What Causes Dandruff?

The exact cause of dandruff is unknown. Possible causes and associations include increased oil production and secretion, and increased numbers of normal skin yeasts.

Bacteria have not been found to cause dandruff. Dandruff is not a fungal infection and is not the same as scalp "ringworm," which is actually a fungal infection called tinea capitis. Dandruff is not contagious.

Dandruff may also be triggered or made worse by poor hygiene and infrequent shampooing and washing. The immune system may also play a role in dandruff. Although mild dandruff is a very common condition in many people with a normal immune system, severe dandruff is more common in people with some chronic illnesses such as Parkinson' s disease or a compromised immune system as in advanced HIV/AIDS.

• Common triggers (factors that may worsen) of dandruff include the following:

o Oily skin

o Oily scalp

o Poor hygiene

o Weather (hot and humid or cold and dry)

o Infrequent washing or shampooing

o Poor immune system

o Chronic illness

o Emotional or mental stress

• Risk factors for dandruff include the following:

o People with extreme or severe cases of dandruff often also have other chronic health conditions

What Are the Symptoms of Dandruff?

Dermatologists commonly refer to dandruff as seborrhea or seborrheic dermatitis. The signs and symptoms include:

• White flakes on shoulders of dark clothing

• Itchy scalp

• Scaly facial skin

• Recurrent ear "eczema"

• Facial rash over eyebrows, nose, and ears

• Oily scalp and facial skin with dry flakes

• Eyebrow rash

• Beard rash

• Chest rash with dry flakes and red spots

One of the most common and often the first symptom of dandruff can be white flakes seen on dark clothes. Scalp itching may be another common first symptom. In some, the initial noticeable symptom is simply dry facial skin without any other rashes. Patients may see their physician complaining of dry skin that fails to respond to daily lotions and creams. Often they have used every lotion possible from the drugstore or more expensive department stores. Frequently this is caused by undiagnosed scalp dandruff that is causing problems "downstream" on the face.

Dandruff can be located in areas of the body with hair follicles. It is most typically found on the scalp, ears, face, and middle of the chest. Seborrhea is not seen on the palms and soles where there are no hair follicles.

Other possible conditions that may have similar signs and symptoms are:

• Psoriasis

• Rosacea

• Tinea Capitis (fungal scalp and hair infection)

• Contact dermatitis

• Atopic dermatitis

• Xerosis

• (dry skin)

• Allergic dermatitis

• Perioral dermatitis

• (acne like rash around the mouth and chin)

• Acne

• Lupus

• Photodermatitis

• (sunlight induced rash)

The four key features of dandruff are:

• White skin flakes on any hair bearing parts of the body

• Scaly skin by the eyebrows, ears, and nose

• White flakes on clothes

• Itchy or scaly scalp

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