What is Dandruff?

Dandruff

It’s itchy.  It’s flaky. It’s white all over your black clothes.  You’re showering and washing your hair, but you worry that others are judging your hygiene based on the desert sandstorm that has accumulated on your shoulders.  Trust me, I know; I’ve been there. The most common cause of dandruff is a skin condition called seborrheic dermatitis.  Seborrheic dermatitis is a hypersensitivity to yeast that are part of your normal skin flora (translation: on everyone’s skin).  The imbalance of flora combined with inflammation contribute to increased cell turnover leading to flakes of dandruff. Why does it happen? There is thought to be a genetic predisposition as well as an environmental trigger such as change of season, stress, illness, or being run down. You may just notice a little flakiness coming from your scalp or it can be a bit more severe, causing the skin to turn red with overlying greasiness and scaliness.  Seborrheic dermatitis may even affect other parts of your skin: some people get a rash around their eyebrows, nose folds, behind the ears, chest, and even the groin.  

The second most common cause of dandruff is psoriasis.  Psoriasis is a chronic, inflammatory skin disorder that can affect almost anywhere on your skin; classically, it affects the scalp, lower back, arms, and legs.  It can even affect your nails and joints. There are other less common causes of scalp flaking and itching that would be best for a dermatologist or other physician to evaluate.  

Ok. I have it. Now what?

So, you realize it’s getting out of control.  It’s time to set an appointment with your dermatologist, who can help clarify the diagnosis, screen for related conditions, and send a script for prescription strength products (including medicated shampoos and topical corticosteroids).  Unfortunately, they don’t have an opening for weeks and you’re miserable with itch.  What can you do in the meantime? The good news is that there are tons of great over the counter products that can help you.  The other good news is that you don’t have to worry about distinguishing seborrheic dermatitis from psoriasis — the same shampoos tend to help both disorders; you can leave that tough job up to us dermatologists.  See related blog posts for tips on choosing and using a medicated shampoo. Lastly, make sure to increase your self care – sleep, being run down, stressed or tired can contribute to a persistent flare.