Do you suffer from dry or oily dandruff? Your scalp itches? Various causes can be responsible for dandruff. Which triggers are possible and how you can effectively combat dandruff with the help of a dermatologist, anti-dandruff shampoo and home remedies.
Dandruff is either an independent clinical picture or occurs in connection with various diseases. Itching, burning, reddening of the skin or a sensitive scalp are typical symptoms. It can also happen that the roots of the hair hurt and touch is felt as uncomfortable.
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Dry or greasy dandruff?
A distinction is made between dry or oily dandruff, asbestos lichen and dandruff that occur as a result of a skin disease such as seborrheic dermatitis (also called seborrheic eczema) and psoriasis (psoriasis). With asbestos lichen, large scales of several centimeters in size are formed, which are distributed over the head like bathing caps.
There are five different scalp types, which allow conclusions to be drawn about the type of dandruff:
Normal scalp: The skin renews itself in 28 days, horn cells detach as individual cells. The scalp is normal.
Dry scalp: The skin renews itself in 28 days, horn cells detach in small groups of ten to 25 cells. The scalp is dry and low in fat (sebostatic), which means that it produces less sebum than usual and can store less moisture – for example in the case of allergies or in old age.
Seborrheic dermatitis (seborrheic eczema): The skin renews itself in seven to 21 days, horn cells detach in conglomerates of 100 to 1,000 cells. The scalp is greasy and moist (seborrheic), it produces an excessive amount of sebum and stores a lot of moisture through increased sweat production. It is also inflamed and red. The seborrheic eczema is probably caused by Malassezia yeast. These are microorganisms that belong to the normal skin flora and above all colonize the areas of the human body that are rich in sebaceous glands, which also include the scalp and facial skin. It is not yet scientifically clear whether malassezia yeasts colonize the skin in seborrheic eczema, whether the germs produce more toxins or whether the immune system reacts in an unusual way to the microorganisms and thus causes the inflammation.
Dandruff: The skin renews itself in seven to 21 days, horn cells detach in conglomerates of 100 to 1,000 cells. The scalp is oily and moist (seborrheic). However, unlike seborrheic dermatitis, it is not inflamed. Malassezia yeasts are also considered to be the cause here, although they have fewer effects on the disease than in seborrheic eczema. Dandruff is therefore often seen as a "minimal variant" of seborrheic eczema.
Scalp psoriasis (scalp psoriasis): With this form of psoriasis, the skin renews itself in less than seven days, horn cells detach in conglomerates of more than 1,000 cells. The scalp in psoriasis has inflamed, reddened psoriasis foci, which often extend an inch beyond the hairline.
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Dandruff: causes of the emergence
Increased formation of dandruff always indicates that the protective, slightly acidic environment of the scalp – the so-called pH value – is disturbed: greasy dandruff is formed when the scalp produces too much sebum, and then rejected skin cells stick together.
Disease-related dandruff occurs because parts of the horny layer of the skin, the so-called epidermis, are rejected more and more. The cause is an over-hasty growth of the horny cells that are in this layer, which affects the structure of the horny layer. The skin needs fewer days than usual to renew it. The rapidly growing horn cells fuse together to form larger conglomerates and are then pushed off the scalp as dandruff.
The accelerated growth of the horny cells is triggered by localized inflammation of the scalp. These can be triggered by various stimuli:
Physico-chemical stimuli, for example intense heat when blow-drying your hair, aggressive shampoos, hair sprays and hair fixatives
Colonization with pathogens, increased sebum production in the skin and a changed composition of the sebum
Mental and physical stress
Sun exposure and sweating
Hormone changes
wrong diet
Diagnosis: With dandruff to the dermatologist
The dermatologist or dermatologist can usually tell in a detailed discussion with the patient (anamnesis) and the subsequent physical examination whether it is simple scaling or an underlying skin disease. In his anamnesis, he asks what symptoms are present, when they first occurred, what previous illnesses existed and which illnesses, including skin diseases, occurred in the family.
During the physical examination, the dermatologist examines not only the scalp itself, but also other regions of the body that, if it is a skin disease such as psoriasis or seborrheic eczema, could be affected.
The nature of the dandruff (e.g. size, dryness, color) and additional symptoms such as reddening of the skin or itching in most cases already guide him to the correct diagnosis.
As a rule, he can easily distinguish whether the white deposits on the hair are actually dandruff or so-called nits, such as those found in head lice. While the nits stick to the hair, the dry scales in particular often detach easily from the hair and trickle down onto the shoulders.
The patient's age also plays a role in assessing dandruff. For example, the appearance of seborrheic eczema in infants and toddlers differs significantly from that of adults.
Dandruff on the scalp: identify the fungus
In order to examine the scales for yeasts and fungi and thus to recognize infectious diseases such as tinea capitis, the doctor can carry out a mycological examination. It is rarely necessary to take a tissue sample from the skin (biopsy) to rule out psoriasis.
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Fighting dandruff: the right treatment
The most effective way to fight dandruff depends on what the cause is. Even if it is just simple dandruff that is not associated with a skin disease such as seborrheic eczema or psoriasis, treatment is worthwhile because many sufferers experience it as a cosmetic impairment. Anti-dandruff shampoos can help in many cases.
Get rid of dandruff with anti-dandruff shampoo
Most dandruff shampoos contain active ingredients that fight fungi and bacteria and inhibit cell division. In this way, the annoying itching in particular can be combated in a targeted manner. Basically, it is recommended to use dandruff shampoos as a cure for about four weeks. If there is no success after this time, it is advisable to ask a doctor for advice. Further drug therapy may be indicated.
There are two types of anti-dandruff shampoos:
Anti-dandruff shampoosthat inhibit microorganisms: Shampoos with antimicrobial agents have proven to be most effective against simple dandruff and dandruff caused by seborrheic eczema. They inhibit the Malassezia yeast and thus counteract the formation of dandruff. The most effective anti-dandruff shampoos contain selenium disulfide, imidazole derivatives (ketoconazole, econazole, miconazole, bifonazole), undecenoic acid derivatives, ciclopiroxolamine or pyrimidine derivatives (zinc pyrithione and piroctone olamine).
Anti-dandruff shampoos that prevent horn formation: Especially at the beginning of treatment, shampoos with active ingredients can be used that slow down the formation of the horny cells and limit their clumping into conglomerates. Examples of such active ingredients are ammonium bituminosulfonate (light sulfonated shale oil as a replacement for the coal tar used in the past, which is now banned in cosmetic shampoos), salicylic acid and colloidal sulfur. For long-term treatment of dandruff, shampoos with active ingredients of this type are usually not sufficient.
The care substances contained in the anti-dandruff shampoos also play an important role. They can give the hair shine, smoothness and volume, simplify the use of the shampoos and improve their tolerance. These are important prerequisites for the shampoos to be used regularly and regularly by those affected – and only then can they be fully effective.
Treatment of scalp psoriasis (scalp psoriasis)
Treating scalp psoriasis is not just about curbing dandruff, but also curing the inflammatory skin changes associated with the disease. Shampoos containing corticosteroids alone or in combination with vitamin D analogues (such as calcipotriol) (clobetasol shampoos) are therefore used. In addition, anti-dandruff shampoos with antimicrobial agents or agents that inhibit horn formation can be used. Read more about therapy for psoriasis here.
Home remedies for dandruff
Nettle hair water: If the head is itchy, it can Nettle hair water can be very beneficial. It relieves the itching and loosens the dandruff. Inside, nettle tea or juice and metabolic teas made from dandelion and horsetail help.
Anti-dandruff oil: Nettle is also part of an anti-dandruff oil. For this, 100 grams of fresh nettles are squeezed out and the juice is boiled with 200 milliliters of water for ten minutes. With 50 grams of soapwort roots (available in the pharmacy), the mixture is boiled for another ten minutes and then strained. The brew is mixed with milliliters of castor oil. The oil is massaged into your scalp in the evening.
Plant tincture: Washing your hair with a special plant tincture can also alleviate dandruff: Have a mixture of five parts of lupine seeds, three parts of female hair leaves and three parts of willow bark mixed in a pharmacy. Boil 110 grams of this mixture with a liter of water for ten minutes.
Chestnut waterr: 60 grams of chestnut leaves are placed in a liter of water and stripped after 15 minutes. Rub the scalp regularly with this chestnut water.
Tea tree oil: Tea tree oil also kills fungi and promotes scalp circulation. However, one should be especially careful with applications with pure tea tree oil, it can trigger allergies.
Prevent dandruff
Proper hair care can help reduce or prevent dandruff: after washing, let the hair air dry better than blow-dry it. If blow drying is necessary for the hairstyle or out of a hurry in the morning, then keep a sufficient distance from the scalp. In addition, there should be regular air to the scalp! The permanent wearing of headgear (baseball cap) can also promote dandruff.
A healthy, balanced diet, sufficient and regular exercise in the fresh air and a stable mental balance strengthen the whole body and thus prevent the formation of dandruff in the long term.
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