Dandruff (Pityriasis Simplex Capillitii)

Dandruff is a skin condition that mainly affects the scalp.Symptoms include flaking and sometimes mild itchiness.It can result in social or self-esteem
problems.A more severe form of the condition, which includes inflammation of the skin, is known as seborrheic dermatitis.

The cause is unclear but believed to involve a number of genetic and environmental factors.The condition may worsen in the winter.It is not due to poor
hygiene.The underlying mechanism involves the over growth of skin cells.Diagnosis is based on symptoms.

There is no known cure.The typical treatment is with antifungal cream such as ketoconazole.Dandruff affects about half of adults.Onset is usually at
puberty.Males are more often affected than females.Rates decrease after the age of 50

Signs and symptoms
Severe dryness of scalp resulting in Dandruff.
Typical case of dandruff.
The signs and symptoms of dandruff are an itchy scalp and flakiness.Red and greasy patches of skin and a tingly feeling on the skin are also symptoms.

Causes
Dandruff can have several causes, including dry skin, seborrhoeic dermatitis, not cleaning/scrubbing often enough, shampooing too often, scalp psoriasis, eczema,
sensitivity to hair care products, or a yeast-like fungus.Dry skin is the most common cause of flaking dandruff.

As the skin layers continually replaces itself, cells are pushed outward where they die and flake off. For most individuals, these flakes of skin are too small to
be visible. However, certain conditions cause cell turnover to be unusually rapid, especially in the scalp. It is hypothesized that for people with dandruff,
skin cells may mature and be shed in 2–7 days, as opposed to around a month in people without dandruff. The result is that dead skin cells are shed in large,
oily clumps, which appear as white or grayish flakes on the scalp, skin and clothes.

According to one study, dandruff has been shown to be possibly the result of three factors:

Skin oil commonly referred to as sebum or sebaceous secretions
The metabolic by-products of skin micro-organisms (most specifically Malassezia yeasts)
Individual susceptibility and allergy sensitivity.

Treatment

Ketoconazole (Nizoral) shampoo
Shampoos use a combination of special ingredients to control dandruff.

Antifungals
Antifungal treatments including ketoconazole, zinc pyrithione and selenium disulfide have been found to be effective.Ketoconazole appears to have a longer
duration of effect.

Ketoconazole is a broad spectrum antimycotic agent that is active against Candida and M. furfur. Of all the antifungals of the imidazole class, ketoconazole has
become the leading contender among treatment options because of its effectiveness in treating seborrheic dermatitis as well.

Ciclopirox is widely used as an anti-dandruff agent in most preparations.

Coal tar
Coal tar causes the skin to shed dead cells from the top layer and slows skin cell growth.

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