Dandruff

The dry, itchy flakes are embarrassing, but they’re not contagious. However, they can be difficult to treat. Changing your hair products, adding vitamins or supplements to your diet or using natural anti-dandruff treatments can help.

Who gets dandruff?

If you keep brushing flakes off your scalp and shoulders, you’re not alone.Estimates of the number of dandruff sufferers range between 15 and 20 per cent of the population, up to 70 per cent. It’s most common in infants and again in adults, particularly men aged between 30 and 60. Dandruff often runs in families.

What causes dandruff?

Dandruff has many causes, ranging from the weather to fungus; from medical conditions to how often you shampoo your hair.

Weather

If you’ve noticed dandruff is worse in winter, blame it on the weather. Long, cold winters combined with dry, overheated houses and offices dehydrate the scalp. Wearing a hat when outside, turning down the thermostat a few degrees and using a humidifier to add moisture to the air can minimise the effects.

Medical conditions

One of the most common causes of dandruff is seborrhoeic dermatitis, a skin condition characterised by red, irritated, oily patches on the skin covered with white or yellow flaky scales. Commonly found on the scalp, it sometimes affects other areas of the body that have oil glands, such as eyebrows, sides of the nose, backs of the ears, breastbone, groin and armpits. Psoriasis and eczema can also lead to a buildup of dead skin cells on the scalp.

Another cause can be Malassezia globosa, a common yeastlike fungus that lives on the scalp. For about 50 per cent of people, it remains on the top layer of skin; for the others, it burrows into hair follicles. This causes scalp irritation, itchiness and a sped-up shedding of skin cells in the form of large flakes, possibly as an overreaction of the body’s immune system to the fungus.

Scientists aren’t sure what triggers the burrowing and subsequent reaction; a number of factors that may play a role include:

• oily scalp
• stress and fatigue
• hormonal changes
• illness or a suppressed immune system
• disorders of the nervous system, such as Parkinson’s disease
• infrequent shampooing
• a sensitivity to the malassezia fungus

Hair colouring and styling products

The same products that may make your hair look better can make your scalp worse. Sensitivities to chemicals found in many conventional hair care products and dyes can cause contact dermatitis, leading to a red, itchy, scaly scalp.

Styling products such as hairsprays, gels and mousses build up on hair and scalp, making them oilier and providing a feeding ground for malassezia. The more you use these products, and the more products you use, the more likely you’ll irritate your scalp and cause dandruff. Another scalp-damaging activity is washing hair in hot water, so try switching to lukewarm.

Natural treatments for dandruff

Many conventional over-the-counter dandruff shampoos contain harsh medications to reduce fungus or slow down the scaling process. For some people, these same ingredients can cause itching, stinging, redness or burning.

For those looking for chemical-free dandruff remedies, researchers are investigating natural treatments, including shampoos and topical gels. Many natural substances have shown promise in preliminary studies.

• Aloe vera: a 30 per cent aloe emulsion may heal and soften skin, reducing itchiness and scaliness.
• Lemongrass:  a 2 per cent shampoo can help fight the dandruff-causing fungus.
• Tea tree oil:  a 5 per cent shampoo, Australian tea tree oil with its antiseptic, antibiotic and antifungal properties, can help control dandruff. Pregnant or nursing women should avoid this product.

Other traditional natural home remedies include:

• a rinse of white vinegar, lemon or lime
• a tea made of steeped burdock, sage or thyme, cooled and used as a rinse
• a paste of fenugreek seeds or bi-carb soda and water, applied topically
• a topical treatment of olive, coconut or baby oil before shampooing
• essential oils such as rosemary, camomile, myrrh, basil, cedarwood, neem, lemon or peppermint, mixed with a carrier oil and applied topically (do a test patch first and follow the bottle’s instructions to ensure you don’t react)

Keep in mind that although traditional remedies have stood the test of time, many have yet to be proven effective in scientific studies. As with all treatments, everyone reacts differently. Experiment with various treatments until you find one that works.

Nutrition tips for a healthy scalp

A well-nourished body means a healthy scalp.

• If your diet is deficient in B vitamins and zinc, consider taking supplements.
• Get sufficient omega-3 fatty acids. Food sources include walnuts, flaxseeds, chia seeds, hemp, some dark green leafy vegetables and cold-water fish. Or take fish oil supplements.
• Stay adequately hydrated.
• Reduce the amount of processed foods, saturated fats and sugar in your diet.
• A food allergy may make symptoms worse. The most common food allergens are dairy, soy, citrus, peanuts, wheat, gluten, fish, eggs, corn and tomatoes.

When to seek help

If your dandruff isn’t clearing up or is getting worse after several weeks, or if your scalp (or other parts of your body) is swollen and inflamed, speak to your health care practitioner.

Cradle cap

Newborns or infants may develop a scaling, crusty scalp called cradle cap. According to dermatologists from St Vincent’s Hospital Melbourne, cradle cap is very common, settling in most newborn infants by the time they are two months old. Mostly found on the scalp, it can also appear on the eyelids, nose and groin area.

If it occurs in the nappy area, see a health care practitioner. It might be eczema, psoriasis or an allergic reaction, which all require different treatment.

For cradle cap, to lift and loosen the scales and crust:

1. Gently massage the baby’s scalp with fingers or a soft-bristle toothbrush or soft brush.
2. Shampoo, rinse and towel dry. Scales should wash off.
3. Brush gently after shampooing and a few more times during the day.

Note: do not use dandruff shampoo, as it can irritate a baby’s eyes and sensitive skin.