, which may lead to the formation of dandruff.

Allergy or sensitivity to hair products – Contact dermatitis is the sensitivity reaction to certain products or clothing. Some ingredients in hair care products may lead to an irritated scaly scalp, making it prone to the formation of dandruff.

Other causes:

  • Poor hygiene
  • Diet rich in salty, sugary and fatty food
  • Psychological stress
  • Physical stress
  • Hormonal changes
  • Cheese, champagne and white wine
  • Pre-menstrual period
  • Cold or dry climate

4Risk Factors

Some factors may increase the risk of developing dandruff, which includes:

  • Males – Males are more prone to having dandruff than women. The male hormones may be blamed for this.
  • Age – Dandruff is common among young adults and may affect even those in the middle ages. However, everyone can have dandruff, particularly those with underlying conditions.
  • Other medical conditions – For unknown reasons, adults with diseases like Parkinson’s disease are prone to having dandruff and seborrheic dermatitis. In some cases, those with HIV infection and other diseases that affect the immune system may suffer from dandruff more than others.
  • Oily scalp and hair – People with oily scalp and hair are prone to the proliferation of Malassezia since it feeds on the oils on the skin.

5Complications of dandruff

There are rarely any complications associated with dandruff. However, in some cases, dandruff is a sign of a more serious health issue. Make sure you consult a doctor right away if the dandruff is extremely severe or it persists despite home remedies, there are signs of infection like swelling or redness, and there are signs of other skin conditions like psoriasis and eczema.

Also, individuals with compromised immune systems like those with Human immunodeficiency virus (HIV) infection or Acquired immunodeficiency syndrome (AIDS), should seek medical treatment when they have dandruff. They are prone to this skin condition.


Dandruff is a condition wherein you can even self-diagnose from the symptoms that include having a scaly, dry and itchy scalp. Also, you can observe white flakes on the shirt or shoulders.

The doctor can also diagnose the condition through a complete medical history taking and a thorough physical assessment. In some cases, to ensure that the dandruff is caused by fungal infection, a scraping method can be used to examine the skin cells under a microscope. This is to rule out other possible cause such as psoriasis.


A common misconception is that dandruff is caused by a dry scalp. However, dandruff is usually oily, so do not put oil on the scalp because it will only worsen the condition.
You can use scalp toners, creams, and shampoos. Here are the common treatment options for dandruff.

Shampoo – Anti-dandruff shampoos are easily available in the market.

Types of shampoos

Tar-based – Tar-based shampoos are used to control dandruff and other skin disorders. Coal tar can slow the proliferation of the skin cells to prevent the shedding off of dead skin cells.

Pyrithione zinc shampoo – These shampoos contain zinc pyrithione, an anti-fungal and anti-bacterial agent. They work by reducing the number of fungi on the scalp that can cause dandruff.

Shampoo with salicylic acid – Salicylic acid can help reduce and eradicate the scale.

Ketoconazole shampoo – This type of shampoo can help fight fungi on the scalp.

Selenium shampoo – Selenium-based shampoos can slow the death of skin cells, reducing the formation of flakes.

Make sure you read the instructions that come with the shampoo properly. For most shampoos, it is important to leave it on the hair for a couple of minutes before washing it out.

Lifestyle remedies

Aside from shampooing the hair regularly, there are ways to help manage dandruff, including:

Shampoo regularly – For people with oily scalp, shampooing the hair daily is important to prevent dandruff

Get exposed to the sun – The sun may help reduce dandruff but be careful when exposing your scalp to the sun since the ultraviolet rays may increase your risk of skin cancer.

Manage stress – Stress is a big factor in health and the development of various medical conditions. Learn to manage stress to prevent dandruff and to manage it.


Dandruff or seborrheic dermatitis is a common skin issue that can affect the scalp.
People can develop dandruff at any age, even in babies, but it’s more common among adults. Preventing the occurrence of dandruff is better than cure.

Here are ways to prevent dandruff:

  • Try using over-the-counter dandruff shampoos that contain salicylic acid and zinc.
    If the dandruff is severe, other ingredients in shampoos may fight the fungi causing the condition.
  • Wash your hair frequently and practice good hair hygiene to prevent the occurrence and development of the scalp. Wash the hair once a day, particularly for those with the irritated or oily scalp.
  • Avoid using hair products like hair gels and sprays because these can lead to the accumulation of oil on the scalp and hair. This may lead to the emergence and development of dandruff. If your scalp is oily, stay away from styling products.
  • Spend more time under the sun. Many studies have revealed that the sunlight can, in fact, prevent dandruff. However, make sure you don’t overdo your sunbathing and you use sunscreen on the other parts of the body before going under the sun to prevent the harmful ultraviolet rays from damaging the skin.
  • Practice stress management and learn to cope with stressful events. Stress is a big factor that could lead to the formation of dandruff. Learn to manage stress and anxiety in school or in work.
  • Eat a healthy diet that is high in vitamin B and zinc. This diet can prevent the fungi from proliferating, causing dandruff.


Dandruff is not a serious condition and it can be easily treated. With the proper treatment and care of the scalp, dandruff can disappear easily. However, it is important to follow all the instructions on the products you will use in order for them to become effective.

Dandruff can be short-lived as long as proper hygiene is practiced and regular shampooing is done. Also, get some light to prevent having dandruff. In the long term, having dandruff can affect one’s psychological and emotional health because it can be stressful and embarrassing. Learning to cope with stress can help prevent and reduce dandruff.