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Recently I was working with a customer that e-mailed me about having a dry itchy scalp (for the purposes of this blog I will call her Claire). There was also redness and irritation. For her this was a recent phenomenon and she felt quite embarrassed by the dry skin flakes on her scalp and the need to scratch her head constantly. After a bit of back and forward via e-mail we established a few things:

Based on the time of year and the suddenness of onset, it is likely that Claire had developed dandruff. The reason for identifying dandruff rather than other issues is firstly, the hot showers which can trigger an attack and secondly the presence of redness and irritation which along with flaking points to something more than just a dry scalp.

Dandruff is defined as the shedding of dead scalp skin cells exceed normal cell normal flaking. A small amount of flaking is common most of which is invisible to the naked eye and is washed away when we wash our hair. However, with dandruff, the skin cell turnover is unusually rapid (up to 8-10 times faster) and visible due to the cells clumping with oil before they shed. In addition, when the shedding is accompanied by redness and irritation it is more likely to be dandruff.

Triggers to an outbreak of dandruff include exposure to extreme hot and cold (hot showers in winter) but the underlying cause is the result of a combination of factors including the overgrowth of skin microorganisms known as Malassezia globsa, a fungus that is normally present on the skin surface of the scalp. Malassezia interacts with components in sebum creating and inflammatory response in the scalp of susceptible persons which results in excessive shedding of the top layer of the skin.

Extremes in temperature such as hot showers in cold weather may trigger an attack. Dandruff may also be the result of an allergic reaction to chemical hair products such as styling products, shampoos and hair oils.
 

The other common cause of redness and flaking of the scalp is seborrhoeic dermatitis, however this condition is not usually confined to the scalp alone and will commonly be occurs in the eyebrows and around the folds of the nose in addition to the scalp. This was not so for Claire and so strengthens the identification of dandruff in her case.

So to the treatment and management of dandruff. What you read next may surprise many of you…I recommended Claire go and get a commercial anti-dandruff shampoo containing either 1.5% selenium or 2% zinc. Yes the base of these products is full of synthetic ingredients but they are only used once, or twice at most and quickly break the cycle of inflammation and kill of the fungus overgrowth. In some cases with skin and scalp issues it is better to break a cycle quickly and then repair any damage and improve health to prevent reoccurrance. I think this is particularly so when the treatment is very effective and relatively harmless or short term.

In the meantime we worked to improve Claire’s diet and reduce her sugar intake, both of which are necessary to maintain a healthy scalp post-treatment. I also recommended Claire change her hair care products and she now uses natural “SLS-free” shampoo and conditioner, a gorgeous smelling hair oil which styles her hair at the same time as nourishing her scalp and a sugar-based hair spray for firmer hold when needed.

Since making these changes, dandruff hasn’t been an issue for Claire. Post dandruff treatment, which Claire used twice, flakiness and redness were no longer an issue. A slight itchiness remained for a week or so but the use of a hair oil quickly cleared that up as well. I am happy to report that Claire is very pleased.

If you have had success with the treatment of dandruff I would love to hear what worked for you as well as any comments you may have about the treatment suggested above.