Earlier this year, BBC host Claudia Winkleman returned as the face of Head and Shoulders in the UK. The hair-care brand, widely known as the go-to treatment plan for targeting dandruff, has undergone something of a glossy makeover with its campaigns recently, yet Winkleman, in various interviews, has been quick to note that she doesn't have a flaky scalp herself. There's nothing wrong with that — she's brilliant and has enviable hair — but the broad assumption about dandruff is that it's still something we need to cover up, or feel embarrassed about.
Actually, the conversation around dandruff has started to change for the better. In the Western media at least, gone is the narrative of the single man who can’t attract a partner because of his flaky scalp, or the woman refusing to wear dark clothes to a meeting for fear of dandruff falling on her shoulders. But even in recent years, hair-care brands globally have used shame to convince consumers to buy their anti-dandruff products. Last year, Sofia Vergara fronted a campaign in which a male character was scared to take his hat off because of his flakes, and one Head and Shoulders ad from India sees a woman refusing to take a selfie with a man who has dandruff — though of course she's more than happy to once he's "cured."
Harmless advertising tactic or not, the repercussions of these scenarios is evident in many individuals — myself included. Only recently, I realized I was consciously avoiding using the term "dandruff" to describe my cracking, sensitive scalp, almost as if it were a dirty word. What's more, a 2015 British Skin Foundation survey found that a third of people have avoided a social situation due to dandruff. By portraying it as something to be ashamed of, we are exacerbating what is in fact a treatable and very common condition. Trichologist Anabel Kingsley tells me that, although 90% of her clients present with some form of scale on the scalp, many of them feel isolated by it. "People do get embarrassed," she told me, "and some men will come into my clinic wearing hats to hide it. Our perception towards it definitely needs to change. It's a skin condition — it doesn't mean that you're dirty, or that it's contagious, which is a common misconception."
From a medical standpoint, dandruff is actually classified as a mild form of eczema. "Dandruff is a condition called pityriasis capitis, which causes fine white flakes of dead skin on the scalp," says Dr. Sharon Wong, a consultant dermatologist who specializes in hair and scalp disorders. "It is considered a low-grade, non-inflamed form of eczema. When the condition becomes inflamed and itchy, it is called seborrheic dermatitis, a specific form of eczema." But what causes dandruff is up for debate. "Dandruff has historically been thought to be due to an oversensitivity towards malassezia yeast, which is naturally present on the surface of our skin," Dr. Wong says. "It's believed that when these yeasts feed off our skin’s natural oils, the byproducts released cause a more rapid skin-cell turnover in some people, hence dandruff. However, more recent studies suggest the picture may be a little more complicated, and that dandruff could result from a disturbance in the delicate balance between surface bacteria and yeasts on the scalp."
Triggers can include diet, stress, and changing hormone levels, with many women reporting dandruff after coming off hormonal birth control. Whatever the cause, the belief that a dry scalp causes dandruff is incorrect, and avoiding shampooing for fear of drying it out more won't help. According to the experts, oily scalps are more prone, and shampooing regularly is the key. When it comes to choosing your products, look out for specific anti-yeast ingredients such as ketoconazole, zinc pyrithione, selenium sulfide, or piroctone olamine, which you can find in a range of anti-dandruff shampoos; Kingsley recommends that her customers try Philip Kingsley's Flaky Scalp Shampoo, which gets its impressive flake-removing power from piroctone olamine and has a pleasant non-medical, fruity scent. Tar-based products, or those containing salicylic acid, can also help.
To really kill off dandruff, you need to commit to your shampoo routine, so it's best to find a product you like. "You have to shampoo daily with a targeting product until your symptoms clear," Kingsley says. "Think of any skin condition — acne, for example. You need to apply topical products daily to see results. If you aren't shampooing, you aren't removing the dead skin cells." Once you're clear, keep using the product regularly for a few more weeks, then keep it in your bathroom cabinet in case of any flare-ups. It's worth noting that if the scalp becomes very inflamed or infected, then it's time to see your doctor.
As for the self-esteem issues surrounding such a common, curable condition, it's high time we kicked that stigma to the curb. I, for one, will not be ashamed to add the word "dandruff" back into my vocabulary.