Experts estimate that about 50% of all people will be affected by dandruff at some point in their lives.
The formation of dandruff on the scalp is caused by disruption of the stratum corneum. In principle, all variants are possible, from light and barely visible scales to scales appearing in large lamellae. Very subtle and almost imperceptible scaling occurs, for example in neurodermatitis of the scalp. The real problem is the itching, which is often very severe, forcing the sufferer to scratch.
With psoriasis of the scalp, more or less severe itching is also often troublesome. The characteristic clinical picture is rough scales, which appear mainly on the front and sides of the head and their appearance can vary from smooth, silvery to rough scaly. Redness often occurs, which becomes more or less noticeable depending on the density of the hair.
However, allergic or irritant contact eczema, which can be caused by hair dyes or hair beauty cosmetics, always causes severe peeling. The cause can be determined through an allergy test.
Dermatologists call the most common flaky problem seborrheic scalp eczema. This is an eczema that tends to occur in the winter and can be made worse by stress or increased alcohol consumption. Scaly skin is clearly visible and often yellowish in color. Often occurs not only on the hairy head, but also in the ear canal area, at the hairline, next to the nostrils and on the chest. Microbiologically, the skin shows increased colonization with a specific yeast fungus (Malassezia). Treatments directed against this fungus usually result in good therapeutic success, although not always long-lasting.
First and foremost, the dermatologist will make a diagnosis and then initiate appropriate therapy if other therapeutic agents that have been recommended at the pharmacy or drug store do not provide significant improvement.
The dermatologist has the opportunity to prescribe a form of therapy tailored to the respective scaly clinical picture of the various effective agents. The active ingredients cignolin, zinc phyritione, selenium sulfide, tar, ketoconazole, salicylic acid, cortisone and vitamin D3 are available in suitable aqueous, alcoholic, cream or ointment bases.
Often this depends on the knowledge of using the means correctly to ensure adequate effectiveness on the one hand and a high level of therapeutic safety for the patient on the other. The dermatologist, together with the patient, is also responsible for identifying and eliminating possible irritating factors that contribute to the development of dandruff. This also includes medications that you have to take if you have high blood pressure, for example, and which cause unpleasant flaking of the scalp as a side effect.
However, psoriasis and common neurodermatitis can also appear first on the scalp and require further dermatological clarification. If the treatment is successful, you can look in the mirror with confidence in the morning because the problem of splinters is no longer expected.