DANDRUFF: CAUSES AND TREATMENT

Pityriasis capitis/simplex is more popularly known as dandruff and can be defined as non-inflammatory excessive scaling of the scalp that represents the more active spectrum of the physiologic desquamation.

Most often dandruff is purely a cosmetic problem with presence of unaesthetic flaking of scales on scalp, descending onto the face and the shoulders.

 

HISTORY OF THE PATIENT:

• Inquiry into severity, pruritus frequency of hair washing/shampooing and seasonal variation is required.
• Further inquiry into medication (gold therapy), dietary deficiencies (vitamin B complex), and history of acne, seborrhoeic dermatitis and psoriasis.

CLASSIFICATION:

 

Dandruff can be graded based on the degree of scale ranging from 0 to 10 i.e. from no trace of scaling to massive scaling.

 

Mild/Grade I - Visible fine scaling, non pruritic, non inflammatory of pure cosmetic significance.

 

Moderate/Grade 2 - Large scaling with pruritus, mild inflammatory changes associated with diffuse alopecia, acne or seborrhea.

 

Severe/Grade 3 - Severely inflammatory, severe signs may require scraping of potassium hydroxide mount (tinea capitis) or biopsy (seborrhoeic dermatitis, psoriasis).