Introduction
The majority of healthy individuals shed up to 100 hair stands each day. New strands develop to replace the ones you lose as part of the cycle of hair growth.1 Alopecia is a condition in which you begin to lose more hair, and it either doesn’t grow back, or very less hair grows back. There are various types of hair loss, and it can affect both children and adults of any gender. You could lose hair only on your head or all over your body. Hair loss can occur suddenly or gradually over many years and can be either transient or permanent, depending on the underlying cause.
Causes of dandruff-related hair loss
Dandruff is a relatively widespread issue.2 An individual with dandruff may experience symptoms like hair loss, especially if the dandruff is severe. Dandruff alone doesn’t cause hair loss. Instead, the cause of dandruff is what leads to the issue. However, severe dandruff can harm the scalp or hair follicles, thus leading to hair thinning or hair fall. To ensure that the issue is not anything else, anyone who feels that dandruff is causing their hair loss should visit a dermatologist.
The term ‘dandruff’ refers to the flakes of dry, itchy skin that appear on the scalp. It is a symptom rather than a definitive diagnosis. Dandruff can be brought on by many things, including dry skin, a poor diet, stress, and various shampoos or hair treatments.2,3
Recurrent inflammation in their follicles can harm and scar tissue, impeding or stopping hair growth.4,6 This may result in thinning or weak hair. This kind of hair loss may become worse if you brush roughly or scratch your scalp.
Dandruff and hair loss can both be brought on by the following conditions:
- Fungal infection
- Scalp Psoriasis
- Folliculitis Decalvans
- Lichen Planopilaris
- Seborrheic Dermatitis
Dandruff and hair loss may not be related in some cases.6 Some people may have dandruff, which could be brought on by dry skin, and a disorder that results in hair loss, like:
- Telogen effluvium: a kind of hair loss brought on by infection, injury, or stress
- Male pattern baldness: a hormonal type of hair loss that both men and women can develop
- An autoimmune disorder like alopecia areata
- Scalp inflammation or scarring
- Scalp maladies
Signs of hair loss due to dandruff
It is important to examine your scalp to understand the underlying issues which could be causing the development of dandruff, like:
- Dry skin: Dry skin causes small flakes, which typically don't have redness or inflammation
- Seborrheic dermatitis: This illness results in a rash that frequently appears red, scaly, and oily. Skin flakes that develop might be either white or yellow.
- Malassezia: In most people’s scalps, a fungus called Malassezia can be present. But occasionally, it can itch your scalp and encourage the development of extra skin cells. Dandruff may result from these skin cells dying.
- Contact dermatitis: Red, flaky skin can result from sensitivity to specific substances in shampoo or hair colour that you use on your hair or scalp
Prevention tips
The goal of preventing hair loss brought on by dandruff is to minimise itching.5,8 By doing this, you will feel less the impulse to scratch and shield your hair follicles from more harm.
- Diagnosis: Dandruff can be brought on by a variety of factors, including the way you wash your hair and underlying skin issues. Make an appointment with your doctor or dermatologist if you are unsure of what's causing your dandruff.
- Try using a medicated shampoo made to treat dandruff if you haven’t already. Some of these medications are listed below. Search for shampoos with these types of components:
- Pyrinthione zinc
- Salicylic acid
- Ketoconazole
- Selenium sulfide
- Whatever the root of your dandruff, it’s critical to moisturise your scalp using conditioner. When using medicated shampoos, especially ones that include salicylic acid, this is very crucial. When used frequently, these can lead to drying of the skin of the scalp.
- Avoid irritating hair products: Ingredients that might irritate delicate skin are frequently included in hair colour and other hair products. Contact dermatitis may result from this. Contact dermatitis on your scalp is commonly brought on by preservatives and scents.
- Stress management- Although stress won’t directly create dandruff, it can, over time, compromise your immune system. As a result, your scalp may become more vulnerable to the malassezia fungus that grows naturally. Control your stress by engaging in relaxing activities like yoga or meditation. Even a short block walk or some regulated breathing for a minute or two can be beneficial.
Treatment options
Various treatment options are as follows.
Anti-fungal shampoos:
- Pyrithione zinc shampoo
- Tar-based shampoo
- Shampoo containing salicylic acid
- Selenium sulfide shampoo
- Ketoconazole shampoo
- Fluocinolone shampoo
Topical corticosteroids:
Topical corticosteroids are steroid medications used topically to soothe and calm irritated skin. Some of the corticosteroids are:
- Clobetasone
- Hydrocortisone
- Desonide
- Mometasone furoate
Essential oils:
Many essential oils can be used to help treat dandruff, according to some studies, including:9
- Bergamot (Citrus bergamia)
- Garlic (Allium sativum L.)
- Tea tree (Melaleuca alternifolia)
- Thyme (Thymus vulgaris L.)
- Lemongrass (Cymbopogon flexuosus)
Home remedies:
- Coconut oil, known for its many health advantages, is also employed as a home cure for dandruff. It might function by hydrating the skin more effectively and avoiding dryness, which can exacerbate dandruff.
- Aloe vera is a type of succulent plant that is frequently used in lotion, cosmetics, and skin ointment; its antibacterial and antifungal qualities may also guard against dandruff.
- Apple cider vinegar is frequently used as a home treatment for dandruff and has been linked to several health advantages. That’s because it’s thought that the acidity of the vinegar may aid in promoting the shedding of dead skin cells from your scalp. To combat dandruff, apple cider vinegar is also supposed to balance the pH of your skin.
- Probiotics are healthy bacteria that may boost immune response and aid in the body’s defence against fungi that cause dandruff.
- A simple and easily accessible treatment for dandruff is baking soda. It is thought to function as a mild exfoliator to remove dead skin cells and lessen scaling and itching. Moreover, it possesses antifungal qualities that might help with dandruff treatment.
When do I see a doctor?
Even though there are various home remedies for dandruff, in some instances, further care may be required. Numerous over-the-counter (OTC) medicated shampoos and scalp treatments have components that are antifungal or antibacterial to lessen dandruff.
After 2-3 weeks, if these remedies are ineffective, you might want to see a dermatologist to see whether other prescription shampoos or drugs will be helpful.7,8
Summary
Hair loss and volume loss are now rather prevalent among all age groups. While stress is thought to contribute to hair loss and greying, dandruff is also believed to be a bothersome source of this. Itchy and red skin on the scalp is highly prone to dandruff. This might make people scratch their skin, damaging the hair follicles, which can occasionally be brought on by psoriasis, fungal infection, or a biotin deficiency, which can exacerbate hair loss. Most of the time, this loss is transient and reversible.
There is nothing dangerous or communicable about dandruff. Although chronic, the majority of instances may be handled with over-the-counter anti-dandruff shampoos. Anti-inflammatory chemicals are used in some shampoos to reduce allergic reactions. While some cleansers work to minimise fungal infections by reducing yeast on the scalp, others offer chemicals that reduce flaking by promoting cell turnover or reducing oil production. Consider speaking with your doctor if anti-dandruff shampoos aren’t providing you with the expected result. You should take care of your scalp since healthy hair depends on a healthy scalp.
References
- Trüeb RM, Henry JP, Davis MG, Schwartz JR. Scalp condition impacts hair growth and retention via oxidative stress. Int J Trichology [Internet]. 2018 [cited 2023 Nov 20];10(6):262–70. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369642/
- Ranganathan S, Mukhopadhyay T. Dandruff: the most commercially exploited skin disease. Indian J Dermatol [Internet]. 2010 [cited 2023 Nov 20];55(2):130–4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887514/
- Borda LJ, Wikramanayake TC. Seborrheic dermatitis and dandruff: a comprehensive review. J Clin Investig Dermatol [Internet]. 2015 Dec [cited 2023 Nov 20];3(2):10.13188/2373-1044.1000019. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852869/
- Grimalt R. A practical guide to scalp disorders. Journal of Investigative Dermatology Symposium Proceedings [Internet]. 2007 Dec [cited 2023 Nov 20];12(2):10–4. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0022202X15526572
- Piraccini BM, Brandi N, Alessandrini A, Bruni F, Starace M. Efficacious and safe management of thick scales, redness and flaky scalp condition using a specific shampoo containing urea, glycolic acid, salicylic acid, icthyol pale and laureth 9. Cogent Medicine [Internet]. 2018 Jan 1 [cited 2023 Nov 20];5(1):1475095. Available from: https://www.tandfonline.com/doi/full/10.1080/2331205X.2018.1475095
- Xu Z, Wang Z, Yuan C, Liu X, Yang F, Wang T, et al. Dandruff is associated with the conjoined interactions between host and microorganisms. Sci Rep [Internet]. 2016 May 12 [cited 2023 Nov 20];6(1):24877. Available from: https://www.nature.com/articles/srep24877
- Limbu SL, Purba TS, Harries M, Wikramanayake TC, Miteva M, Bhogal RK, et al. A folliculocentric perspective of dandruff pathogenesis: Could a troublesome condition be caused by changes to a natural secretory mechanism? BioEssays [Internet]. 2021 Oct [cited 2023 Nov 20];43(10):2100005. Available from: https://onlinelibrary.wiley.com/doi/10.1002/bies.202100005
- Poojary PV, Sarkar S, Poojary AA, Mallya P, Selvaraj R, Koteshwara A, et al. Novel anti‐dandruff shampoo incorporated with ketoconazole‐coated zinc oxide nanoparticles using green tea extract. J of Cosmetic Dermatology [Internet]. 2023 Nov [cited 2023 Nov 20];jocd.16027. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jocd.16027
- Jain S, Arora P, Nainwal LM. Essential oils as potential source of anti-dandruff agents: a review. CCHTS [Internet]. 2022 Aug [cited 2023 Nov 20];25(9):1411–26. Available from: https://www.eurekaselect.com/194681/article