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What is Dandruff?
Dandruff is the term used to describe the simple scaling of the scalp. The top layer of skin is constantly being shed and renewed. Normally this goes unnoticed on the rest of the body, however, on the scalp the hair traps the scaling skin so that the scales become more evident.
About 50 per cent of the population suffer from dandruff. It can be treated by regular washing of the scalp with a medicated shampoo. Sometimes prescribed creams and lotions are necessary to bring it under control.
Itching
Itching of the scalp, with or without scaling is a very common problem. It may be caused by an underlying disorder of the scalp such as:
- Seborrhoeic dermatitis
- Psoriasis
- Sensitive skin
- Atopic dermatitis, or
- Common pityriasis capitis (dandruff)
Itching also commonly occurs in middle-aged people without an obvious underlying cause. And there are a number of rare skin conditions which can present as itching in the scalp.
The usual response to itching is to scratch and this will often cause scratch marks and little, crusty sores throughout the scalp. The regular use of a simple, medicated shampoo may be all it takes to relieve itching.
Seborrhoeic Dermatitis
Seborrhoeic dermatitis is the name given to a red, itchy, scaly reaction in the scalp. This is similar to dandruff except that the scale is more marked and the scalp is often inflamed (redness is often apparent).
Seborrhoeic dermatitis can be very itchy and can also affect other parts of the body including the ears, face, eyebrows, beard area and central chest. This is an extremely common condition and probably affects most people at some stage.
There are a number of reasons why it could be worse at different times including illnesses or emotional stress.
Seborrhoeic dermatitis often requires a medicated shampoo and may even require medication to be applied to the scalp to relieve the inflammation and discomfort.
Psoriasis
Psoriasis is a generalised skin problem that is relatively common affecting about 3 per cent of the population. It is inherited and there is often a family history of the condition.
Psoriasis is usually very mild and is often confined to the scalp, elbows and knees.
Whereas seborrhoeic dermatitis tends to involve almost all of the scalp, psoriasis often occurs in small localised patches of redness with quite prominent thick scaling. Psoriasis can be very itchy when it involves the scalp.
Psoriasis of the scalp will usually require the application of medication as well as the use of medicated shampoos.
For more information on Psoriasis visit our Psoriasis information page
Medicated Shampoos
Anti-dandruff Shampoos
There are many anti-dandruff shampoos available in supermarkets and over-the-counter in pharmacies. The most common contain one or more of the following active ingredients:
- Tar
- Selenium sulphide
- Zinc pyrithione/zinc omadine
- Piroctone olamine
- Ketoconazole or Miconazole
- Salicylic acidShampoos containing tar have been used for decades and can be very effective in controlling dandruff. In the past they may not have been as aesthetically acceptable in terms of scent and feel as other medicated shampoos, but a variety of newer preparations are usually well tolerated and simple to use.
Piroctone olamine is a recent addition, known as a "second generation" anti-dandruff agent.
It differs from zinc pyrithione in that it is much less toxic and consequently products containing piroctone olamine do not have to carry a "WARNING - if swallowed seek medical advice" label, so they are safer for family use.
Ketoconazole and miconazole are other recent additions and are similarly generally well tolerated. They are anti-fungal or anti-yeast agents and usually improve a variety of scaling and itchy scalp conditions.
Salicylic acid is found in several medicated shampoo's. It helps to separate and lift off scalp scales.
Based on information provided to the Australasian College of Dermatologists
by Dr John R Sullivan
Last Modified 4 March, 2001 / © 2001 Australasian College of Dermatologists
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