Blame it on stress. Blame it on your genes. Blame it on the heat and humidity here in Southeast Asia. Beyond those dreaded white flakes, symptoms of dandruff include oily, itchy, inflamed, and irritated skin. It may not be contagious or life-threatening, but dandruff is indeed a mild form of an inflammatory scalp disease called seborrheic dermatitis and it may be holding you back from living your best life in black blazers and other dark garments.
Like skin on the face and body, the turnover of cells averages at about 28 days however those experiencing seborrheic dermatitis encounter this at an increased pace. Not to dandruff shame anyone, and to prove that this is entirely manageable, Dr Teo Wan Lin of TWL Specialist Skin & Laser Centre assures us that dandruff is common, particularly on this side of the equator. “The common scalp problems seen in Singapore and Malaysia are due to our [tropical] climate, which means that it creates very a specific skin and scalp microenvironment,” shares Dr Teo. “There is increased retention of sweat because of the low evaporation rates owing to the humidity and warm temperatures from the tropics.” In short, our balmy climate creates a literal hotbed for the microorganisms that set up shop and cause scalp problems to flourish. Truly, hair-raising stuff.
What causes dandruff?
“Dandruff is a lay person’s term for a medical condition called seborrheic dermatitis,” says dermatologist, Dr Teo who sees this in individuals who tend to be more active, such as athletes or people who work outdoors and are naturally prone to sweating more. “In this case, [dermatitis] is a combination of excess sebum, which is oil production, as well as the overgrowth of a yeast organism known as Malassezia furfur.” While healthy people may have fungal Malassezia furfur on their skin and scalp, an “overgrowth of these organisms” leads to an “imbalance of the microbiome, which is the balance of good bacteria, pathogenic bacteria, and various yeast organisms.”
“Excess sebum production as well as the proliferation of this yeast, Malassezia, is the cause of seborrheic dermatitis,” says Dr Teo who shares that those experiencing dandruff may also have a “slightly different physiochemical composition of their sebum” which yeast thrives on.
What are the symptoms of seborrheic dermatitis or dandruff?
Dr Teo shares that a common complaint amongst patients is the excess production of oil, with many troubled by “very greasy scalp symptoms.” In these instances, abstaining from washing their hair for more than 24 hours results in a significant itch associated with dandruff. Aside from flakey dandruff, seborrheic dermatitis and a concomitant disease known as scalp folliculitis or pimples on the scalp are common in our region, according to Dr Teo.
What lifestyle and environmental factors trigger dandruff?
Does the old ‘you are what you eat’ adage apply to our scalp? Dr Teo says that based on acne studies, “deep fried saturated fats in your meals increases your production of oil. What’s more important to appreciate is the role of a poor diet, as well as a sedentary lifestyle in terms of one’s physiology. The skin and the scalp have to deal with a lot of inflammation on a daily basis because it is exposed to the external environment.” Tackling dandruff holistically, Dr Teo shares, “Excessive sun exposure, exposure to environmental pollutants and in the case of a poor diet and lifestyle increase the amount of free radical damage that occurs in our bodies, on our skin and also on the scalp and that in turn leads to inflammatory processes.”
According to Tien Goh, Shiseido Professional’s education manager, oily dandruff is greasy and clumpy. It may be caused by insufficient shampooing or products that are too rich. Goh also reminds us to wash our hair thoroughly after exercising or excessive sweating and to not go to bed with wet hair, as moist scalp encourages bacteria growth on the scalp and pillow. Dry dandruff on the other hand is characterised by white and flat flakes, and is caused by scalp that lacks hydration and other Natural Moisturising Factors, according to Goh. Breaking down the keys to healthy scalp, Goh says it’s about achieving a “balance of hydration inside the epidermis layer of the scalp and sufficient sebum on the Stratum corneum, otherwise known as the outer layer of our skin.” How do we know if we have dry or oily skin? Look at the skin on your forehead after cleansing, says Goh, and you’ll get a sense of your scalp, which can be dry, oily, sensitive or a combination of all of the above.
How to get rid of dandruff
Dr Nisha Suyien Chandran, head and senior consultant of the National University Hospital’s dermatology division says, “People with oily scalp or dandruff can use over-the-counter anti-dandruff shampoos periodically. These usually contain Zinc Pyrithione as the active ingredient. These shampoos can be interspersed with a regular shampoo. Medicated anti-dandruff shampoos such as Ketoconazole shampoo can likewise be used periodically, under the direction of a doctor.” However, Dr Chandran warns that adverse reactions to Ketoconazole include dry skin, itch, abnormal hair texture or other signs of contact dermatitis. Needless to say, make a beeline to your GP or dermatologist if you’re experiencing these side effects.

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Shiseido Professional Sublimic Fuente Forte Dandruff Shampoo
For hair that’s healthy and unplagued by dandruff, this at-home treatment works across oily, dry, and combination scalp to remove dandruff flakes and the itchiness associated with it. It helps create a healthier scalp environment while rebalancing combination scalp, leaving locks lighter after every wash.
Shiseido Professional Sublimic Fuente Forte Dandruff Shampoo, $38 for 250ml; available at Shunji Matsuo

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Rene Furterer Melaleuca Anti-Dandruff Shampoo for Oily, Flaking Scalp
Melaleuca anti-dandruff shampoo is enriched with clarifying and stimulating essential oils to eliminate greasy, clumpy dandruff while helping to stave off relapses. It helps to reduce the growth of Pityrosporum ovale or Malassezia furfur, the fungus that causes dandruff with active ingredients of Zinc pyrithione, tea tree oil and Curbicia extract to purify the scalp, reduce itching, and regulate oil production on the scalp.
Rene Furterer Melaleuca Anti-Dandruff Shampoo for Oily, Flaking Scalp; $39.80 for 120ml; available at Guardian

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Goldwell Dualsenses Scalp Specialist Anti-Dandruff Shampoo
It can be frustrating for those with sensitive scalp and thinning hair to also have to battle dandruff: thankfully, this mild cleansing shampoo regulates the scalp function to fight against seborrhoeic dermatitis. The Dualsenses Scalp Specialist Anti-Dandruff Shamppoo regulates the scalp with hydro-lime extract and octopirox to deep cleanse, degrease and add freshness to your tresses.
Goldwell Dualsenses Scalp Specialist Anti-Dandruff Shampoo, $30 for 250ml; available at Evolve Salon

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Vichy Dercos Anti-Dandruff Sensitive Scalp Shampoo
There’s nothing more annoying than purchasing an anti-dandruff shampoo to discover it’s too harsh and stripping on your already irritated scalp. For those with sensitive scalp, this sulfate and paraben-free shampoo eliminates and controls dandruff for up to six weeks, all while soothing scalp discomfort. Use several times a week to prevent a dandruff relapse.
Vichy Dercos Anti-Dandruff Sensitive Scalp Shampoo, $25 for 200ml; available at Vichy

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Kérastase Intense Anti-Dandruff Care
An anti-dandruff scalp treatment programme to help treat and remove oily and dry dandruff flakes from the comfort of your own home. It features a dozen 6ml vials that aims to restore the quality of the scalp while protecting it against oxidative stress. Its benefits extend long after the programme, with the appearance of visible flakes reduced by up to four weeks after treatment.
Kérastase Intense Anti-Dandruff care, $60 for box of 12 vials; available at Sephora

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Oribe Serene Scalp Soothing Leave-On Treatment
Scalp is as complicated as the skin on our faces and when it comes to treating dandruff with a side of sensitive scalp thrown in, look no further than Oribe’s lightweight BHA-infused treatment. It gently exfoliates loose dandruff flakes while energising the scalp and rejuvenating hair follicles. Oribe’s Signature Complex of watermelon, lychee and Edelweiss flower extracts help defend hair from oxidative stress, photoageing and the damaging and colour-depleting effects of the environment. Peppermint oil offers instant cooling relief, while willowherb, aloe, cucumber and rosemary help calm and protect against free radical damage, leaving you to go ahhhh with every application.
Oribe Serene Scalp Soothing Leave-On Treatment, $68 for 50ml; available at Kim Robinson