Causes of dandruff, which diseases are related to it?

There are many causes of dandruff, but it's worth noting that this scalp flaking is not a contagious condition. It's not a serious condition either, although it is quite common, and if you have it, you've probably been embarrassed by it at some point ⁽¹⁾. But don't worry, you're not condemned to endure it for the rest of your life. Here we clarify your doubts and give you tips to improve it.

Main causes of dandruff

Often no apparent reason can be found or, on the contrary, more than one factor is involved. However, the most common causes are:

• Seborrhoeic dermatitis.
• Allergic reactions.
• Psoriasis.
• Eczema.

Among these, an over-reaction to the presence of Malassezia, a yeast found on the scalp, stands out as one of the triggers of seborrheic dermatitis and thus dandruff ⁽²⁾.

Similarly, certain hair and skin care products can irritate and cause dandruff. If you think this is happening to you, you should stop using them and try substituting a mild, less chemical-based product instead ⁽²⁾.

Factors that increase the risk of developing dandruff

In addition to the possible causes of dandruff, there are environmental, nutritional and hygienic factors that can increase the likelihood of dandruff. For example ^(1,3):

• Excessive sweating and secretion of the sebaceous (sebum-producing) glands.
• Not shampooing enough, so that skin cells build up and form flakes.
• Too much brushing of the hair on the head, as this creates too much friction with the sensitive skin of the scalp.
• Too much exposure to sunlight.
• Excessive pressure on the scalp from wearing tight hats.
• Exposure to dust or dirt.
• Age: dandruff usually starts in early adulthood and continues into middle age.
• Being male: dandruff is more common in men than in women.
• Extreme winter temperatures and possibly a combination of cold weather and overheated rooms.
• Stress.
• Hormonal factors such as the menopause.

There are certain conditions or diseases that can also be causes of dandruff, such as ⁽²⁾:

• HIV.
• Acne.
• Parkinson's disease.
• Epilepsy.
• Alcohol dependence.
• Depression.
• Eating disorders.
• History of stroke or heart attack.
• Weakened immune system.
• Fatigue.
• Obesity.

Characteristic signs and symptoms

The main manifestations of dandruff occur, of course, on the scalp; these can be ⁽¹⁾:

• Skin flaking on hair, eyebrows, beard or moustache and shoulders.
• Itching.
• Scaly and crusty scalp.

However, depending on the origin of the dandruff, other signs may appear on the body, such as ⁽⁴⁾:

• Seborrheic dermatitis: red patches on the face and other areas of the body characterized by intense itching.
• Tinea capitis: red or silvery rash on the scalp, sometimes with patchy hair loss.
• Eczema: dry skin, red, scaly and very itchy skin on other parts of the body.
• Contact dermatitis: red, irritated skin, blistering and cracked skin following the use of hair dyes, sprays, gels or mousses.
• Psoriasis: patches of red skin, with silvery scales and crusts, which are painful.
• Cradle cap: one of the causes of dandruff in babies. It presents with greasy, yellowish patches on the scalp, eyebrows and nappy area.

Controlling the causes of dandruff during menopause

To prevent the appearance of dandruff, it is necessary to examine what causes it. For this reason, we recommend that you see a dermatologist before starting any treatment and follow their instructions. However, some general recommendations are ^(2,4,5):

• Wash daily with a mild cleansing shampoo and gently massage the scalp.
• Reduce the amount of time spent in the sun.
• Use fewer hair products and prefer shampoos containing one of these ingredients: zinc pyrithione, salicylic acid, selenium sulphide, ketoconazole, coal tar.
• Manage stress.
• Avoid products containing detergents and harsh chemical ingredients.
• Brush hair often.
• Keep moisturised skin.
• Ensure adequate intake of zinc, omega 6 and 3, and B vitamins. Especially B7, so that your hair enjoys the biotin benefits.

The causes of dandruff can affect you at any age, but you don't have to live with them. Take these recommendations into account and see your dermatologist regularly. We invite you to enjoy every stage of your life, and don't let a little dandruff hold you back!

Bibliographical references

1. Mayo Clinic. Dandruff - Symptoms and causes . 2021 . Available from: https://www.mayoclinic.org/diseases-conditions/dandruff/symptoms-causes/syc-20353850

2. Brazier Y. How to treat dandruff . Medical News Today; 2023 . Available from: https://www.medicalnewstoday.com/articles/152844

3. Marcin A. What Causes Dandruff and How to Remove It . Healthline; 2021 . Available from: https://www.healthline.com/health/dandruff-itchy-scalp

4. NHS. Dandruff . 2022 . Available from: https://www.nhs.uk/conditions/dandruff

5. Pevzner H. What Is Dandruff? Symptoms, Causes, Diagnosis, Treatment, and Prevention . Everyday Health; 2022 . Available from: https://www.everydayhealth.com/dandruff/guide/