Nearly 50 percent of the world's population will suffer from dandruff at some point in their lifetime, according to Dr. Seema Hirji, a dermatologist. While some cases are easy to treat, others are more extreme and require medical intervention. Extreme dandruff may result from a medical condition, dietary choice or external influence. Treating extreme dandruff is often done with special shampoos, but steroid lotions may be needed in some cases.
Characteristics
A condition of the scalp, extreme dandruff results in a scaly, itchy scalp with flaking skin. Extreme dandruff is often caused by a condition called seborrheic dermatitis.
The condition is not contagious but can be embarrassing for those afflicted with the disorder.
Common Causes
There are a few causes for dandruff in general, and depending on how extreme the dandruff is, other factors may be considered.
Dry skin is a common reason for dandruff, though the flakes associated with dry skin dandruff are often smaller and less oily than severe cases of dandruff.
If hair and scalp are not shampooed often, it allows oils and skin cells to build up, which can result in dandruff. Also, if any allergy exists to a hair care product, a condition called "contact dermatitis" can occur and result in dandruff.
Medical Causes
Seborrheic dermatitis, an extreme case of dandruff, is more difficult to treat. The skin is very oily and irritated and often has a layer of crust on the scalp resulting in scales that attach to the hair follicle. In babies, this condition is referred to as "cradle cap."
Skin disorders like psoriasis and eczema may also be responsible for extreme dandruff if they exist on the scalp. Psoriasis causes dead skin cells to build up and form thick scales. Eczema causes the skin to be more sensitive, often resulting in an itchy red rash.
Another possible medical cause for extreme dandruff is a yeast-like fungus called malassezia. Malassezia is present on most adult's scalps and usually does not cause a problem. Occasionally the malassezia will get out of control and begin feeding on oils surrounding the hair follicles. As the dead skin cells fall off, they clump together with the oils and become more visible on clothing.
Risk Factors
Young adults are more likely to get dandruff until they are middle-age adults. Occasionally it will be a lifelong problem. Men tend to suffer from dandruff more than women and, according to the Mayo Clinic, have larger oil glands on their scalps which could increase the risks of getting dandruff.
Diet and illness can also play a part in extreme dandruff. The Mayo Clinic indicates diets deficient in zinc, B vitamins or specific fats may increase chances of suffering from dandruff.
Other illnesses make adults more likely to suffer from extreme dandruff for reasons that are not yet understood. Adults suffering from neurological disorders, recovering from heart attacks or strokes and those who have compromised immune systems are also more likely to suffer from extreme dandruff.
Treatments
Depending on how extreme the dandruff is, treatments can vary from over-the-counter shampoos to steroid lotions. Regardless of how extreme the dandruff is, the first recommended treatment option is over-the-counter shampoos.
Such shampoos should contain at least one of the following ingredients: ketoconazole, ciclopirox, tar, pyrithione zinc, selenium sulfide or salicylic acid. Shampooing with these products should be done once a day until symptoms are under control and then two or three times a week.
If these shampoos do not cure the extreme dandruff, a medical professional may prescribe topical corticosteroids, anti-fungal medications or even oral medications.
