Dandruff: Who Gets It?

Adult Skin Problems Slideshow

Author: Melissa Conrad Stöppler, MD
Editor: William C. Shiel, Jr, FACP, FACR

Dandruff is certainly unsightly and it can be a cause for concern. Is it just a result of poor hygiene? Or is there a medical reason for dandruff, so that the sufferer "can't help" but have it?

The answer isn't so simple. While doctors don't know exactly what causes dandruff, we do know it is a very common condition that affects nearly everyone at some point in their lives. It's not the result of a bacterial or fungal infection (like the misnomer "ringworm" of the scalp). Some potential causes for dandruff have been suggested, including increased oil production of the skin, increases in certain skin secretions, and increased numbers of normal skin yeasts, but the exact cause of dandruff has never been established.

There are also many factors that may trigger dandruff. Common factors that may trigger dandruff include:

• weather conditions,
• concurrent yeast or fungal infections,
• a suppressed immune system, stress, and
• yes, poor hygiene with infrequent hair washing.

While it isn't contagious, dandruff does tend to run in families, suggesting a genetic vulnerability in some people. Those with unusually severe cases of dandruff often have chronic medical conditions.

Most cases of dandruff can be well controlled with proper hygienic practices that include appropriate shampooing products. However, this doesn't mean that a few flakes won't be visible from time to time in a susceptible person despite meticulous grooming practices and proper anti-dandruff care. For moderate to severe cases that do not respond to typical dandruff shampoos, a variety of prescription creams and shampoos are available. Very rare and severe cases may even be treated with a short-term course of oral steroid medications. Your doctor can help you decide what level of dandruff care is necessary for your individual case.

So can a person "help it" if they have dandruff? A genetically susceptible person may not be able to prevent having it, but for most people, good skin and hair hygiene will help prevent flares of dandruff and reduce its unsightly symptoms.