What is the medical term for dandruff?

Medical Term for Dandruff

The medical term for dandruff is seborrheic dermatitis when referring to the clinical condition, with dandruff itself representing a mild, non-inflammatory form of seborrheic dermatitis limited to the scalp. 1, 2

Clinical Characteristics

Dandruff presents with the following features:

• Flaking on the scalp and in the hair
• Itching (pruritus)
• Severity ranging from mild scaling similar to dry skin to severe scaling
• Generally responds to regular shampooing
• Affects up to 50% of the population at some point in their lives 3

Seborrheic dermatitis, the broader medical condition, is characterized by:

• Follicular papules and pustules
• Greasy yellowish scaling
• Underlying erythema (redness)
• Itching and discomfort 1
• Affects sebum-rich areas including scalp, face, ears, neck, chest, upper back, and body folds

Pathophysiology

The condition is linked to:

• Proliferation of Malassezia yeasts (previously known as Pityrosporum)
• Sebaceous gland activity
• Immune dysregulation 1
• Enhanced cell-mediated immunity to Malassezia in 40% of chronic cases 1

Differential Diagnosis

Several conditions may be confused with seborrheic dermatitis/dandruff:

• Psoriasis (especially sebopsoriasis)
• Atopic dermatitis (eczema)
• Tinea capitis (fungal infection of the scalp)
• Contact dermatitis (both irritant and allergic)
• Discoid lupus erythematosus 1

In the context of tinea capitis, it's important to note that some infections can present with "diffuse scale" resembling dandruff with minimal or absent alopecia and generalized scaling of the scalp 4.

Treatment Options

For mild dandruff:

• Regular shampooing with longer lathering periods
• Avoidance of hair sprays and pomades/gels

For persistent dandruff/seborrheic dermatitis:

1. Antifungal agents:

   • Ketoconazole shampoo or cream
   • Selenium sulfide
   • Ciclopirox olamine
   • Zinc pyrithione 1, 3

2. Anti-inflammatory agents (for short-term use):

   • Low-potency topical corticosteroids
   • Topical calcineurin inhibitors 1

3. Keratolytic agents:

   • Salicylic acid
   • Coal tar
   • Sulfur 3

Maintenance and Prevention

• Regular use of antifungal shampoos (1-2 times weekly after initial control)
• Gentle cleansing with pH-neutral formulations
• Avoiding greasy hair products that may facilitate yeast growth
• Consider rotating between different antifungal agents to prevent resistance 1

Special Considerations

Seborrheic dermatitis/dandruff may be more pronounced in patients with:

• HIV infection
• Parkinson's disease
• Down syndrome 1
• Highest prevalence and severity in young men 3

Common aggravating factors include:

• Changes in humidity
• Trauma (e.g., scratching)
• Seasonal changes
• Emotional stress 3

Understanding that dandruff is the mild, non-inflammatory form of seborrheic dermatitis helps guide appropriate treatment selection and patient education about this chronic, often recurring condition.