Dandruff

Dandruff in hair is the equivalent of scales on the skin's surface. It is a very common condition, since 50% of the population gets dandruff in hair(1). It appears as clusters of dead cells, or scales, that are whitish in colour and stick more or less to the hair. It is a mild, harmless, but particularly visible condition that can be difficult to live with on a daily basis.

This thematic dossier aims to answer any questions you might have about dandruff: What is it? What causes it? How can I treat it? What should I do? What daily measures can I take?

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Summary

What is dandruff?

Dandruff is caused by accelerated cell renewal. The cells of the epidermis, which is the outermost layer of the scalp, multiply too quickly allowing no time for the dead cells to be progressively eliminated. They clump together on the scalp's surface and form what we call dandruff.

Dandruff can accumulate on any area of the body where there is hair. We most often find dandruff in the hair on the head, but it can also be found in beards and eyebrows.

What causes dandruff?

There are multiple causes of dandruff and triggering factors. Three quite distinct phenomena have been identified, allowing us to understand where dandruff comes from.

  • An individual and particular scalp sensitivity favouring the development of dandruff in some people.
  • A dysfunction in the secretion of sebum by sebaceous glands: either too much or too little.
  • The development of yeasts of the genus Malassezia, which live naturally on the skin surface, but which under certain conditions, particularly in the presence of sebum, can proliferate causing inflammation and accelerated cell renewal.

Beyond the mechanisms at the origin of its development, there are numerous factors that can trigger and maintain a flare-up phase of dandruff, in particular stress, an unhealthy lifestyle, use of unsuitable products, stress, wearing a helmet or cap, etc. There are so many factors, and they cannot always be easily controlled, which may explain why dandruff returns despite very effective treatments.

Different types of dandruff

There are many solutions available in pharmacies for treating dandruff. To be able to establish the most suitable treatment, it is important to understand what dandruff i s and to identify the type of dandruff on the scalp. There are two types of hair dandruff: oily dandruff and dry dandruff.

Dry dandruff

Dry dandruff develops on a dry scalp. When the scalp is dry, it becomes dehydrated and irritated. The scalp can then react, resulting in itching, redness and desquamation, which in turn can lead to dandruff. Dry dandruff is easy to recognise. It is small in size, white, volatile and can be seen on clothes in the form of flakes.

Oily dandruff

Oily dandruff develops on an oily scalp. The excess surface sebum promotes the development of Malassezia yeasts, which can induce inflammation and accelerate cell renewal.
Oily dandruff is larger, usually itchy, sticks to the hair and accumulates in patches. It is less commonly seen on clothing than dry dandruff.

When there is a lot of oily dandruff and intense itching, it becomes a severe dandruff condition, also called dermatitis or seborrheic dermatitis of the scalp.
Seborrheic dermatitis is a condition that affects on average 3% of the population and affects mostly the face(1). It is characterised by scales that are yellower in colour (due to the excess sebum) and red patches. It is not a serious skin condition, but it is chronic, and a dermatologist must be consulted to begin appropriate treatment.

How can I eliminate dandruff?

Pharmacies stock a whole arsenal of hair care products and shampoos for eliminating dandruff. Treatments are very effective and help to fight dandruff. However, no treatment to date has been able to permanently cure dandruff. That is why it can return regularly, in flare-up phases. Treatment shampoos can be used in flare-up phases, as well as afterwards in the maintenance phase to prolong the effects over time and avoid recurrence. This requires integrating the treatment shampoo as part of a regular hair care routine during the maintenance phase.  

Anti-dandruff shampoo

Hair dandruff is treated traditionally using a treatment shampoo.
The type of shampoo chosen will depend on the type of dandruff.

  • Shampoo formulated for oily dandruff will act on one or more of the causes of dandruff, with an antifungal active ingredient to combat yeast proliferation, a keratolytic active ingredient (acts by loosening and eliminating the dead cells) to eliminate the dandruff, generally speaking an anti-inflammatory active ingredient to limit redness and itching, and an active ingredient for absorbing the excess surface sebum.
  • Shampoo formulated for dry dandruff will usually have a keratolytic action, a soothing action, and sometimes an antifungal action to reduce the amount of yeast on the surface, while providing the necessary hydration for a dry and irritated scalp.

The shampoos are used in two steps.

  • First in an intensive treatment phase, the aim being to treat and reduce the dandruff. It will be used several times a week.
  • This is followed by a maintenance phase, the aim of which is to prevent dandruff from returning too soon. It is used less frequently and alternated with a mild shampoo.

In case of doubt, do not hesitate to ask your doctor or pharmacist for advice, they can help you choose the most suitable treatment.

Living daily with dandruff

Living with dandruff on a daily basis can seriously affect quality of life. It is sometimes thought that dandruff is an indication of poor hygiene, but of course there is no connection.

It can become a constant concern, affecting choice of clothing, social interaction and self-esteem, which is why it is important to deal with it.

Do not hesitate to talk to the health professionals around you, they can tell you what to do if you have dandruff. There are lots of treatments and everyday tips to help you manage your dandruff.

(1) https://dermato-info.fr/, French Society of Dermatology.

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