Dandruff

Dandruff is a common, chronic scalp disorder characterized by the shedding of small, white or grayish flakes of dead skin from the scalp. It is a non-contagious and generally benign condition, though it may be associated with pruritus (itching) and social discomfort.

Etiology and Pathophysiology:
Dandruff is considered a mild form of seborrheic dermatitis, a chronic inflammatory skin condition that primarily affects areas rich in sebaceous glands, including the scalp. The exact cause is multifactorial and may involve increased sebaceous gland activity, colonization by Malassezia species (lipophilic yeasts), and individual susceptibility.

Clinical Features:

• Flaking of dry or oily white scales from the scalp

• Itching or scalp irritation (in some cases)

• Recurrent or persistent course

• Absence of erythema or inflammation in mild cases

Management:
Mild cases may respond to regular cleansing with a gentle, non-medicated shampoo to reduce oil and skin cell buildup. Persistent or moderate-to-severe cases often require medicated shampoos containing agents such as:

• Zinc pyrithione

• Selenium sulfide

• Ketoconazole

• Salicylic acid

• Coal tar

These treatments help reduce Malassezia proliferation, normalize keratinocyte turnover, and alleviate symptoms.

Prognosis:
Dandruff is a chronic condition with no definitive cure. Although symptoms can typically be controlled with appropriate treatment, recurrences are common. Long-term management may be necessary to maintain symptom remission.