Dandruff doesn’t directly cause hair loss. However, it can sometimes contribute to it. Flaking often leads to an itchy scalp, and frequent scratching may damage hair follicles (the base of the hair strand) or cause breakage. Some underlying conditions that cause dandruff can also cause scalp inflammation, disrupt hair growth, and increase the risk of hair loss.
Dandruff is a common condition that causes the skin on your scalp to flake. It doesn’t directly cause hair loss. However, dandruff can contribute to it in several ways. Your scalp may feel itchy and irritated as the skin flakes off due to dandruff. This may cause you to scratch or pick at your scalp in an attempt to find relief, which can damage hair follicles and lead to hair thinning or breakage.
One of the main causes of dandruff is a type of yeast called Malassezia. This yeast lives naturally on the scalp and can grow out of control, especially when there’s a lot of sebum (oil) on the skin.
Other factors that can contribute to dandruff include:
- Hormonal changes
- Certain hair products or styling habits
- Stress
- Cold, dry weather
- Nutritional deficiencies, particularly zinc and B vitamins
Several conditions can cause dandruff and also lead to hair loss. Causes often involve scalp inflammation, infection, or irritation. This can lead to temporary or, in some cases, permanent thinning.
1. Seborrheic Dermatitis
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Seborrheic dermatitis is a chronic (long-term) skin condition that affects areas with a lot of oil, including the scalp. It causes:
- Scaly patches
- White or yellow skin flakes
- Scalp redness
- Itching
The irritation and frequent scratching may lead to hair breakage or shedding. In more severe cases, inflammation from seborrheic dermatitis can weaken the hair follicles, contributing to hair thinning.
2. Scalp Psoriasis
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Scalp psoriasis is an autoimmune condition that makes skin cells grow faster, resulting in thick, scaly patches of skin (plaques). On the scalp, these can appear as raised, crusted patches or fine, flaking areas.
The buildup and inflammation can cause temporary hair loss. Some medicated shampoos used to treat scalp psoriasis may dry out the hair, making it more likely to break.
3. Scalp Ringworm
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Ringworm (tinea capitis) is a fungal infection that affects the scalp. It often starts as a red, itchy, circular rash and may cause hair in the affected area to fall out. Without treatment, the infection can spread and create larger bald spots.
4. Yeast Overgrowth
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An overgrowth of Malassezia, a yeast that naturally lives on the scalp, can lead to dandruff. When this happens, it may also lead to inflammation and irritation that affects the scalp’s ability to support healthy hair growth.
Another type of yeast, Candida, may also affect the scalp. Both types of yeast overgrowth can disturb the scalp environment, leading to increased flaking, itching, and possible hair thinning.
5. Folliculitis
Folliculitis is inflammation of the hair follicles. It most commonly develops due to a bacterial, fungal, parasitic, or viral infection that affects the scalp. Folliculitis may appear as small pimples or bumps around hair follicles and can feel tender or itchy. In some cases, folliculitis can lead to scarring on the scalp, which can damage hair follicles and cause patchy, permanent hair loss.
Dandruff is usually manageable at home. Over-the-counter (OTC) shampoos are generally the first line of treatment and can help relieve itching, reduce flaking, and soothe an itchy scalp.
Try to use medicated shampoos that contain any of these active ingredients:
- Zinc pyrithione
- Ketoconazole
- Selenium sulfide
- Coal tar
- Salicylic acid
Always follow the directions on the label. Many dandruff shampoos work best when left on the scalp for five to ten minutes before rinsing. Use them consistently to see the best results.
If your scalp still feels irritated, applying a small amount of OTC hydrocortisone cream to itchy areas may help relieve discomfort. Use it sparingly and only for short periods unless otherwise directed by your doctorr.
When OTC options aren’t enough, a dermatologist can help. A dermatologist is a doctor who specializes in diagnosing and treating hair, skin, and nail conditions. They may prescribe stronger treatments, including antifungal shampoos or topical (applied to the skin) medications, to manage inflammation and reduce flaking more effectively.
Good hair care habits can help prevent hair loss that sometimes comes with dandruff. These habits can keep your scalp healthy and reduce the risk of hair loss:
- Use dandruff shampoo regularly: Even when flakes improve, continue using a medicated shampoo once or twice a week to prevent future flare-ups. Otherwise, wash your hair regularly with a gentle shampoo to remove dead skin cells and excess oil.
- Avoid scratching: Scratching the skin on your scalp can damage hair follicles, leading to hair thinning or breakage.
- Keep your scalp moisturized: Use a lightweight, non-comedogenic scalp oil or conditioner to help prevent dryness.
- Limit tight hairstyles: Styles that pull on the scalp, such as braids, buns, or ponytails, can increase hair tension and the risk of breakage. Choose loose styles that don’t put pressure on your scalp or hair follicles.
- Protect your scalp from the sun: Ultraviolet (UV) rays from the sun can irritate skin and worsen dandruff symptoms. Wear a wide-brimmed hat outdoors to protect your scalp from sun damage, and consider using a broad-spectrum sunscreen with SPF 30 or higher to prevent skin damage.
- Eat a balanced diet: Making sure you’re getting nutrients such as biotin, zinc, iron, and omega-3 fatty acids is important for maintaining healthy hair and scalp.
Consider seeing a dermatologist if you experience dandruff that doesn’t improve after a few weeks of at-home treatment or have dandruff with any of the following symptoms:
- Scaly patches of skin on your scalp that don’t go away
- Swollen lymph nodes on the back of your neck or scalp
- Painful, swollen, or oozing areas on the scalp
- Bumps or pimple-like spots along your hairline
- Significant or ongoing hair shedding or thinning
Dermatologists can examine your scalp to determine the cause of dandruff and hair loss, such as a fungal infection or an underlying skin condition, and recommend effective treatments.
Dandruff can cause irritation and inflammation that may lead to hair breakage or thinning. In some cases, an underlying skin condition, such as seborrheic dermatitis, may cause both dandruff and hair loss.
Using medicated dandruff shampoos, avoiding scratching, and caring for your scalp can help reduce dandruff and protect your hair. If symptoms are severe or not improving, a dermatologist can recommend treatment.
