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To understand how dandruff develops, one must first know a little about the skin structure and physiology.


The skin has 3 layers. The outer layer, the epidermis, consists mostly of flat epithelial cells, that is surface cells. New epithelial cells are produced at the bottom of this layer when cells called keratinocytes divide, and as new cells are made, existing cells are pushed upwards. As they move to the surface, they are gradually filled with the protein keratin so that the outermost cells are mostly dead plates of keratin. This keratin layer is also steadily shed or worn off at the surface.

The layer beneath, the dermis, consists of connective tissue. It contains strong and elastic protein fibers between the cells, and has blood vessels. The lowest layer consists mostly of fat cells. Hairs grow up from deep pouches in the skin going down through the epidermis, through the dermis and reach the fat layer, the hair follicles. The hair follicles have an inside covered by epidermal cells. High up at one side of the follicle there is a gland, the sebaceous gland, that excrete the oily blending called sebum that lubricates and protects the hairs and the skin.


Dandruff is a thickening of the outermost keratin-filled layer of the skin and this extra sheath of dead cells is also blended with fungi that grow in the thick outer layer and with oils produced by the sebaceous glands. This extra sheet is rather loose and it is steadily shed as small flakes that will typically stick to the hairs. The thickening occurs because of an increased production of new cells from the bottom of the epidermis.

Dandruff most often occurs in areas with tight hair growth, like the scalp. Other conditions like sebhorreic dermatitis (eczema) can cause dandruff-like scaling both at the scalp and at other parts of the body. Real dandruff also tend to co-occur with conditions like sebhorreic dermatitis, so that two conditions have to be treated. A symptom often associated with dandruff is redness and itching at skin areas where the outer layers are thickened and shed. The symptoms are partly caused by the dandruff itself and partly by scratching at the skin.


The fungi, especially yeasts, growing at the skin make substances that stimulate the extra growth of epidermal cells, especially the fatty acid oleic acid. The substances penetrate deep into the epidermis where it will stimulate cell proliferation. Also an increased production of oils in the sebaceous glands caused by internal factors seem to increase the growth of the epidermal cells. There may also be an increased susceptibility for these stimulating agents.

The stimulation seems first to cause an allergic inflammatory reaction and this process will in turn make the cells proliferate faster. One ultimate cause of dandruff is therefore factors that make the fungi thrive and grow and a tendency for allergy is another ultimate cause.


Dandruff is most often treated with shampoos to loosen the stuff and to hinder new growth of dandruff. Conditioners to put in the hair without washing it away is also used to stop further or new growth of dandruff. The remedies can contain several natural and pharmacological agents that work by different principles.

One principle of dandruff treatment is to make the extra sheet resolve and then wash it away. The ingredients salicylic acid and sulfur are often used in anti-dandruff remedies for that purpose. Coal tar is also a traditional ingredient used for this purpose. In modern remedies tea tree oil is often used as a dissolving agent.

Another treatment principle is to use substances that kill the fungi and make it difficult for the fungi to thrive. Pharmacological anti-fungal ingredients often used is imidazolone or hydroxypyridones like ciclospirox. Extracts from the seeds of the Indian tree neem is a traditional anti-fungal remedy used to treat dandruff.

A third principle is to inhibit the proliferation of cells from the keratinocytes. An ingredient used for this purpose is selenium sulfide and also coal tar has this effect. One also uses anti-inflammatory agents like steroids to hinder the allergic reaction and the extensive proliferation of cells.

One can also try to take away internal factors that make the skin a good environment for the growth of fungi and to stimulate the natural protective mechanisms in the skin. To increase resistance against dandruff lean protein rich food like lean fish and lean meat may work. Fresh fruit, fresh vegetables, fish oil and vitamins of the B-group are also supposed to hinder growth of dandruff. It can also be wise to reduce the consume of milk and milk-based food.

Many natural ingredients used for treatment of dandruff work by several mechanisms. One of this is black pepper that has a traditional use in Indian medicine. Another traditional remedy is egg oil, which is fatty oils extracted from egg yolk.

An old effective natural anti-dandruff-treatment is to wet the hair and the scalp with olive oil, let the oil stay for some time and then wash the hair thoroughly with a mild soap or even better, an egg and soap based shampoo.

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