Excessive hair shedding and diffuse alopecia may develop when dandruff becomes recurrent or chronic making it challenging to treat.
Franchimont et al (2006) conducted a study of dandruff-associated alopecia. They studied 40 men whom they examined 40 times over 5 consecutive years. A relationship between the percentage of telogen hairs and the severity of dandruff. In this study, hairs affected by dandruff were those in the late Telogen phase, which actually increased with severity of dandruff. Whether or not this altered desquamation process in dandruff is similar or linked to the altered anchorage of Telogen hairs to the follicle is unknown. These processes are cmplex and take place in multi step procedures involving a series of enzyme activities.
A study conducted by Pierard-Franchimont et al (2002) on men with telogen effluvium (hair loss condition) related to male pattern hair loss associated with dandruff. In this study, they demonstrated that the use of any of the 3 selected anti-dandruff shampoos 2-3 times a week for 6 months reduced hair shedding and hair thinning. In addition, the percentage of hair in the active growth phase of the hair cycle increased. Anti-dandruff formulations with some anti-inflammatory activity can improve the hair cycle disturbance caused by dandruff (Pierard-Franchimont et al, 2006).
Since there is no proper treatment of dandruff besides the use of anti-dandruff shampoos, it tends to recur or become chronic. The presence of dandruff may precede or accompany telogen effluvium. It may also exacerbate androgenic alopecia. A survey revealed that people with dandruff shed more hair than those without, 100-300 and 50-100 respectively (Ranganathan and Mukhopadhyay, 2010). In some cases of dandruff, hair shedding may be due to alterations in teloptosis process.
Anti-dandruff formulations with inflammatory activity can improve both dandruff and its subsequent hair growth cycle disturbance.
There is increased hair shedding associated with carrying M. globosa, the microorganism associated with dandruff (Sentamilselvi, 2009).
There is evidence of a relationship between dandruff and percentage of hair in the telogen phase of the hair growth (franchimont et al).
The patient with is likely to lose hair on temples and vertex at an early age (Caspers, 1958).
Dandruff severity was found to have 2 peaks per year, April and September. Similarly, hair shedding had 2 peaks as well. However, hair shedding was only associated with the April peak and not September, the second peak for hair shedding occurred after winter. Although dandruff has been reported to affect hair in late tellogen, the biorhythms on the hair cycle in people with or without dandruff are essentially the same.
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- Caspers, A.P., Pityriasis Capitis (Dandruff). A Clinical Evaluation Of Three Remedies Currently Employed In The Prophylaxis And Treatment Of A Common Scalp Disorder, Canadian Medical Association Journal, 1958 Jul; 7(2):113-118
- Pierard-Franchimont, C., Goffin, V., Henry,F., Uhoda, I, Braham, C. and Pierard, G.E., Nudging Hair Shedding By Antidandruff Shampoos. A Comparison Of 1% Ketonazole, 1% Piroctone Olamine and 1% Zinc Pyrithione Formulations, International journal Of Cosmetic Science, 2002; 24:249-256
- Pierard-Franchimont, C., Xhauflaire-Uhoda, E., Loussouarn, G.Saint Leger, D. and Pierard, G.E., Dandruff Associated Smouldering Alopecia: A Chronobiological Assessment Over 5 Years, Clinical Experiments in Dermatology, 2006 Jan; 31(1):23-26
- Pierard-Franchimont, C., Xhauflaire-Uhoda, E., and Pierard, G.E., Revisiting Dandruff, International journal Of Cosmetic Science , 2006; 28:311-318
- Ranganathan, S. and Mukhopadhyay, T., Dandruff: The Most Commercially Exploited Skin Disease, Indian Journal Of Dermatology, 2010 Apr-Jun; 55(2):130-134
- Sentamilsevi, G., Janaki, C., Murugusundram, S., Tricomycosis, International Journal of Trichology, 2009; 1:100-107