Risk factors

Almost any adult is a candidate for dandruff, but certain factors can make you more susceptible:

• Age. Dandruff usually begins at puberty — about the same time as acne. It's common throughout adolescence and young adulthood and peaks around age 40. But older adults aren't immune, and for some people, the problem can be lifelong.

• Sex. Because far more men than women have dandruff, some researchers think male hormones may play a role in dandruff. Men also have larger sebaceous glands that produce an oil called sebum.

• Oily hair and scalp. Malassezia feeds on oils in your scalp. For that reason, having excessively oily skin and hair makes you more prone to dandruff.

• Certain illnesses. For reasons that aren't clear, adults with neurologic diseases such as Parkinson's disease are more likely to develop seborrheic dermatitis and dandruff. So are people recovering from stressful conditions, particularly heart attack and stroke, and those with immune systems compromised by HIV infection or AIDS.

When to seek medical advice

Most cases of dandruff don't require a doctor's care. But if you're still scratching your head after several weeks of experimenting with over-the-counter (OTC) dandruff shampoos, or if your scalp becomes red or inflamed, see your doctor or dermatologist. You may have seborrheic dermatitis or another condition that resembles dandruff. Most often, your doctor can diagnose the problem simply by looking at your hair and scalp.

• Ringworm

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