Shake it off: the best scalp solutions to banish dandruff and keep you flake-free

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.