Written by Dr. Paul M. Graham
As the summer wanes and the humidity begins to decrease, more and more people will suffer from dandruff. Dandruff is a very common skin condition that affects approximately 2-5% of the population. One study demonstrated that approximately 50 million people suffer from dandruff with over $300 million dollars spent on various dandruff treatment products annually. Despite the prevalence of this disease, many people elect not to seek help for this treatable skin disease.
Known also as seborrheic dermatitis, this disease tends to be chronic and frustrating. It is a superficial, inflammatory disorder of the skin’s surface that tends to occur on the scalp, eyebrows, eyelids, facial folds, ears, chest, underarms, under the breast, buttocks, and groin. Clinically, it appears as dry scaly or flaky skin on a red background. Additionally, itching tends to be a very common association and is often moderate to severe in some individuals.
The etiology is complex but is proposed to be due to the presence of a yeast called Pityrosporum ovale. The severity often depends on the density of the yeast on the skin as evidenced by improvement often seen with topical antifungals/anti-yeast medications.
Dandruff is an extremely frustrating problem and often plagues affected individuals psychologically due to the appearance of white flakes on dark clothing. Many people feel embarrassed and often avoid certain social situations secondary to this treatable condition. Fortunately, treatment is available and often very simple with effective results.
The most common medications used to treat this condition include topical steroids and topical antifungals agents. Topical steroids often have a rapid response and come in creams, gels, foam, solution, and sprays. Despite the swift onset of action, topical steroids do have side effects including skin thinning, blood vessel formation, and stretch marks with prolonged or inappropriate use. For the treatment of scalp dandruff, topical steroid solution, foam, or ointment is often used in combination with a topical antifungal cream, lotion, or shampoo. This regimen is quite effective and may be used with varying application regimens depending on the severity and location.
Some common over-the-counter (OTC) treatment options that have been shown to be effective in treating seborrheic dermatitis include:
Antifungal shampoos
- Selenium sulfide (Selsun Blue)
- Zinc pyrithione (Head and Shoulders)
- Ketoconazole (Nizoral)
- Tar (T/Gel)
Topical Corticosteroids
Topical Antifungal creams/lotions/sprays
It is vital to see a dermatologist if you experience minimal to no improvement in the severity of your dandruff after trying these OTC products as stronger regimens may be required. A thorough skin evaluation is imperative as this skin condition can mimic other potentially dangerous skin diseases that must be treated. If you or someone you know suffers from this disorder, please make it a priority to schedule an appointment with your dermatologist today!
Make sure to check out our previous article on Dandruff entitled: Dandruff: An Unfavorable Pandemic.
References:
- James, W. D., Elston, D. M., Berger, T. G., & Andrews, G. C. (2011). Andrews’ Diseases of the skin: Clinical dermatology. London: Saunders/ Elsevier.
- Manuel, F., & Ranganathan, S. (2011). A New Postulate on Two Stages of Dandruff: A Clinical Perspective. International Journal of Trichology, 3(1), 3–6. http://doi.org/10.4103/0974-7753.82117
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