Dandruff occurs, essentially, when small...

Dandruff occurs, essentially, when small bits of dry skin are shed from the scalp. You might spy these flakes in your hair or on your shoulders. Dandruff may make your scalp itchy, too. It’s a common problem, but it isn’t as simple as it seems. Dandruff is actually quite tricky to define because it overlaps with seborrheic dermatitis (a chronic form of eczema) and other skin conditions that lead to a scaly scalp. Here’s what you need to know. Signs and Symptoms of Dandruff The big tip-off that an individual may have dandruff are the telltale patches of white flakes on the scalp, made up of dead skin, that come loose in your hair. According to the Merck Manual, other signs include:right up arrow At times, the scalp can be itchy Greasy or dry scales on the scalp Yellowish to reddish scaly raised bumps along the hairline (in severe cases) Causes and Risk Factors of Dandruff Dandruff can happen for a number of reasons: Seborrheic Dermatitis If you have a particularly bad case of dandruff, it’s likely a mild case of seborrheic dermatitis (SD), according to the American Osteopathic College of Dermatology.right up arrow SD is a chronic form of eczema that impacts areas of the body that secrete the most sebum, or oil, notes the National Eczema Association.right up arrow People with oily skin are often more prone to dandruff. The reason: A yeast called Malassezia globosa feeds on oils on the scalp. Some people’s bodies perceive this breakdown of oil as an irritant, so the scalp reacts by upping the speed at which skin cells renew, causing dandruff. For those without dandruff, it takes a whole month for new skin cells on the scalp to mature, die, and shed. But for those with dandruff, this process occurs in a mere two to seven days, according to a report in the Journal of Medical Chemistry.right up arrow Almost anyone can have dandruff, but certain factors can make you more susceptible, including: Shampooing Habits “For those who are already at risk for dandruff, washing infrequently can worsen the condition.” Taking extended breaks can lead to a buildup of oil that can lead to dandruff. Age - Dandruff often begins at puberty and peaks around age 20, becoming far less prevalent among folks over 50 years old. Sex Androgen hormones, such as testosterone, stimulate activity in the sebaceous glands. More oil means an increased chance of an inflammatory reaction and dandruff. Men are more frequently affected by dandruff than women. Weakened Immune System SD is more prevalent in individuals who’ve undergone an organ transplant and those with HIV or AIDS, hepatitis C, or alcoholic pancreatitis. For example, 30 percent to 83 percent of those with HIV report SD. Neurologic and Psychiatric Conditions Parkinson's disease, Alzheimer's disease, epilepsy, traumatic brain injury, and spinal cord injury are among the conditions that elevate one's risk of SD, including dandruff. Those with Parkinson's disease, for example, have an impaired autonomic nervous system that helps to control things like oil gland secretions, which can lead to an overproduction that leads to dandruff, according to the American Parkinson’s Disease Association. History of Other Skin Disorders Having had eczema, rosacea, psoriasis, or acne can trigger or worsen seborrheic dermatitis. Oily Skin If you have naturally oily skin, you’re at an elevated risk for seborrheic dermatitis.right up arrow Oiling Your Scalp “Certain oils applied to the scalp can cover the scale, but worsen the flaking and itching response.” How Is Dandruff Diagnosed? A dermatologist can usually diagnose dandruff simply by looking at your scalp. If your dandruff does not respond to treatment, your healthcare provider may opt to perform a skin biopsy. Duration of Dandruff Dandruff due to seborrheic dermatitis is a chronic condition that warrants repeated or long-term treatment. As for dandruff that arises from contact dermatitis, dry skin, or shampooing habits, changing habits can clear up flakes fairly quickly. Treatment and Medication Options for Dandruff Dandruff is often a chronic, but treatable condition. Treatment options include: Gentle Over-the-Counter Shampoo To reduce oil and skin cell buildup, wash hair daily with a gentle shampoo, lightly massaging the scalp to loosen flakes. OTC Dandruff Shampoo If gentle shampoo is not helping, try an over-the-counter (OTC) dandruff shampoo. For mild to moderate cases, look for dandruff shampoos that contain the following active ingredients: Selenium Sulfide This antifungal slows the death of skin cells. This active ingredient can be found in Head & amp; Shoulders Intensive, and Selsun Blue, among other shampoos Pyrithione Zinc This antibacterial and antifungal combo is in Head & amp; Shoulders, DermaZinc, and Jason Salicylic Acid rely on salicylic acid to slough away flakes and promote healthier skin. Ketoconazole is a treatment that contains the antifungal ketoconazole; it can be found both OTC and can be formulated as a shampoo, gel, or mousse Tar - Tar-based shampoos act as both an antibiotic and antifungal. But if you have blonde, white, or grey hair, a tar shampoo can cause discoloration. This treatment can also make the scalp extra-sensitive to sunlight. Prescription Dandruff Treatment If regular and proper use of OTC shampoo, for several weeks, does not alleviate dandruff, ask your dermatologist if you’d benefit from a prescription-strength antifungal shampoo like Loprox or Nizoral, or a topical corticosteroid lotion, such as Capex or Synalar (fluocinolone topical), Luxiq (betamethasone topical), or Clobex (clobetasol topical) An alternative to corticosteroids for dandruff treatment is a class of drugs called calcineurin inhibitors. These, like Protopic (tacrolimus topical) and Elidel (pimecrolimus topical), work by helping to suppress the immune response Alternative and Complementary Therapies Tea Tree Oil Shampoos or topicals that contain 5 percent tea tree oil (an antiseptic, antibiotic, and antifungal) appear to be a safe and effective treatment for dandruff, Healthy Fats Increasing your intake of omega-3 fatty acids, like those found in salmon, tuna, and mackerel, help regulate oil production on the skin Get some sun. Brief bouts of sunshine can help reduce yeast production on the scalp.right up arrow But if you are also using a tar-based dandruff treatment, avoid direct sun exposure, as your scalp is especially sensitive to sunlight. Cut back on hair products. Styling gels, sprays, pomades, and more can build up on the hair and scalp, increasing oiliness and dandruff