Does Dandruff Cause Hair Fall? Causes, Myths & Solutions

Have you ever looked at those tiny white flakes scattered on your shoulder and wondered whether they are causing your hair to fall at a rapid pace? Well, you are not alone. It is natural to be stressed when your scalp is problematic and itchy, while your hair is quietly falling off. The connection between dandruff and hair fall still remains a mystery, as there is no straightforward relationship established so far. It is essential to understand what happens to your scalp when affected by dandruff and how dandruff is linked with hair fall to tackle both hair issues effectively.

What Is Dandruff?

Dandruff is a common scalp issue that occurs due to fungal infection, and dead skin cells begin shedding as little white specks that are visible to the human eye. Though not a serious hair condition, dandruff can be persistent, distressing, and embarrassing. Any individual will have to deal with dandruff at least one time in their life, as it can occur in kids, teens, and adults during stress-filled times or seasonal changes [1]. Even though the skin of your scalp automatically renews each month, dandruff speeds up this process. So, the result is clusters of dead skin cells falling from your head mixed with scalp oil, making it large and visible. You might be surprised to know that about 50% of the people across the globe have dandruff [2]. It is also referred to as Pityriasis capitis, associated with itchiness and flaking.

Does Dandruff Really Cause Hair Fall?

Not really. Your dandruff is not directly responsible for causing hair fall, and the flakes developed on the scalp don’t determine the amount of hair you shed each day. However, this scalp condition can cause severe itching and irritation, making you scratch your head without control. Harsh and continuous scratching can cause damage to follicles and lead to hair shaft breakage and hair fall. Apart from this, scalp inflammation caused by fungal elements in the scalp during dandruff will weaken the roots and induce hair fall. Several studies have also pointed out that dandruff might also be accompanied by serious issues like androgenetic alopecia and telogen effluvium [3].

Signs Your Hair Fall Is Linked to Dandruff

Though this scalp condition doesn’t have a direct connection to hair fall, some of the dandruff symptoms might make the hair shafts and roots weak. It might also contribute to the hair shedding rate and cause thinning. The link between hair fall and dandruff is explained below.

• Dandruff causes inflammation and irritation, making the scalp itchy and flaky. These signs of dandruff can make you scratch your scalp continuously, which might cause shaft breakage and damage hair follicles.
• If you are having chronic dandruff, the flakes will transform into plaques, which will destroy and damage the follicles, causing severe hair loss.
• If your dandruff is triggered by Malassezia fungi, it infects the scalp and causes hair to fall. This fungal infection is also responsible for weakening the roots of your hair, owing to inflammation, and will affect hair health [4]. This factor will also lead to severe hair shedding issues and patterned hair loss.

Types of Dandruff and Their Impact on Hair Fall

Dandruff’s effect will not be similar for everyone. The behavior of this scalp issue tends to vary based on your underlying health issues, lifestyle choices, seasonal changes, scalp type, and skin type. It is important to learn about the type of dandruff you might have to select the right treatment for effective results. The major types of dandruff are:

1. Dry Skin Dandruff

• This type of dandruff occurs as tiny, dry, non-greasy flakes in white that keep falling from the scalp to reach the shoulders.
• The symptoms of this dandruff type will worsen with seasonal changes like dry summers and winters.
• You might feel extreme itchiness or scalp tightness after taking a hot shower, as the natural oil balance in the scalp would be low.

2. Seborrheic Dandruff / Oily Scalp Dandruff

• This dandruff type can be identified with the distinct flakes in yellow that appear sticky and large [5].
• These sticky flakes don’t fall off the scalp but instead cling to hair.
• It triggers excess sebum production in the scalp, and the dead skin cells get clumped together.
• Your scalp might have a slight mushy odour and will feel heavy with greasiness.

3. Malassezia Fungal Dandruff

• Malassezia globusa fungus is naturally found in your scalp, and when it is within the normal range, it will not affect hair health [6].
• When there is an excess growth of Malassezia fungus that looks similar to yeast, this type of dandruff develops on the scalp.
• Overgrowth of this fungus causes the oil in the scalp to break down and changes it into fatty acids. It causes scalp irritation along with extreme flaking, itching, and redness.

Prevention Tips for a Healthy Scalp & Strong Hair

It is easier to prevent dandruff than to treat it. Following these prevention tips will help you maintain a healthy and clean scalp.

• Washing your hair at a regular pace will help maintain a clean scalp and keep the accumulation of dead skin cells and oil buildup at bay. However, do not overwash hair as it might rob the scalp of its natural oils and make hair dry.
• Opting for gentle scalp-balancing hair products free from sulfates and harsh chemicals will help prevent dandruff associated with flaking and irritation.
• Maintain scalp health by limiting sun exposure or using hats or umbrellas to cover the head to prevent the scalp from getting irritated or dry.
• Consuming foods loaded with vitamins, omega-3s, and zinc, along with staying hydrated with enough water, will help nourish your scalp and hair.
• Having a stressful lifestyle will lead to dandruff flare-ups and affect scalp health. It is essential to practice meditation, yoga, and breathing exercises to stay stress-free for hair growth.
• Avoiding hair styling products like hair wax, gels, and sprays will help the scalp from developing dead skin buildup and flakes.

Can Chronic Hair Fall from Dandruff Lead to Permanent Hair Loss?

Though dandruff will not directly cause permanent hair loss, it can cause chronic hair fall if left untreated for a long time. Several mechanisms of chronic dandruff might eventually cause permanent hair loss in the long run.

• Chronic dandruff or seborrheic dermatitis will cause scalp inflammation, irritation, and redness owing to the hyperactivity of Malassezia fungus [7]. Such long-term inflammation will make hair follicles weaker, and it will lead to longer telogen or shedding phase and shorter anagen or growth phase. So, the rate of hair growth will be slow, and the shedding rate will be high, causing permanent hair loss [8].
• Prolonged scalp inflammation triggered by chronic dandruff that lasts for several months will lead to miniaturization of follicles [9]. It causes the scalp to produce short and thinner hair. Some follicles will stop hair production, and the growth cycle is reduced, leading to baldness.
• Chronic dandruff causes severe itching, which will create a constant urge to scratch vigorously. It will cause your fingernails to experience micro injuries, infections, trauma, and damage to follicles. This, in turn, will make your scalp skin try to heal repeatedly and lead to scar tissue formation [10]. If your hair follicle gets replaced by scar tissue, the chances of hair regrowth in that area are zero.
• If you are prone to a genetic hair loss condition like male pattern baldness or androgenetic alopecia, dandruff can make it worse. This scalp issue will cause inflammation and shrinkage of hair follicles, causing hair thinning and visible balding.

When to Consider a Hair Transplant for Long-Term Hair Restoration

Considering a hair transplant procedure to get permanent hair is a wise choice if:

• You experience stable hair loss for more than a year, and shedding doesn’t occur at a rapid pace.
• You have reversed or controlled chronic dandruff, pattern baldness, and telogen effluvium to get positive outcomes with high success rates.
• You can have a receding hairline, balding in crown areas, and thinning hair at temples.
• Your scalp has active donor sites with good hair density without any miniaturized hair follicles at the sides and back.
• You are 25 years or above and have realistic expectations regarding hair restoration.

Reference Links:

1. Khan, Hamda & Akhlaq, Muhammed & Anwar, Neha & Malik, Aiman & Masiullah, Warisha & Faizan, Nimra. (2024). Prevalence of Hair Loss, Dandruff, and Its Knowledge and Prevention Among the Pakistani Population: A Cross-Sectional Study: Hair Loss and Dandruff in Pakistan. Journal of Health and Rehabilitation Research. 4. 1-9. 10.61919/jhrr.v4i3.1329. – https://www.researchgate.net/publication/383032023_Prevalence_of_Hair_Loss_Dandruff
2. Manuel F, Ranganathan S. A new postulate on two stages of dandruff: a clinical perspective. Int J Trichology. 2011 Jan;3(1):3-6. doi: 10.4103/0974-7753.82117. PMID: 21769228; PMCID: PMC3129121. – https://pmc.ncbi.nlm.nih.gov/articles/PMC3129121/
3. Amirhosein Faghihkhorasani, Afsaneh Sadeghzadeh, Masoumeh Rohaninasab, Iran University of Medical Sciences (IUMS), Tehran, Iran, Department of Dermatology, School of Medicine Hazrat-e Rasool General Hospital Iran University of Medical Sciences, Tehran, Iran – https://brieflands.com/journals/jhrt/articles/144076
4. Blake E. Vest: University of Texas-Medical Branch, Kevin Krauland: Brooke Army Medical Center – https://www.ncbi.nlm.nih.gov/books/NBK553091/
5. Borda LJ, Wikramanayake TC. Seborrheic Dermatitis and Dandruff: A Comprehensive Review. J Clin Investig Dermatol. 2015 Dec;3(2):10.13188/2373-1044.1000019. doi: 10.13188/2373-1044.1000019. Epub 2015 Dec 15. PMID: 27148560; PMCID: PMC4852869. – https://pmc.ncbi.nlm.nih.gov/articles/PMC4852869/
6. Brhane Gebremedhin Gebrezihier, Mahmud Abdulkadir, Desta Berhe Sbhatu, Ephrem Tsegay & Goitom Gebreyohannes Berhe – https://link.springer.com/article/10.1186/s13104-024-06998-z
7. Gupta AK, Landells I, Talukder M, et al. Understanding the Scalp: Dandruff and Seborrheic Dermatitis. Journal of Cutaneous Medicine and Surgery. 2025;0(0). doi:10.1177/12034754251368845 – https://journals.sagepub.com/doi/10.1177/12034754251368845
8. Berk T, Scheinfeld N. Seborrheic dermatitis. P T. 2010 Jun;35(6):348-52. PMID: 20592880; PMCID: PMC2888552. – https://pmc.ncbi.nlm.nih.gov/articles/PMC2888552/
9. Trüeb RM, Henry JP, Davis MG, Schwartz JR. Scalp Condition Impacts Hair Growth and Retention via Oxidative Stress. Int J Trichology. 2018 Nov-Dec;10(6):262-270. doi: 10.4103/ijt.ijt_57_18. PMID: 30783333; PMCID: PMC6369642. – https://pmc.ncbi.nlm.nih.gov/articles/PMC6369642/
10. Susan L. Limbu, Talveen S. Purba, Matthew Harries, Tongyu C. Wikramanayake, Mariya Miteva, Ranjit K. Bhogal, Catherine A. O’Neill, Ralf Paus – https://onlinelibrary.wiley.com/doi/full/10.1002/bies.202100005