Dandruff is an ugly and embarrassing issue; but it is not necessarily an indication of any underlying medical or hygiene issues or skin diseases, although it can be. It can be rather unpleasant, showing up on the scalp, eyebrows, and other areas of the face and head, groin, and chest. And it is an issue that plagues up to half of American adults. (Source). As a dermatologist, or aesthetician/aesthetic physician, there are developments in the field that you will want to be aware of.

What is Dandruff

Sometimes confused with seborrheic dermatitis, dandruff presents as skin that is flaky, itchy, and non-inflamed. Isolated to the scalp as dandruff, when it shows up on other parts of your body, frequently with a red and crusty, or greasy, look, it is known as seborrheic dermatitis. These related conditions result in scaling or flaking of the skin. This is the skin shedding oils and dead skin cells. Generally speaking the flakes are white, however, they may be yellow, brown, or gray. (Source).

The subject of much research, and the reason for many commercial and prescription-grade products that claim to solve the problem, the root cause of both dandruff and seborrheic dermatitis remain unknown. However, there seem to be links between them and overall poor health, rather than hygiene or allergies. Some diseases and medications indicate a more likely issue, however with up to half of the adult population suffering from dandruff and up to one third suffering from seborrheic dermatitis, these are not strongly correlated.

Conditions that may indicate a higher prevalence of dandruff sufferers include:

• HIV
• Depression
• Epilepsy
• Alcoholism
• Parkinson’s disease
• Stress
• Head injuries or strokes
• Eating Disorders

Medications that may put you at risk for a greater chance of suffering include:

• Interferon
• Lithium
• Psoralen

Other risk factors for dandruff include:

• Young adult age
• Being male
• Having an oily scalp

Dandruff-like symptoms can also be caused by not shampooing with regular frequency (which allows the buildup of oil, hair product, and dead skin cells to accumulate on the scalp). Dry skin and contact dermatitis caused by an allergic reaction to a product will also cause the flaking, and even some irritation. There is also a yeast-like fungus, malassezia, which lives on the scalps of adults, and in some people, can irritate the scalp and trigger excess growth of skin cells. (Source).

How Can Dandruff Be Treated

As medical professionals we are frequently called on to help make people who are suffering unsightly maladys more aesthetically pleasing. Treating dandruff and dandruff-like symptoms falls into this category. It is important, however, to make sure that when making recommendations to your clients, you have a diagnosis. This will assure that the treatment is right for the problem. It does not benefit anyone to make a recommendation that does not address the source. For that reason, if you do not have the expertise to accurately diagnose, it is incumbent on you to refer your client to someone who can.

That said, treating most dandruff, as the Mayo Clinic notes, is not difficult but may take some “trial and error.” Over the counter dandruff shampoos, used daily, should help most people, but there are those who will require prescription-strength shampoo or even a steroid (which can usually be delivered in lotion form). There have been some fantastic studies done that compare the different medicated shampoos available, cataloged by the Journal of Dermatological Treatment. A number of studies have looked at the plant extract tea tree oil, as a natural alternative treatment for dandruff. When compared to Zinc Pyrithione and Ketoconazole-based shampoos, tea tree oil demonstrates a consistently high level of treatment promise for dandruff caused by malassezia. (Source). Other shampoo ingredients that have proven effective in treating dandruff are selenium sulfide and salicylic acid. (Source).

How Can Dandruff Be Avoided

While dandruff may not be completely avoidable, there are lifestyle choices that your clients can embrace to reduce their risk of dandruff. These include:

• Regular shampooing with a dandruff-controlling shampoo. There are plenty of products that are salon quality and contain one of the active ingredients that are designed to keep dandruff at bay. This is great news for the client who is particular and discerning about the products they use on their hair. Soft, luxurious, shiny hair is achieved by having a healthy scalp. Carefully rinsing all of the shampoo and conditioner from the hair will prevent product buildup. For those clients who have styles which require reduced shampooing, have them consult with their salons about what products they can use to maintain a healthy and clean scalp.
• Sun exposure. While too much sun is dangerous and causes,premature aging, sunlight is also healthy and healing for the skin in moderation. While the Skin Cancer Foundation disagrees, the Mayo Clinic and other major medical providers think that the sun has therapeutic benefits.
• Good Diet, Exercise, Sleep, Hydration, and Reduced stress. These all help the body look and feel better overall, and can help with dandruff too.