What is the medical term for dandruff?

Medical Term for Dandruff

The medical term for dandruff is seborrheic dermatitis when it affects the scalp, characterized by flaking skin, mild inflammation, and sometimes itching. 1, 2

Understanding Seborrheic Dermatitis

Seborrheic dermatitis is a common chronic inflammatory skin condition that affects sebum-rich areas of the body, particularly the scalp. When limited to the scalp with flaking without visible inflammation, it is commonly referred to as dandruff 2. The condition is characterized by:

• Greasy yellowish scaling
• Underlying erythema (redness)
• Itching and discomfort
• Affects up to 50% of the population at some point in their lives 3

Key Features

• Most prevalent in young men, with less frequency in children and older adults 3
• Often exacerbated by changes in humidity, trauma (scratching), seasonal changes, and emotional stress 3
• Commonly affects sebum-rich areas including scalp, face, ears, neck, chest, upper back, and body folds 1

Pathophysiology

The pathogenesis of seborrheic dermatitis/dandruff involves multiple factors:

• Malassezia yeasts: Now accepted as the primary causative agent 3, 1
• Sebaceous gland activity: Excessive sebum production creates an ideal environment for yeast proliferation
• Immune dysregulation: Enhanced cell-mediated immunity to Malassezia has been detected in 40% of patients with chronic seborrheic dermatitis 1

Clinical Presentations

Seborrheic dermatitis can present in various forms:

• Mild scaling (simple dandruff): Similar to dry skin, limited to the scalp 3
• Severe scaling: More extensive involvement with visible inflammation
• Diffuse scale: In some cases, it can resemble generalized diffuse scaling of the scalp with minimal or absent alopecia 4

Differential Diagnosis

Several conditions may mimic seborrheic dermatitis/dandruff:

• Psoriasis vulgaris (sebopsoriasis)
• Atopic dermatitis
• Tinea capitis (fungal infection of the scalp)
• Candidiasis
• Contact dermatitis (both irritant and allergic) 1, 5

Management Approaches

Treatment options for dandruff/seborrheic dermatitis include:

1. Antifungal agents:

   • Ketoconazole shampoo (1-2%)
   • Selenium sulfide
   • Ciclopirox olamine
   • Zinc pyrithione 1, 6

2. Anti-inflammatory agents:

   • Low-potency topical corticosteroids
   • Topical calcineurin inhibitors 1

3. Other topical treatments:

   • Salicylic acid
   • Coal tar preparations
   • Sulfur-containing products 5

Treatment Pearls

• Regular shampooing with longer lathering periods helps control dandruff 3
• Avoid hair sprays or pomades that can exacerbate the condition 3
• Consider rotating between different antifungal agents to prevent resistance in resistant cases 1
• Maintenance therapy is crucial as seborrheic dermatitis is chronic and relapsing 1

Common Pitfalls to Avoid

• Inadequate treatment duration: Antifungal treatments need to be continued for the full recommended course (typically 4 weeks for ketoconazole cream) 1
• Prolonged use of potent topical corticosteroids on the scalp can potentially worsen hair loss over time 1
• Failure to address maintenance therapy: After initial control, transition to maintenance therapy with antifungal shampoo 1-2 times weekly 1
• Misdiagnosis: Conditions like psoriasis, atopic dermatitis, and tinea capitis can mimic seborrheic dermatitis 1

In clinical studies, shampoos containing proven antifungal compounds like ketoconazole have shown superior efficacy in controlling the causative yeast compared to other commercial products 6.