Urgent! What should I do if I have a lot of dandruff? Dermatologists tell you these tips

Expert of this article: Wang Ruiyan, MD, associate chief physician of dermatology department, Air Force Specialty Medical Center

If you clicked on this article, you must have been troubled by dandruff to some extent. Who doesn’t want their hair to be fresh and flowing every day?

But sometimes it’s not that we don’t like cleanliness, but that we really can’t do anything about dandruff!

Dandruff is the most common scalp problem for humans. It can make you feel bad and cause you embarrassment in social situations. Everyone naturally desires to have dandruff-free hair.

Why do some people have very clean hair, while you have dandruff that can never be washed away?

Why do you have so much dandruff?

First, let’s look at some misunderstandings about dandruff. Do you have any of them?

Is dandruff contagious? Generally not contagious, but dandruff caused by tinea capitis is contagious;

Does not drying your hair after washing cause dandruff? Wrong. There is no evidence that dandruff is aggravated in a humid environment.

In fact, a normal scalp has a small amount of dandruff.

Typical dandruff is a collection of fine white or gray scales on the surface of the scalp. Dandruff is closely related to stratum corneum dysfunction, and is mostly believed to be caused by Malassezia fungal infection.

Malassezia is a lipophilic fungus and a normal flora of the scalp. After puberty, under the influence of androgens, the sebaceous glands secrete more sebum, which is distributed to the scalp surface through the sebaceous gland ducts of the hair follicles. After absorbing sebum, Malassezia multiplies in large numbers and produces free fatty acids. These fatty acids penetrate into the stratum corneum and damage the skin barrier. The damage to the barrier leads to excessive synthesis and secretion of sebum, and then the over-synthesized sebum provides rich food for the reproduction of Malassezia, thus forming a vicious circle.

Another cause of dandruff is dry scalp. Dry skin or frequent washing, perming, dyeing, etc., can damage the scalp skin barrier, reduce the activity of the protease responsible for the shedding of epidermal cells, and cause epidermal cells to not shed normally, thus causing dandruff. This type of dandruff is often small, dry, white scales.

Dandruff may occur due to several reasons:

Physiological dandruff

Our skin cells are renewed every day, and the entire epidermis is completely replaced every 25-30 days, so everyone will have dandruff. It's just that normal dandruff is relatively small, and before you notice it, it will be mixed with sebum and dust in the air.

Physiological dandruff generally does not cause obvious itching and redness of the scalp and can be removed by washing your hair normally and keeping it clean.

Pathological dandruff

If there are many small white or gray scales on the scalp, often accompanied by itching, you should consider whether it is pathological dandruff.

——Seborrheic dermatitis

If your scalp is constantly itchy, oily, and sometimes scabbing and excessive flaking, you should consider whether it is seborrheic dermatitis, which may spread from the head to the face in severe cases.

--psoriasis

Psoriasis, which we commonly call psoriasis, can also cause redness of the scalp and more and thicker dandruff. In the early stages, if the lesions only affect the head, it is often mistaken for seborrheic dermatitis.

How to clean dandruff?

Frequency of shampooing

Many people find that they have more and more dandruff, and mistakenly believe that it is caused by inadequate cleaning, so they blindly increase the frequency of washing their hair.

In fact, if you have oily skin with strong sebum secretion, you can wash your hair once a day. If your hair is already damaged or dry, you can reduce the frequency of washing your hair appropriately. Dry skin has less sebum secretion. If you wash your hair too frequently, it may wash away the sebum film that is not much to begin with, which can easily lead to dandruff problems.

As you age, the oil content of your scalp decreases, so you may need to wash your hair less frequently.

Water temperature

The most suitable water temperature is about 40℃. Water that is too hot will damage the hair follicles, take away the moisture and oil on the surface of the scalp, and make the scalp drier. Especially for people with oily hair, overheated water may stimulate the scalp to secrete more sebum and produce more dandruff.

Shampooing Action

Although it is comfortable to scratch your hair with your fingernails when washing your hair, the scalp is more fragile than we think. If you are not careful, it will damage the scalp, and bacteria between your fingers may take advantage of the opportunity to enter. The correct way is to clean your scalp by drawing circles with your fingertips.

Many people are also concerned about whether shampoo can come into direct contact with the scalp. Some people worry that direct contact with the scalp will irritate the scalp and they need to rub out foam before contacting the scalp. In fact, a regular and qualified shampoo must have minimal irritation to the skin to meet the standard. As long as you are not allergic to the ingredients in the shampoo, it can come into direct contact with the scalp.

How to treat dandruff that won’t wash off?

There are many folk remedies for removing dandruff. In fact, these remedies not only fail to remove dandruff, but if used for a long time, some of the ingredients may irritate the scalp, promote cell proliferation and keratinization, and make the dandruff problem more serious.

There are two main reasons for dandruff: oily scalp, seborrheic dermatitis and dry skin. It is best to use different treatments for different causes.

/Oily scalp, seborrheic dermatitis/

Malassezia is a resident bacterial flora on the skin, which means we cannot completely eliminate it. Only by inhibiting its growth and reducing its interference with the metabolism of scalp keratinocytes can we control dandruff. Therefore, it is critical to choose products containing anti-dandruff ingredients.

According to different mechanisms of action, anti-dandruff active ingredients are mainly divided into the following three categories:

Cytostatics (inhibit cell replication): selenium sulfide, pyridone ethanolamine salt, coal tar

Keratolytics (which remove damaged surface cells of the stratum corneum by scaling): coal tar, sulfur, salicylic acid

Antimicrobial: zinc pyrithione, climbazole, selenium sulfide, ketoconazole

Using drugs and shampoos containing these ingredients can alleviate the troubles caused by dandruff to a certain extent. Hydroxypyrithione zinc and pyridone ethanolamine salt added to shampoo can both inhibit Malassezia and relieve inflammatory reactions on the scalp.

Since dandruff is a chronic disease that is prone to recurrence, it can be treated with medication in severe cases. During the remission period, shampoos containing antifungal ingredients can be used for maintenance treatment, which can not only reduce scalp inflammation, but also reduce scalp itching or scratching behavior, reduce hair damage, improve hair texture and appearance, and reduce recurrence.

/Dry scalp skin/

In this case, it is not recommended to use anti-dandruff shampoo. You should reduce the frequency of shampooing, perming, and dyeing, do a good job of sun protection, and frequently use scalp care products, especially essences and lotions for repairing the scalp barrier. Apply by hand and massage to promote scalp absorption. After the above treatment, when the scalp barrier is repaired normally, dandruff will gradually decrease.

In daily life, you should pay attention to regular work and rest, eat less high-fat or spicy foods, use less hot water and alkaline soap to wash your hair, and avoid scratching.

If the dandruff problem is still not alleviated after the above treatment, it is recommended to go to a regular hospital to see a dermatologist in time.

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