Contents
Introduction
Light, white to yellow and dispersed flaking on the scalp and hair without erythema and with absent/mild pruritus.
- Affects half of world population
- Mildest form of seborrhoeic dermatitis (SD)
Aetiology

Disease associations (excessive dandruff):
- Seborrhoeic dermatitis
- Skin condition associated with an overgrowth of yeast on the skin, which can cause the scalp, face and other areas of the body to become scaly, itchy and red
- Tinea capitis
- Fungal infection of the scalp, also called scalp ringworm
- Eczema
- Skin condition that causes the skin to become dry, red, flaky and very itchy
- Allergic contact dermatitis
- Reaction to products used on the scalp, such as hair dye, hairspray, hair gel or mousse
- Psoriasis
- Skin condition that causes red, flaky, crusty patches of skin covered with silvery scales

Physiology
Factors responsible for dandruff production:
- Sebum or sebaceous secretions of skin
- Metabolic by-products of skin commensals (most specifically Malassezia yeasts)
- Individual susceptibility and allergy sensitivity
Dandruff scale
Cluster of corneocytes (protein complex that is made of tiny threads of keratin in an organised matrix), which have retained a large degree of cohesion with one another and detach as such from the surface of the stratum corneum.
- Size and abundance of scales are heterogeneous from one site to another and over time
- Parakeratosis (mode of keratinization characterized by the retention of nuclei in the stratum corneum) is seen in the plaques of psoriasis and in dandruff.

Diagnosis
Differential diagnosis
Seborrheic dermatitis:


Management
Anti-dandruff substances:
- Zinc pyrithione (coordination complex of zinc with fungistatic and bacteriostatic properties)
- Salicylic acid (help remove outer layer of skin)
- Selenium sulphide (antifungal agent)
- Ketoconazole (broad spectrum antimycotic agent)
- Coal tar (causes the skin to shed dead cells from the top layer and slows skin cell growth)