Dandruff is produced due to excessive shedding of skin on the scalp that typically results with white flakes in the hair and on the top of the shoulders. Dandruff is most often associated with seborrheic dermatitis of the scalp. The cause of seborrheic dermatitis is poorly understood but yeast organisms that are part of the skins normal micro biome appear to play an important role in development of the condition. In addition to dandruff, seborrheic dermatitis often presents with scaly plaques that are reddish in colour.
Dandruff typically responds well to treatment but flare-ups often occur. Treatment options include the following:
1. Shampoos - e.g. Coal-tar based products, selenium, ketoconazole. Normally these are used twice weekly depending on symptom severity. Products will usually need to be used for several weeks before significant symptomatic improvement is seen.
2. Creams - Steroid based creams should be considered if dermatitis is causing significant inflammation or itching. Anti-fungal creams are often effective at treating dandruff by reducing the amount of yeast organisms on the skin. These creams are usually applied twice a day. Steroid-based creams should be considered for treatment of flare-ups but should not be used on a daily basis for prevention of symptoms as they can have a thinning effect on the skin.