What is dandruff, causes and its treatment

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What is dandruff?

Dandruff is the excessive production of small flakes of skin from the scalp. It is a normal process because the cells of outer skin die and are replaced constantly. The dead cells move to the outer edge of the skin and flake off after one month. About 50% of the population have significant dandruff issues.

What does it mean?

Dandruff is a common normal condition, and it carries no risk for the health. It is not contagious and does not cause baldness.

What aggravates dandruff?

Dandruff seems to get worse by emotional stress, diet, hygiene like rarely washing or shampooing the hair, allergies and various cosmetics applied to the skin.

What about very severe dandruff?

In some people the dandruff is severe, persistent, and itchy. Two causes of this are seborrheic dermatitis and psoriasis. There is usually an evidence of these skin disorders on other parts of the body.

What is the treatment?

There are many shampoos which are suitable for the treatment of dandruff but no particular shampoo suits everyone.

Mild cases

Suitable shampoos are zinc pyrithione like “head and shoulders”, selenium sulfide like “Selsun”. The shampoo is massaged into the scalp skin, left for five minutes and then rinsed thoroughly. Use it 2 to 3 times a week.

Stubborn scaling and itching

This is often due to seborrheic dermatitis and psoriasis. Coal tar shampoos are effective for psoriasis. Antifungal shampoo like Nizoral is suitable for seborrheic dermatitis. Leave Nizoral shampoo for 4-5 minutes and then rinse it off. If itching is a problem, cortisone scalp lotion such as Betnovate scalp lotion can be used.

Dr Sadaf Sarwar

MBBS (King Edward Medical College),

Fellow Royal Australian College of General Practitioner (FRACGP, Australia)

Ex-Assistant Professor, The University of Lahore, Pakistan

Consultant General and Family Physician


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