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Dandruff
Dandruff and hair loss: two problems at once do not necessarily share one cause.
When two symptoms appear in the same place, the mind links them by itself. "I started getting a lot of dandruff and around the same time I notice fewer hairs: so the dandruff is making them fall out." It is a natural piece of reasoning, and it is also why many people treat the scaling for months expecting the hair to come back.
Dandruff, in most cases, is the manifestation of seborrhoeic dermatitis of the scalp: scaling, redness and itching, with more intense phases and periods of respite. It is an inflammatory condition, not a matter of washing. And it concerns the skin.
Hair loss and thinning concern the hair itself, and follow their own mechanisms — androgenetic alopecia, telogen effluvium, other forms. None of these is diagnosed by observing dandruff. Treating the scaling well can remove itching, redness and embarrassment without changing anything about what is happening to the hair.
The point that matters is that the two can perfectly well coexist, and often do: a person may have seborrhoeic dermatitis and, independently, an alopecia. Separating them does not mean ignoring that they may interact — it means not attributing everything to a single cause and finding yourself, six months later, with a healthy scalp and exactly the same thinning.
Two problems together do not make one cause
Dandruff concerns the skin, hair loss concerns the hair. They can happen to the same person at the same time without one producing the other, and that is the most frequent situation. This is why the visit looks at both together — the state of the scalp and the distribution of the hair — instead of deriving the second from the first. Those who treat only the scaling hoping the hair will return usually get half the result they were after.
How it shows
- Whitish or yellowish flakes in the hair and on the shoulders
- Itching of the scalp, sometimes intense
- Redness of the skin, visible when parting the hair
- A phasic course: intense periods alternating with respite
- A sensation of a tight scalp
- Sometimes hair loss or thinning at the same time
How we proceed
- 1Trichological visit: examination of the scalp and the hair, not just the scaling
- 2Assessment of the skin component: seborrhoeic dermatitis or otherwise
- 3Separate assessment of any hair loss or thinning, with its own mechanisms
- 4Treatment plan for the active phase on the skin
- 5Maintenance plan, since seborrhoeic dermatitis is recurrent
Available treatments
- Trichological visit
- Dermatology visit
- Treatment of the active phase
- Maintenance plan
- Scheduled follow-up
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Frequently asked questions
Does dandruff cause hair loss?+
Not in itself. Seborrhoeic dermatitis of the scalp and the forms of hair loss have different mechanisms, and the presence of one does not demonstrate the other. They can, however, coexist in the same person, and that is the situation that causes most confusion: the flakes are treated, the itching goes, and the thinning stays exactly the same because that was not the problem.
Does it depend on how I wash my hair?+
No, and washing more does not resolve it. Seborrhoeic dermatitis is an inflammatory condition involving the skin barrier, sebum production and interaction with yeasts that are a normal part of the skin flora. Washing too often or too aggressively can in fact irritate the scalp and worsen the picture.
Why does it always come back?+
Because it is a relapsing condition: it goes through active phases and periods of respite, often linked to season, stress and other individual factors. Treatment can control an acute phase well without removing the predisposition. This is why the pathway distinguishes the active phase from maintenance, and the return of flakes does not mean the previous treatment failed.
Should I book a trichological or a dermatological visit?+
If the problem is only the scaling, a dermatological visit is fine. If alongside the dandruff you also notice loss or thinning, a trichological visit is preferable: it looks at the state of the scalp and the distribution of the hair at the same time, which is exactly what is needed to understand whether the two are connected or merely simultaneous. Both are available in Siena and Florence.
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