Everyone has had to deal with dandruff at one point or another. And let’s face it, those flakes are just never welcome! For most of us, a quick washing with Head and Shoulders, Nizoral, Selsun Blue, or some tea-tree inspired something is enough to clear up most flake flare ups— but sometimes dandruff can be, well . . . not really dandruff. If you’ve used every dandruff treatment in the book and still can’t seem to beat the flakes, it might be that you are really fighting something other than dandruff.
How do you know if your dandruff is just dandruff, a false alarm, or a real symptom of something else entirely?
The Real Deal
Before we talk about the dandruff false alarms— let’s talk about real dandruff. Sometimes dandruff really is dandruff. Real dandruff is believed to be caused by excessive growth of a fungus called malasezzia. Malesezzia is naturally found on the scalp in non-dandruff sufferers, but the fungal population is out of control in those who are plagued with dandruff. Experts are not quite sure why malassezia multiplies on the scalp, but many attribute its growth to having excessive amounts of oil on the scalp from infrequent cleansing, having a compromised immune system, poor diet, or simple hormonal changes in the body. In most cases, a standard shampoo regimen will clear up dandruff in a few weeks. Common shampoo active ingredients include zinc pyrithione, ketoconazole, selenium sulfide, coal tar, tea tree and other tingly active ingredients. For stubborn cases, the active ingredient in the shampoo may need to be rotated for best results (for example, using zinc pyrithione shampoo during weeks 1 and 2, and a selenium sulfide-based shampoo in weeks 3 and 4).
The False Alarms:
One commonly mistaken dandruff lookalike is plain old dry scalp. Some products have a knack for drying out the scalp— shampoos are a common culprit. Regularly using a soap or shampoo formula that is too harsh (usually sulfate-based) will lead to scalp dryness over time. Other dry scalp instigators include weather changes, using water with a high mineral content or pH, and using water that is too hot. Those who chemically treat their hair with relaxers, texturizers, or hair coloring products and those who overdry their hair when blowdrying may also run into this kind of problem as those treatments/techniques tend to dehydrate the scalp. If you aren’t hydrating your body from within by drinking water, you’ll also tend to have dry skin— not just on the scalp— but all over. Proper diet is also key to maintaining the skin— and essential fatty acid and Vitamin C deficiencies are common triggers of dry, itchy scalp You can add more fish, citrus fruit, nuts and leafy green veggies to your diet to work around this, but know that it can take three months of good nutrition or more before the results improve.
Product buildup and less than thorough rinsing can also lead to dandruffy looking conditions! Conditioner is the number one culprit here, and in kinky-curly hair (or relaxed hair with considerable new growth) conditioner can become “trapped” near the roots upon rinsing. If efforts aren’t taken to gently agitate or free conditioner that has settled close to the scalp, you will be in for an itchy, flaky mess once the hair dries. In my experience, this type of buildup is also oilier and gummier— like a gross, icky blanket on the scalp. Gels, serums and oils can also create sticky films that combine with sebum and regular debris to produce what looks like flaky, dandruffy scalp conditions.
Psoriasis and Seborrheic Dermatitis
Sometimes real dandruff can be a symptom of some other scalp condition— and making a distinction between plain dandruff, psoriasis and seborrheic dermatitis can be tricky. What really helps distinguish the conditions from one another is the degree and kind of flaking you tend to get. In psoriasis and seborrhea, dandruff is usually the main symptom among other symptoms like redness and crusting, for example. Psoriasis tends to produce thicker, drier looking scales of skin than seborrhea does— and it also tends to appear on other parts of the body (knees/elbows). Seborrhea tends to produce an oilier kind of flake. Fortunately, treatments specifically targeted for basic fungal dandruff can help clear up outbreaks of psoriasis and seborrheic dermatitis. A quick visit to the dermatologist will help you figure out if your dandruff is just dandruff, a false alarm, or if you’ve got a dandruff as a symptom of something else.
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