Dandruff is one of those stubborn, often embarrassing scalp issues that many of us have had to deal with at some point – yet few of us truly understand it.

Whether it’s the tell-tale white flakes on your scalp or the relentless itch that won’t quit, dandruff can be both irritating and persistent.

But what actually causes it? Is it dry skin, poor hygiene, or something more complex?

We spoke to Glenn Lyons, senior consultant trichologist and clinical director at Philip Kingsley, who has broken down the real causes of dandruff and suggested some effective ways to prevent and manage it – so you can leave the flakes behind for good.

What is dandruff?

“It’s a non inflammatory scaling of the scalp,” says Lyons. “It’s a combination of the presence of a yeast-like fungus, but also, and importantly, an increase in our normal shedding and renewal process which can lead to a build-up of dandruff.

“It can be both fine little scales, or sometimes larger scales.”

What factors can impact dandruff?

“The main reason is susceptibility, as some people are more susceptible to get it,” says Lyons. “Stress can also influence it. An increase of stress seems to increase the normal turnover of skin and scalp cells.”

Hormones can also be an influential factor.

“Adolescence with hormonal changes seems to initiate it in a lot of young people,” notes Lyons.

But the trichologist explains that for most people, what looks like dandruff is often caused with not washing your hair regularly enough.

“Interesting, the main thing that is often perceived as dandruff is caused by not washing the hair sufficiently or frequently enough to get rid of our normal turnover,” he explains. “If it’s washed regularly, even daily, it often gets rid of it without the necessity of an anti-dandruff shampoo.

“But having said that, the anti-dandruff shampoos of today are very efficient at controlling dandruff. I use the word controlling because I think if there’s susceptibility, I don’t think it’s curable. I think you can have very lengthy periods of not having dandruff, it tends to eventually come back.”

Does the time of year impact dandruff?

“Dandruff seems to be a little bit better in the summer months, but I think that’s a lot to do with people shampooing their hair more often in the summer months,” says Lyons.

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Is dandruff sometimes caused by inflammatory conditions like eczema or dermatitis?

“A lot of dermatologists talk about it [dandruff] being seborrhoeic dermatitis [which can present with scaly, itchy and red patches on skin on scalp, face and other areas of the body, according to the NHS website],” says Lyons. “But dermatitis is an inflammatory condition. With true dandruff, you don’t get inflammation, as it’s the non-inflammatory scaling of the scalp.”

There are some key differences to look out for between dandruff and inflammatory conditions, such as redness.

“Conditions like eczema and psoriasis are inflammatory conditions, so are always associated with redness and inflammation, whereas with dandruff, you don’t tend to get any redness,” notes Lyons.

However, redness may occur if you scratch your scalp.

“Not all dandruff causes itching, but obviously scratching can cause the appearance of redness,” he adds.

In addition, conditions like eczema tend to affect the face as well as the scalp.

“With eczema in particular, when it’s true eczema on the scalp, some of the facial areas like alongside the nose and the eyebrows get affected as well, and are red. So, that’s an indication of eczema, whereas dandruff would never cause that,” explains Lyons.

What can you do to treat or manage dandruff?

“Anti-dandruff shampoos have ingredients in them that help to reduce and even stop the yeast-like fungus that’s on the scalp, so they are very efficient,” says Lyons. “But, my advice would be to someone who’s not shampooing their hair regularly and frequently is to try shampooing at least every other day or daily, as that should help control it.

“You can also see a specialist, a trichologist like myself, if the symptoms don’t clear, or it’s very, very severe. There are different approaches that are slightly more intensive for people who are really fed up with it.

“For example, in some cases at our clinic, we would use a scalp mask, which is put on the scalp and then massaged in gently which is more intensive and goes in a bit deeper into the scalp skin, rather than just shampooing.”