Dandruff - Causes, symptoms and treatment. MF.

Dandruff is an excessive exfoliation of scalp cells with periodic itching. The disease is a permanent dermatological condition of the scalp. Dandruff affects about 20% of the population. The pathological process is most clearly manifested in an area rich in sebaceous glands: the scalp, forehead, nasolabial folds, eyelashes, eyebrows and the outer ear. Dandruff is a seasonal phenomenon, the period of exacerbation falls on the winter season.

Conventional head dander is a pathological process associated with exfoliation of skin cells that form a dry white coating. It can be a consequence of causes that are not painful.

Fat dandruff - layered yellowish crusts with visible signs of inflammation. Exfoliation is accompanied by increased secretion of sebum. The process is most pronounced in an area rich in sebaceous glands in the scalp, forehead, nasolabial folds, eyelashes, eyebrows and outer ear. It is usually associated with skin diseases.

Reasons for dandruff

• Poor nutrition.

• Not enough personal hygiene.
• Impact of environmental pollution.
• No sunlight.
• Stress.
• Impaired immunological processes.
• Abnormal sebum and sebaceous gland function.
• Hormonal disorders.
• Violation of the normal component of human flora.
• Excessive colonization of Malassezia SPP fungus.
• Hyperhidrosis( increased sweating).
• Allergic reactions.
• Excessive consumption of sugar, saturated fats and starch.
• Hypovitaminosis.
• Genetic predisposition.
• Frequent use of gels and lacquers, hair colors.
• Frequent washing of the head.

Diseases in which the symptom of dandruff

can be observed. There are certain conditions and diseases predisposing to the appearance of dandruff:

• Seborrheic dermatitis is an extensive inflammatory-exudative skin disease. Its cause is an increase in the secretion of the sebaceous glands. Most often the process is localized in the scalp, forehead, nose, nasolabial folds and cheeks, in the sternum and between the shoulder blades. Skin fat is a nutrient medium for organisms, decomposes and irritates the skin. Thus, numerous erythematous areas appear on the patient's body, covered with abundant, yellow and greasy scales. Stains can merge with each other, increase, discolor skin. The disease has a chronic, cyclical character and is characterized by a period of exacerbation in the winter and improvements in the summer.

Lishi is a collective concept that includes skin diseases of various etiology( origin).

- Impulsive lichen - chronic mycosis of the skin caused by fungus Malassezia. It is a yellow-brown spotted rash. They easily peel off and the skin remains discolored. The disease often recurs, as the fungi are constantly in the epidermis of the skin.

- White lichen( Alba) of the scalp - a condition of severe seborrhea, characterized by a chronic and recurrent course. Forms white, well-defined foci. These rashes are located on the face and limbs. Most often, it occurs in children.

• Psoriasis is a chronic non-infectious skin disease manifested by dermatosis.

• Neurological diseases( Parkinson's disease, paralysis VII, syringomyelia) - diseases of the central and peripheral nervous system.
• Mental disorders( depression and use of psychotropic drugs).
• Alcoholism - physical and mental dependence on alcohol.
• HIV infection is a disease due to infection with the human immunodeficiency virus.
• Cancer is a malignant tumor.
• Diseases of the gastrointestinal tract - diseases of the digestive system.
• Chronic diseases of the respiratory tract.
• Atopic dermatitis - diffuse neurodermatitis, a chronic inflammatory disease of an allergic nature.
• Scabies - parasitic skin disease.

For many years, there was an opinion that dandruff can lead to baldness. But now it is proved that alopecia is not associated with this disease!

To which doctor should I contact if I have dandruff

With any type of dandruff you need to contact a trichologist( a doctor dealing with hair and scalp problems), or a dermatologist. Self-medication is not always effective. The doctor not only prescribes the right medicine, but also recommends appropriate skin care and prevention.

Symptoms requiring immediate contact with a doctor

- Severe itching of the skin, scratches.
- Nervousness, irritability.
- Strange spots, red or rose.
- Rash on the skin.

Treatment of dandruff

Treatment of dandruff is a long and time-consuming process, success depends on several factors: age, region of residence and the severity of the changes. To obtain a satisfactory therapeutic effect, the patient should follow the doctor's recommendations. First of all, it is necessary to find the cause and treat the patient taking into account the diagnosis. Dandruff can not be completely eliminated, but it is possible to restrain the process of peeling of the skin within normal limits.

Local dandruff therapy

For local treatment, shampoos, creams, oils and tonics with keratolytic, antifungal and cytostatic effects are used. The effect of these drugs is aimed at alleviating clinical symptoms( removing crusts and scales, sebum) and reducing inflammation.

• Shampoos: Pantene Pro-V, Selsun Blue, Neutrogena, Nizoral 1% -2%( containing ketoconazole), Head &Shoulders, Gard purple, Pantene Blue. Shampoos based on coal tar containing zinc salts, salicylic acid, selenium and sulfur sulphide. Therapeutic shampoos for dandruff can also include extracts: burdock root, radish, kidney black poplar, juniper, hops, birch leaves, aura, nettle and nasturtium, chamomile, mullein, mallow, rhubarb root, sage, rosemary, ivy fruit, oak bark, inflorescences of lime, onion, inflorescence of marigolds, hibiscus flowers, alkane root.
• Compositions( "talkers") from salicylic acid, resorcinol, tar, selenium or cadmium sulfide, sulfur - reduce inflammation and eliminate itching and burning. The concentration of these substances depends on the individual characteristics of the patient and the severity of the changes.
• Dermocosmetics - tonics, lotions( for example, Seboderm).
• Imidazole derivatives( preparations: ketoconazole, flutrimazole, clotrimazole, bifonazole, miconazole, klimbazol) - act on the pathogen of the fungal infection, suppress the reproduction of Malassezia SPP fungus.
• A diet rich in vitamins B, A and E. It is necessary to include unsaturated fatty acids in the diet.
• Corticosteroids in combination with metronidazole, erythromycin, vitamin D3 derivatives and calcineurin inhibitors. They are creams, aerosols, gels.(for example, Ointment Gexisone, Fucikord)
• Phototherapy UF - possesses bactericidal properties.
• Photochemotherapy( PUVA) - application of long-wave ultraviolet rays in combination with photosensitizing substances.

General dandruff treatment

Therapy is indicated in patients with extensive chronic lesions and includes mainly oral medications( applied orally):

• Retinoids( isotretinoin) - derivatives of vitamin A.
• Antibiotics( gentamicin, neomycin, apramycin, tetracycline) - substances that inhibit the growth of bacterial cells.
• Corticosteroid hormones( prednisolone, hydrocortisone, cortisol) are physiologically active substances that suppress inflammatory processes.
• Antifungal drugs( terbinafine, ketoconazole, itraconazole) are medicines that act directly on the fungus pathogen.

Phytotherapy and other home remedies against dandruff

• Nettle lotion - 1 tablespoon of dry leaves of nettle pour a glass of water. Leave to stand for 20 minutes. Infusion filter, rinse them hair and scalp.
• Mint lotion ( for dark hair) - pour three tablespoons of mint( fresh or dried) with a liter of fruit vinegar and close in a bottle. Keep in a warm sunny place( on the windowsill) for two weeks. Then strain through gauze into the bottle. Use after washing hair.
• Limestone lotion ( for light hair) - boil 4 tablespoons of lime in 2 glasses of water. Rinse your hair with liquid.
• Lotion from horsetail and burdock - 2 tablespoons dry horsetail, root of saponarium and burdock pour a liter of hot water and cook in a water bath for 7 minutes. Dilute a liter of water and rinse your hair after each wash.
• Lotion of horsetail, marigold and chamomile - 3 tablespoons of chamomile, calendula, horsetail and willow per liter of water. Cook the broth by boiling the herbs for 5 minutes. Then drain the water and allow the broth to cool, rinse and dry the hair. Use 2-3 times a week.

Masks for dandruff

• Mask "Mediterranean Sea" - nourishes the scalp and moisturizes the hair. Take 1 cup of olive oil, 1 egg yolk and freshly squeezed juice of one lemon. Mix everything and apply the mask on the hair after washing, leave for 20 minutes. Then rinse with water and wash with non-sulfate or baby shampoo.
• Egg mask with rum - recommended for dry hair. Mix two egg yolks with 2 tablespoons of rum and two teaspoons of olive oil. For washed and dried hair, apply a mask. Leave for 30 minutes and wrap the head with a towel, then rinse the mask with warm water and wash the hair with a mild shampoo.
• Coconut mask with jojoba - for dry dandruff. Mix a spoonful of coconut oil and a teaspoon of jojoba oil. Mix the mixture with massage movements into the scalp and leave for half an hour, covering your head with a towel. Then wash your hair with usual shampoo, repeat the procedure in a week.
• Lemon juice - cleanly washed hair rinse with lemon juice. Treat the lemon juice every day, until the full exfoliation of dandruff.
• Castor oil - wash hair, towel dry. Rub in the scalp 1 glass of oil, wrap the head with a towel and wait half an hour. Rinse your head with water and wash your hair with a mild shampoo. Repeat treatment once every 2 weeks.
• Garlic wraps - mash garlic to grind two and add a glass of warm boiled water. Mix everything together, and insist for 5 minutes. Massaging movements rub the mixture into the scalp, leave on hair for 5 minutes, then rinse thoroughly with water. Wraps do not often more than once a week, because garlic has a strong irritant effect and can often cause redness and irritation if it comes into contact with the skin frequently.
• Egg mask - Separate the egg yolk from the protein. Whip the whisk with egg whites, then add the egg yolk and gently mix. On clean, lightly dried hair, apply a mask, carefully massage it into the skin, wrap the head with a food film and leave for 30 minutes. Mask rinse with warm water without using shampoo.
• Yoghurt mask - on washed, slightly damp hair, apply non-sweet yogurt, wrap the head with a towel and leave for about an hour. After this time, wash off the mask with warm water and wash the hair with a mild shampoo.

Prevention of dandruff

Full nutrition and proper skin care is the basis for the prevention of dandruff.

Prevention of recurrence of seborrheic dermatitis of the scalp is extremely important, since it helps to prevent the life of the colony Malassezia SPP.

Patients should:
- Use shampoos with ketoconazole or cyclopyrox once a week, for several months.
- In cases of remission, it is important to maintain hygiene and proper skin care, prone to the resumption of the pathological process.

Doctor cosmetologist Kondratenko NA