The itchy truth: Dandruff, a lifelong recurring concern

CHENNAI: Dandruff is a common scalp concern that affects millions globally, and for some, it can become a chronic issue. While many assume it’s a temporary problem caused by dry skin or poor hygiene, the reality is more complex. In fact, dandruff can stem from underlying medical conditions that make it a recurring — and sometimes lifelong — battle.

The two main causes of chronic dandruff

Dandruff usually arises due two major causes. Seborrheic dermatitis (often triggered by Malassezia furfur, a type of yeast) or scalp psoriasis, an autoimmune disorder.

Malassezia furfur – Fungal infections

One of the leading causes of dandruff is the overgrowth of a fungus called Malassezia furfur, which naturally resides on the scalp. In some individuals, this fungus can multiply uncontrollably, leading to inflammation, flaking, and persistent itching. Once it colonises the scalp, it is extremely difficult — if not impossible — to eliminate entirely. Although anti-fungal treatments can control the symptoms, the organism often remains on the scalp in a dormant state, ready to flare up again under favourable conditions such as stress, hormonal changes, or cold weather.

Scalp psoriasis – Autoimmune condition

Scalp psoriasis is another major reason why dandruff can become a lifelong concern. This condition occurs when the immune system mistakenly attacks healthy skin cells, accelerating their turnover. As a result, thick scales, redness, and flaking appear on the scalp. Since this is an autoimmune disorder, it cannot be cured permanently. Instead, it must be managed with consistent care and medical treatments.

Common symptoms

Despite their different causes, both seborrheic dermatitis and scalp psoriasis share similar symptoms like,

1. Persistent itching

2. White or yellowish flakes

3. Red, irritated scalp

4. Worsening in cold or dry weather

These symptoms can impact self-esteem and interfere with daily activities, especially when flare-ups are frequent or severe.

Lifelong management, not a one-time cure

Unfortunately, neither fungal-based dandruff nor autoimmune scalp conditions can be completely cured. However, with proper maintenance therapy, such as medicated shampoos, topical treatments, and lifestyle adjustments, the symptoms can be controlled effectively. By following a tailored treatment plan and responding to flare-ups promptly, it is entirely possible to prevent these conditions from disrupting your daily routine.

If you’re dealing with chronic dandruff, know that you are not alone — and more importantly, that you are not powerless. While the root causes might not go away permanently, managing them smartly can keep your scalp healthy and your confidence intact. Consult a dermatologist to develop a long-term treatment strategy that works for your specific condition.

—The writer is a plastic and hair transplant surgeon, heading the team at Follicle Hair Clinic