Dandruff and scalp problems are extremely common, with nearly half of the world’s population affected. While dry, itchy or inflamed skin conditions can vary in their severity and duration, herbal and natural remedies may help to nourish and relieve the scalp and promote healing.
The symptoms of scalp conditions depend on the cause – with the most readily identifiable symptoms linked to dandruff and seborrheic dermatitis. Second to these, psoriasis of the scalp is also relatively common, with its own set of uniquely identifiable symptoms.
Dandruff and seborrheic dermatitis are often considered to be the same condition, but at opposing ends of severity. Either scalp condition is commonly characterised by a scaling (known as hyperkeratosis) where the outermost layer of skin (known as the stratum corneum) clumps together. People reporting dandruff often actually have seborrhoeic dermatitis, but other skin conditions such as psoriasis or eczema can also be mistaken for dandruff.
Dandruff and seborrheic dermatitis are rare between infancy and puberty, but are prominent in infants up to three months as well as in adults.
Dandruff (also known as pityriasis capitis) is the most common and mildest form of seborrheic dermatitis. It is characterised by a series of common symptoms, including:
Seborrheic dermatitis is a more severe form of skin condition. It is similar to and sometimes occurs in patients with eczema. Scaling of the skin is typically marked by greasy, yellowish scales that form around the scalp, face, nasal folds and eyebrows, and can extend to the ear canal, armpits, upper chest, pubic area and groin region. The scaling may be contained in patches, or spread across the surface of the scalp and skin.
Similar to dandruff, seborrheic dermatitis can lead to irritation, a feeling of tightening caused by dryness, and inflammation.
Cradle cap is a form of seborrheic dermatitis that typically occurs in infants in the second to tenth week of life, peaking at three months of age. It appears as thick, greasy scales on the vertex (centre) of the scalp. Scales typically appear as large white, off-white or yellow flakes.
Psoriasis is a chronic inflammatory condition that affects 2% of the population worldwide, with roughly half of all cases involving the scalp.
On the scalp, psoriasis of the scalp typically presents itself as clearly defined scalp plaques, which look like raised, red patches covered with a silvery white build up of dead skin cells. Itchy scalp and burning may typically follow the appearance of lesions.
The scalp protects the head through its dense follicular structure and high rate of sebum production (which is responsible for its natural oiliness). These characteristics also create an ideal environment for microorganisms to flourish, making the scalp prone to surface-level fungal infections, parasite infestation and inflammatory skin conditions.
While the causes of dandruff and seborrheic dermatitis are not completely understood, the various forms of seborrheic dermatitis can be linked to several causal factors, including changes in hormone levels, fungal infections, nutritional deficiencies and issues related to the nervous system.
Scalp conditions such as psoriasis may also be exacerbated by friction and injury. Heated styling elements such as blow dryers and hair straighteners in particular can irritate and aggravate the scalp.
Dandruff and seborrheic dermatitis have been linked to a type of fungal infection from the Malassezia species, a species of yeast that feed off lipids (fatty acids) found in sebum.
Malassezia settle in those areas of the body that are high in sebaceous glands where they metabolise neutral fats, producing oleic acid. In turn, the oleic acid can penetrate the outer layer of the skin and disrupt its normal barrier functions, ultimately triggering an inflammatory response that causes skin cells to split and flake.
Dandruff and seborrheic dermatitis are known to flare up in response to allergies. There may also be links to the change of seasons, as it sometimes worsens in winter.
Scalp conditions such as psoriasis are known to have some genetic link. A genetic predisposition to psoriasis or a link to family members with the condition may play a part in its occurrence.
In traditional Chinese medicine (TCM), symptoms of dandruff and seborrheic dermatitis, including dry, itchy skin and inflammation, are often associated with an energetic imbalance in which there is excess Dampness in the body, often followed by excess Wind and/or Heat.
Scalp problems that are caused by Damp-Heat commonly exhibit redness, inflammation and swelling (such as seborrheic dermatitis and dandruff), while scalp problems involving Damp-Wind tend to be itchy and irritable (such as psoriasis).
The impact of dandruff is purely cosmetic in nature; dandruff is not harmful or contagious and if left untreated does not lead to more serious conditions. Seborrheic dermatitis, on the other hand, can be more difficult to treat. Several treatment options may help the scalp to soothe and heal and alleviate symptoms of both conditions.
In traditional Chinese medicine (TCM), the internal treatment of dandruff and scalp conditions often involves the use of herbs with cooling properties that dispel excess Wind and Dampness, such as Fang Feng, Dong Quai, White Peony and Fallopia Multiflora.
Burdock, traditionally regarded to improve skin conditions by supporting detoxification, purifying the blood purifier and aiding metabolic waste elimination, is also used to cool and dispel excess Heat.
Zinc may assist in the management of mild-to-moderate dermatitis, and the alleviation of minor wounds often attributed to dermatitis - such as scratching and abrasions. Zinc and vitamin C contribute to the healthy functioning of the immune system, and in assisting the body to maintain and repair healthy skin cells and fight infection.
Topical applications of natural antiseptics such as aloe vera, tea tree oil and golden seal have been traditionally used to soothe and calm itchy and inflammatory skin conditions such as dermatitis. Echinacea may also enhance the resistance of the body to infection, promoting the healing of wounds and new tissue formation.
Dandruff and scalp conditions may also be attributable to diet and nutritional deficiencies, but as yet there is no clear link. In managing seborrheic dermatitis, there are several things you can do to reduce inflammation, relieve itching and the negative effects of scaling, including:
For more information treating dandruff and scalp problems, visit our hair health concerns page.