Nothing like a fun quiz to start your day!

Malazzeia Globosa is A) the name of the hollywood starlett who is making her screen debut in "The Transformers", B) a highly fragrant night blooming flower found only in Borneo, or C) a scalp-specific yeast found on human skin which can result in dandruff?

The correct and icky answer is C, and worse yet, this yeast is likely sitting on your head as we speak.  It sits quietly, merrily multiplying, while munching away on the tryglycerides found in the sebum your body natural generates. That in itself is gross, but for some of us, overly simplified, the byproduct of this "yeast feast" is an overproductive excretion of oleic acid (OA), which can be quite irritating to the skin, and can lead to the itching and flaking symptoms we commonly know as dandruff. EEEEEY!

Malazzeia Globosa It is astounding to me how little is actually known about dandruff, and how many "scientific errors" have been made in it's treatment. Especially since more than 50% adults will experience dandruff in their life time, and an estimated 1.1  billion dollars is tied to the study, treatment, and banishment of good ol' dandruff worldwide. But what we do know about dandruff was summed up quite nicely by Wikipedia, and to follow are the most meaningful details.

As the epidermis replaces itself, cells are pushed outward where they eventually die and flake off. For most people, these flakes of skin are too small to be visible. However, certain conditions cause cell turnover to be unusually rapid, especially in the scalp. For people with dandruff, skin cells may mature and be shed in 2–7 days, as opposed to around a month in=2 0people without dandruff. The result is that dead skin cells are shed in large, oily clumps, which appear as white or grayish patches on the scalp, skin and clothes. The fungus Malassezia furfur (previously known as Pityrosporum ovale) is now considered the cause of dandruff. Rarely, dandruff can be a manifestation of an allergic reaction to chemicals in hair gels/sprays, hair oils, or sometimes even dandruff medications like ketoconazole. There is convincing evidence that food (especially sugar and yeast), excessive perspiration, and climate have significant roles in the pathogenesis (creation) of dandruff.

In order for dandruff to exist, there are three required factors:

1. Skin oil commonly referred to as sebum or sebaceous secretions
2. The metabolic by-products of skin micro-organisms (most specifically Malassezia yeasts)
3. Individual susceptibility "

So what are the most common OTC treatments and how do those treatments rank, in terms of effectiveness?

Anti-Dandruff use a combination of ingredients to control the symptoms and treat the root cause. "Salicylic acid (used in Sebulex) removes dead skin cells from the scalp and decreases th e rate at which these cells are created. Zinc pyrithione (introduced by Revlon in ZP11 shampoo, now used in Head & Shoulders) kills pityrospora. Selenium sulfide (used in Selsun Blue) achieves the results of both salicylic acid and zinc pyrithione. Simply increasing usage with normal shampooing will remove most flakes.However, elimination of the fungus (itself is what) results in dramatic improvement. Regular shampooing with an anti-fungal product can reduce recurrence".

There are any number of additional treatments. Soothing preparations may contain Sodium bicarbonate (baking soda), and coal tars. A study under way in France is looking at the soothing antibacterials contained in pomegranite and that might be added to the anti-dandruff list. I have personally added Evening Primrose supplements to my diet, which is a remedy suggested by holistic practioner of integrative medicine, Dr. Andrew Weil. One company markets a trademarked treatment "tool" for home use which combines "UV light" with "oxygen" to combat dandruff.

The most common antifungal agents used are Zinc pyrithione, Selenium sulfide and Ketoconazole Other products used include Tea tree oil and Piroctone olamine (Octopirox). Anti-fungal/anti-dandruff shampoos (includes Head and Shoulders, and Selsun Blue) containing ketoconazole have been shown to be more effective than zinc pyrithione. Although a 1981 study reported selenium sulfide as being the most effective of the tested shampoos at treating dandruff, a 1999 comparative study concluded that ketoconazole was the most effective antifungal agent. (Although ketoconazole had been approved by F.D.A. in 1981, it was not approved for topical use in a shampoo until 1990, and was therefore not included in the 1981 study.) Other treatments include Ciclopirox olamine, Coal tar, Zinc pyridinethione(ZPT), Miconazole, or tea tree oil medicated shampoos.

And there you have it, the completion Dandruff 101.  More than you wanted to know, no doubt.

PS.  I am currently testing an interesting anti-dandruff treatment .... my new "copper bristled" hair brush, made by Goody, which is marketed to specifically target dandruff. The copper bristled hair brush and the theory behind it is so interesting that it (and the trademarked tool made by Viatek which uses UV light and oxygen) will be the focus of a standalone review, coming to Truth In Aging in July.