## How dandruff happens The skin has a high lipid content, which is a favorable breeding ground for the fungus Pityrosporum ovale. Under certain conditions, it becomes aggressive and destroys the skin barrier. What can become a trigger?=== - Skin diseases — seborrheic dermatitis, psoriasis, atopic dermatitis, eczema, pityriasis versicolor, acne, and others - Endocrine disorders, metabolic changes such as obesity, diabetes mellitus - Gastrointestinal diseases - Specific infections - Decreased immunity - Emotional and mental stress - Physical stress - Increased sweating - Nutritional issues such as alcohol consumption, sweet, spicy, and fatty foods, carbonated drinks, fast food, individual allergenic products - Certain medications (for example, antibiotics, immunosuppressants) - Lack of vitamins, microelements - The influence of climatic conditions including excessive humidity, cold, heat - Incorrectly selected care products such as shampoos, creams, hair dyes - Aggressive self-care including drying with a hot hairdryer, skin burns with chemicals - Environmental air pollution, water composition ## Symptoms to look out for Dandruff shows up as white scales found all over the scalp, and sometimes in patches of the ears, face, back, and chest. It is accompanied by itching, a feeling of dryness or excessive oiliness of the scalp, and, in rare cases, hair loss. ## Treatments A quick purchase of dandruff shampoo at the supermarket probably won't help. To identify the cause and draw up a treatment plan, you will have to consult with a dermatologist, who will individually select an anti-seborrheic agent that has antifungal activity. These substances are divided into two large groups: synthetic in the composition of medicines and substances of natural origin. Of the synthetic drugs, the leading imidazole derivative is ketoconazole, typically sold as a 1–2 % concentration in shampoos and less often as creams. Pyrithione zinc and octopirox are also widely used, which are included in well-known shampoos — for example, Head & Shoulders. There is also a group of products containing tar, sulfur, or ichthyol. In extreme cases, strictly according to the doctor's prescription, hormonal creams and sprays are used in combination with salicylic acid. Extracts of some plants have a sebum-regulating effect — for example, nettle, birch buds, celandine, chamomile, calendula, burdock, and oak bark (as infusions for rinsing). The duration of treatment depends on the severity of the disease. Typically, short-term treatment is between 2–6 months. Chronic dandruff requires prolonged use of medicated shampoos and return to treatment as the problem develops. ## Other considerations The skin's immune line of defense is strengthened with vitamins (D, A, E, groups B, C), trace elements, foods with these vitamins, and herbal extracts. Microelements such as iron, zinc, copper, and iodine are also important. Doses and frequency of internal and local treatment are prescribed by a doctor. To improve the condition, it is necessary to follow a diet with restrictions of sweet, fatty, and spicy foods, except alcohol and carbonated drinks. It is recommended to eat lean meat including turkey and beef, dairy products, fruits, and fresh juices. It is also recommended to sleep at least 7–8 hours each night as well as get fresh air and sunshine.