Dandruff (Seborrhoeic Dermatitis) is a very common condition of scalp in which usually dry skin flakes off from the scalp and it is associated with itching. This is considered to be a mild form of an inflammatory disorder of scalp called known as 'Seborrhoeic Dermatitis'.
We can easily differentiate two conditions because dandruff typically affects only the scalp with loosely adherent flakes and seborrhoeic dermatitis may extend beyond the scalp and affects the folds like the side of the nose, behind the ears, eyebrows, beard area, upper back and chest. Redness and itching of the skin on the scalp are seen along with flaking, which may be dry or yellowish and greasy in case of seborrhoeic dermatitis.
The exact cause of dandruff and seborrhoeic dermatitis is not known. The most possible causes include increased oil production and secretion by sebaceous glands, increased numbers of normal yeasts on the affected skin and a genetic predisposition. Excessive oily skin or scalp, weather (cold and dry), infrequent head washing or shampooing are common triggering factors. Seborrhoeic dermatitis is not contagious or transmissible to contacts or other family members.
The diagnosis of Seborrhoeic dermatitis is mainly by history, clinical appearance, and behavior. There are no particular conclusive laboratory tests to diagnose seborrhoeic dermatitis. Skin scrapings can be done to rule out other conditions that can resemble seborrhoeic dermatitis (like ringworm, psoriasis).
The treatment options include antidandruff shampoos, anti-inflammatory antifungal creams/ lotions, and sometimes mild topical steroids may be required to reduce inflammation. The choice of treatment depends on the sites affected, and the extent of symptoms. Topical antifungals such as ketoconazole, clotrimazole, and climbazole can be used or combined with mild topical steroids. Oral antifungals may be needed in severe cases. Keratolytics can be used to remove scales when necessary (e.g. salicylic acid).
Seborrhoeic dermatitis improves with treatment, but because of increased sebum production tendency of an individual can recur this condition again. Patients, those who have a tendency to develop recurrent Seborrhoeic dermatitis may require retreatment at frequent intervals.