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Can dandruff cause hair loss?

Dandruff is not a direct cause for hair loss but it can exacerbate genetic baldness

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Dandruff in itself is harmless

Dandruff refers to the flaking of the scalp’s skin, which often is accompanied by itchiness. It happens when skin cells on the scalp reproduce too quickly and old cells are shed in high frequency. Small pieces of dry skin come off the scalp and often end up on the clothing, covering the shoulder areas and the back. 

There are many reasons for why dandruff can develop, ranging from using the wrong shampoo or hair dye that irritate the skin to dehydration, excessive hair washing and experiencing abrupt air moisture changes (for example, when you move to Nevada after having lived your whole life in Hawaii). 

There also is a more severe and not uncommon condition called malassezia, which sounds like Spanish gourmet food but actually is a fungus that lives on most people’s heads and sometimes can trigger excessive skin cell growth. Malassezia converts natural skin oils on the scalp into other chemical compounds that can irritate the skin. Some bacteria can do the same. About 50 percent of adults at least once in their lifetime experience dandruff, with men being more often affected than women.       

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Dandruff for many people is an aesthetic nuisance and sometimes cause for embarrassment (to be on the safe side, try white and light grey clothes on a date), but dandruff does not harm hair. Several clinical studies could not establish a causal relationship between dandruff and hair loss. 

What can do harm is when the scalp gets so itchy that people start scratching. Frequent scratching can damage hair follicles and thus cause individual hairs to fall out. However, it would take much and constant scratching to achieve a visible balding effect.   

 

However, dandruff can worsen genetic pattern hair loss

While not directly triggering hair loss, there is some evidence that dandruff can expedite the progress of androgenic alopecia (pattern hair loss) in men and women. Androgenic alopecia is a genetic condition that causes up to 80 percent of men and roughly 50 percent of women to loose hair as they get older. Hair loss here is caused by a hormonal process that injures hair follicles and inhibits them from growing new hair.

Research shows that the presence of dandruff may stress the already damaged hair follicles and thereby speed up the balding. The accompanying itching and scratching further damages the follicles. Therefore, dermatologists usually recommend that men and women who suffer from pattern hair loss use special anti-dandruff shampoos at the first sign of dandruff. Talk to your dermatologist to find out what medicated shampoos or other haircare products would work best for you to combat dandruff’s effect on androgenic alopecia.     

 

How to fight dandruff

There are several effective treatments for getting dandruff and the associated itchiness under control. In mild cases, keeping yourself hydrated and regularly moisturizing the scalp with a good conditioner and/or lotion will solve the problem. Massaging the scalp with oil, such as coconut oil or special hair oils will also work, but sometimes the scalp may be irritated further by the oil. It’s best to first check with a dermatologist before deciding on an oil massage treatment.

If none of the above works, there is a wide range of special antidandruff shampoos on the market that often effectively eliminate the dandruff problem within a few weeks of use. 

Another, admittedly radical way to reduce dandruff would be to completely shave off your hair, as it destroys the cozy living environment of the malassezia fungus. A shaved head is too cold and light for malassezia to dwell on. If your head is shaved but still itchy and speckled with flakes of old skin, your scalp most likely is simply dehydrated, but it is not dandruff.  

 

References

  1. Piérard-Franchimont, C., et al. “Revisiting Dandruff.” International Journal of Cosmetic Science, vol. 28, no. 5, Oct. 2006, pp. 311–318, https://doi.org/10.1111/j.1467-2494.2006.00326.x. Accessed 28 Nov. 2019.
  2. Alexanber, Suzanne. “Loss of Hair and Dandruff.” British Journal of Dermatology, vol. 79, no. 10, Oct. 1967, pp. 549–552, https://doi.org/10.1111/j.1365-2133.1967.tb11411.x. Accessed 28 Nov. 2019.
  3. Pierard-Franchimont, C., et al. “Dandruff-Associated Smouldering Alopecia: A Chronobiological Assessment over 5 Years.” Clinical and Experimental Dermatology, vol. 31, no. 1, Jan. 2006, pp. 23–26, https://doi.org/10.1111/j.1365-2230.2005.02026.x. Accessed 28 Nov. 2019.

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