If dandruff and itchiness persist, it may not be simple dandruff.

White dandruff on the shoulders, repetitive itching of the scalp. Many people take these symptoms lightly as temporary problems caused by just being tired or not using the right shampoo. However, if you only use dandruff shampoo and the symptoms keep recurring, it may not be simple dandruff. It is most likely a sign of chronic ‘skin disease’ from your scalp.

1. Difference between dandruff and dead skin cells

Many people use the terms ‘keratin’ and ‘dandruff’ interchangeably, but the two must be clearly distinguished. Dandruff is a noticeable phenomenon in which dead skin cells on the scalp fall off at a faster rate than normal. Even on a healthy scalp, dead skin cells fall off periodically, but the particles do not appear small. However, when the replacement cycle of dead skin cells becomes abnormally fast due to certain causes, the dead cells fall out in clumps, which is dandruff. In other words, all dandruff is dead skin cells, but not all dead skin cells are dandruff. Dandruff is a clear sign that something is wrong with your scalp health.

2. Why dandruff isn’t solved with shampoo

One common cause of dandruff is an overgrowth of a fungus called Malassezia. These bacteria feed on sebum, and when the number of bacteria increases, they cause inflammation in the scalp and cause dandruff. In this case, using a medicated shampoo (dandruff shampoo) containing ketoconazole or zinc pyrithione may provide temporary results. However, if dandruff does not go away even if you continue to use dandruff shampoo, or if it recurs as soon as you stop using it, it means that there is a more fundamental cause besides Malassezia bacteria.

3. Scalp skin disease that causes dandruff

Persistent dandruff is a typical symptom of the following chronic scalp skin diseases:

• Seborrheic dermatitis:It is the most common cause of dandruff. It is a chronic inflammation that occurs on the scalp that secretes a lot of sebum, and is accompanied by a red scalp, lumpy or slightly oily dandruff, and itching.
• psoriasis:It is an autoimmune disease that occurs due to abnormalities in the immune system. It is characterized by layers of thick, silvery-white dead skin cells over red spots with clear boundaries.
• Dry scalp:In contrast to seborrheic dermatitis, it is dry dead skin cells that occur when the scalp is too dry. It is characterized by small, white powdery dandruff.
• Contact dermatitis:Irritation or allergic reactions to certain hair products or dyes can cause inflammation and dandruff.
• Other aggravating factors:Stress, lack of sleep, hormonal changes, etc. worsen the above diseases by increasing sebum secretion or lowering immunity.

4. Treatment of chronic scalp diseases

To relieve severe inflammation and itching, hospitals use topical steroids or oral medications. These drugs can quickly relieve symptoms, but if they recur when use is stopped, the disease may be considered chronic. In this case, long-term steroid use is not recommended as it may cause side effects such as decreased immune function or thinning of the scalp.

Chronic scalp skin diseases are difficult to cure with treatments that simply suppress inflammation, and complex improvements must be made, including regulation of immune function, suppression of inflammation, and regeneration of healthy new skin. At Lee Moon-won Oriental Medicine Clinic, we use natural ingredients such as honeysuckle, dermis, astragalus, and angelica root to treat chronic scalp skin diseases and suppress the recurrence of dandruff and itchiness as much as possible. Additionally, moisturizers using flaxseed mucilage and aloe vera are used on dry scalp to maintain a strong moisturizing film.

5. Lifestyle practices for a healthy scalp

• Proper shampoo habits:You should gently massage your scalp with your fingerprints, not your fingernails, and rinse thoroughly. We recommend shampooing once every 1-2 days for oily scalp and once every 2-3 days for dry scalp.
• Completely dry scalp:After shampooing, you should completely dry your scalp with cool air to create an environment in which fungi cannot grow.
• Change your pillowcase frequently:It is recommended that you change your pillowcase at least twice a week, especially if your scalp is inflamed.
• Stress management and getting enough sleep:It is the main factor that lowers immunity and worsens scalp inflammation.
• Diet Control:Avoid fatty and sweet foods, and eat a variety of foods rich in vitamins and minerals.
• To increase the dyeing interval:Since hair dye irritates the scalp, it is recommended to use it at least 8 weeks apart.

Dandruff and itchiness are not just an inconvenience; they are a health signal from your scalp. Please do not take it lightly, but find the root cause and actively treat and manage it.