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Dandruff is a scalp condition that causes flakes of skin to appear. There may also be itching. Most people experience dandruff at some point in their lives, but it is more common from the teenage years up to midlife.

There are various possible causes, including seborrheic dermatitis, allergic reactions, psoriasis, and eczema. An overreaction to Malassezia , a yeast that occurs on the scalp, is among the causes of seborrheic dermatitis. Poor hygiene is not a factor , but the flakes may be more visible if a person does not wash or brush their hair often.

Some treatments will target an underlying condition, such as psoriasis. Others aim to exfoliate dead skin cells or counter the yeast production that can trigger dandruff.

If dandruff and itching are severe and persistent, or if symptoms worsen, it may be a good idea to see a doctor. They may identify an underlying problem that will respond to a specific treatment. For mild dandruff without a specific cause, various over-the-counter products can help manage flaking and itchiness. Before using an anti-dandruff shampoo, individuals should carefully try to remove as many scaly or crusty patches on the scalp as possible.

This will make the shampoo more effective. Gently use a comb or hairbrush to remove loose scales or flakes, and then wash with a medicated shampoo. Take care not to remove patches or plaques too aggressively, as this could irritate the condition.

Most anti-dandruff or antifungal shampoos contain at least one of the following active ingredients:. Dandruff shampoo is available online. Products to treat dandruff in the beard area are also available. How often a person needs to use a medicated shampoo may depend to some extent on their hair type. As a result, we obtained three isolated clusters.

One cluster was the negative interaction network of Staphylococcus and Propionibacterium , which were the major commensal bacteria on the scalp. Another cluster consisted of low abundance bacteria that were positively correlated with one another; most of them belonged to two phyla Proteobacteria and Actinobacteria that have been reported to be widely distributed in nature and commonly occur in soil and water 6.

The third cluster was the fungal network, with M. These results indicated that the bacteria and fungi located on the scalp were independent, and each had its own member relationships for competition or mutualistic symbiosis. Each node shows one genus of bacteria or one species of fungi. The size of the node corresponds to the log-transformed relative abundance of the microbiota.

The thickness of the edges corresponds to the r value of the Kendall relationship. The color of the edges corresponds to the positive red or negative blue relationship. The length of the edges has no meaning.

Of them, 33 genera including Staphylococcus showed a significant positive correlation with dandruff. In contrast, only two genera Propionibacterium and Labrys showed a significant negative correlation with dandruff Fig. Because Staphylococcus and Propionibacterium were the two dominant but reciprocally inhibited bacterial genera on the scalp, these results indicated that dandruff was mainly associated with the balance of these two genera.

Responding genera and OTUs are indicated by blue arrows. The top 10 key bacterial genera and the fungal OTU serial numbers were listed near the arrows. The color of the spot corresponds to the log-transformed relative abundance.

The genera or OTUs and samples are clustered according to Kendall correlations. These 27 OTUs belonged to M. Notably, the relationship between the OTUs of M. Fourteen OTUs of M. These results suggested that different strains of M.

Redundancy analysis was performed on the relationship between host factors demographics and physiological conditions and bacteria Table 2 and Supplementary Table S1.

This analysis indicated that the bacteiral community was significantly affected by the age, gender, sebum and TEWL and showed weak relationships with the sampling region and water content.

Of the two major genera, Propionibacterium was affected by the three host demographics, sebum and water content and prefered to exist on the side region, in males and the younger group. It also showed positive relationships with the sebum and water content. Staphylococcus was affected by the sampling region, TEWL and water content, showed a higher ratio with the top region of the scalp, and was positively associated with the TEWL and negatively associated with the water content.

In this study, we provide the first systematic view of the relationship among the host physiological conditions, demographics, commensal microbiota and dandruff. We found that dandruff was associated with the interactions between the host and the microorganisms on the human scalp Fig. The shape of the nodes corresponds to the type of each factor. The color of the edges corresponds to the positive red , negative blue or sole effect black relationship.

Microorganisms on the scalp, especially fungi, have been predominantly thought to be the main cause of the development of dandruff. In this work, we were surprised to observe that there was not a close association between the bacteria in genus and fungi in species. Furthermore, the relationship between bacteria and dandruff was stronger than the relationship between fungi and dandruff. This finding may be explained because Propionibacterium can secrete bacteriocins to suppress the growth of Staphylococcus 25 , whereas Staphylococcus can mediate the fermentation of glycerol and inhibit the overgrowth of Propionibacterium Compared with a normal scalp, the dandruff region had decreased Propionibacterium and increased Staphylococcus , suggesting that the balance between Propionibacterium and Staphylococcus might be important to the severity of dandruff.

Clavaud has recently noted that the disequilibrium in the proportion of the major bacterial and fungal populations was associated with dandruff 6. Our result is somewhat different in that we did not find close linkages between the bacteria and fungi. Moreover, overall fungi did not exhibit an important role in the severity of dandruff at either the species or OTU level.

This discordance in the evaluation may be partially due to the functional diversity within the fungal species. Indeed, we found that different OTUs of the same Malasseiza species showed opposing relationships with dandruff, which consists with the studies in Brazilian and Japanese population that different Malassezia subtypes were found in different proportions in samples 27 , This finding suggests that not all of the Malassezia are bad for healthy scalps. Thus, studies of the relationship between fungi and dandruff might be more reasonable at the OTU level instead of the species level.

Our study revealed that the physiological conditions were highly relevant to the host age and varied in different regions of the same scalp. Scalp sebum could act as a food source for Propionibacterium , and a high water content provided a suitable environment for Propionibacterium growth. The relationship between the severity of dandruff and the bacteria suggested that adjusting the equilibrium of the bacteria, particularly by increasing the Propionibacterium and decreasing the Staphylococcus on the scalp, might be a novel way to lessen the severity of dandruff.

The interactions among host factors and microorganisms imply that regulating host physiological conditions may also be a solution to inhibit the development of dandruff.

Volunteers with overall healthy physical condition but varying dandruff levels were recruited from the Shanghai Skin Disease Hospital Shanghai, China , which holds a big biobank collecting special samples for scalp and hair test. The bank had been more than two years before our study and all subjects should not use any anti-dandruff products once they joined in the bank.

After screening, 60 qualified subjects joined the formal test and 59 subjects finished the test. Their physiological information was recorded Table 1. All experiments were performed in accordance with the approved guidelines and regulations. All of the volunteers signed the informed consent, which explained the procedure and purpose of the study. The dandruff level of each division was graded according to the grading approach of the adherent scalp flaking scale ASFS Supplementary Fig.

S1 For each subject, 3 divisions with minimum, medium and maximum ASFS scores were marked for sampling. In brief, subjects held electrode with hands and then the probe was pressed slightly onto the scalp for several seconds until values displayed on the panel.

The sample collection was performed on the previously marked division of each subject using swabs based on the procedure proposed by Gemmer et al. Bacterial and fungal DNA were extracted using the DNeasy Tissue kit Qiagen, according to the provided protocols with minor modifications Shanghai, China.

Briefly, sequences were quality trimmed, and chimeric sequences were identified with ChimeraSlayer and removed. Network drawing was performed in Cytoscape 3. How to cite this article : Xu, Z. Dandruff is associated with the conjoined interactions between host and microorganisms.

Sommer, B. Identification and characterization of lipases from Malassezia restricta, a causative agent of dandruff. Ro, B. The role of sebaceous gland activity and scalp microfloral metabolism in the etiology of seborrheic dermatitis and dandruff.

J Investig Dermatol Symp Proc 10 , — DeAngelis, Y. Three etiologic facets of dandruff and seborrheic dermatitis: Malassezia fungi, sebaceous lipids, and individual sensitivity. Article Google Scholar. Turner, G.

Stratum corneum dysfunction in dandruff. Int J Cosmet Sci 34 , — On the scalp, you may have reddish patches, dandruff-like flaking, silvery-white scale, and dryness. Scalp psoriasis is often itchy, with the itch ranging from mild to intense, notes the American Academy of Dermatology Association.

Tinea Capitis This highly contagious fungal infection is also called ringworm of the scalp and hair shafts. Symptoms may include itchy, scaly, and bald patches on the head.

Tinea capitis is most common in toddlers and school-age children, per the Mayo Clinic. Editorial Sources and Fact-Checking. Seborrheic Dermatitis. Merck Manuals: Consumer Edition. March American Osteopathic College of Dermatology. National Eczema Association. Journal of Medical Chemistry. March 19, Seborrheic Dermatitis — Looking Beyond Malassezia. Experimental Dermatology. July 16, American Academy of Dermatology Association.

The Facts about Dandruff. PIH Health. April 12, Cleveland Clinic. May 29, Journal of Clinical and Investigative Dermatology. December July 23, Seborrheic Dermatitis Diagnosis and Tests. Dandruff Diagnosis and Treatment. Mayo Clinic. September 11, Skin cells are formed continuously on the scalp, so the shedding of dead skin cells is a normal process.

Sometimes with dandruff, however, skin cells are shed at a faster rate than normal. Oil from the scalp causes the skin cells to clump together and appear as white flakes.

Dandruff can be caused by a number of things, including dry skin; sensitivity to hair products; and skin conditions such as seborrheic dermatitis or eczema.

The overgrowth of a yeast-like fungus can also cause dandruff. This overgrowth can be caused by stress, hormones, too much oil on the scalp, or problems with the immune system.

The symptoms of dandruff include white flakes of dead skin in the hair and on the shoulders, as well as an itchy, red, or scaly scalp. Dandruff flakes are usually scattered throughout the scalp. If seborrheic dermatitis is the cause of dandruff, the symptoms usually appear gradually. The scalp becomes dry or greasy, is red, and feels itchy. As skin cells die, they turn to yellowish scales. A bad case of seborrheic dermatitis can also cause symptoms in other parts of the body.