Dandruff

• Dandruff (Pityriasis Capitis)


  A chronic, relapsing, noninflammatory hyperproliferative skin condition
• Role of microorganisms in dandruff pathogenesis

  • Research has focused on the yeast Malassezia, although evidence is inconclusive as to whether Malassezia is the primary cause or a contributory factor
  • Malassezia makes up more of the scalp flora of dandruff sufferers, which might explain why dandruff improves in the summer months (fungal organisms thrive in warm and moist environments that exist on the scalp due to wearing hats and caps)
  • Positive effect of antifungal therapy on clearing dandruff supports a role of Malassezia
• Dandruff is not caused by poor hygiene, although it may be more obvious if hair is not washed regularly
• Stress and cold weather may also make dandruff worse
• Possible causes of symptoms similar to dandruff

  • Seborrheic dermatitis
  • Tinea Capitis, aka ring
  • Contact Dermatitis
  • Psoriasis
  • Eczema
  • Cradle Cap
• Management/treatment of dandruff


  1. Salicylic acid (keratolytic properties)

  2. Piroctone olamine

  3. Ketoconazole (inhibits Malassezia replication, helps control itching and flaking, effective treatment, similar efficacy to selenium, acts as a prophylactic agent)

  4. Nizoral (initial dose every 3-4 days for 4 weeks, prevention dose once every 1-2 weeks)

  5. Coal tar

  6. Selenium sulfide (antifungal action, effective as an antidandruff agent, adults and children over 5 use twice a week for 2 weeks then once a week for 2 weeks, avoid if inflamed or broken skin, can discolour hair)

  7. Zinc pyrithione (reduces cell turnover rates, antifungal properties, use daily until dandruff clears, dermatitis reported)