THE IMPORTANCE OF SCALP BARRIER: SCIENTIFIC

APPROACHES TO DANDRUFF PREVENTION AND

TREATMENT

Prof. Dr. dr. Sandra Widaty, Sp. D.V.E., Subsp. D.T., FINSDV, FAADV
Dr. dr. Eliza Miranda, Sp. D.V.E., Subsp. D.T, FINSDV, FAADV
dr. Euis Mutmainnah, Sp. D.V.E, FINSDV, FAADV
dr. Sofiah AT Lontoh, Sp. D.V.E, MSc.CSO. FINSDV

1
The Importance of maintaining Scalp’s Health

The scalp acts as an incubator environment for preemergent hair fibers. A healthy scalp provides sufficient
nutrients and oxygen supply to hair follicles, promoting the growth of thicker and stronger hair.

The early signs of scalp health issues to watch for

- Dry or oily scalp: Can result from chemical exposure or stress.

- Redness or inflammation: A sign of irritation that can develop into folliculitis.

- Itching or pain: May be an early indication of inflammation.

- Hair loss: Can be caused by thyroid disturbances, medication use, or postpartum conditions.

Trueb et al. 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
Wolff H, Fischer TW, Blume-Peytavi U. The Diagnosis and Treatment of Hair and Scalp Diseases. Dtsch Arztebl Int. 2016 May 27;113(21):377-86. doi:
10.3238/arztebl.2016.0377. PMID: 27504707; PMCID: PMC4908932.
The Impact of Poor Scalp Hygiene

A study has shown a

significant correlation between
shampooing less than five
times per week and the
prevalence of dandruff. Poor
scalp hygiene can lead to an
accumulation of oil, dirt, and
dead skin cells, creating an
environment where dandruff,
itching, and other scalp issues
can thrive.

Wikanto et al. Haircare Practice and Dandruff Problems Among Indonesian Medical Students [Internet]. Vol. 6, Journal of General - Procedural Dermatology &
Venereology Indonesia. Universitas Indonesia, Directorate of Research and Public Service; 2022. Available from: http://dx.doi.org/10.7454/jdvi.v6i2.1000
How a Healthy Scalp Could lessen the Risk of Dandruff

● Infrequent shampooing can lead to the buildup of sebum lipids and metabolic byproducts from Malassezia.
Regular shampooing helps prevent the overgrowth of Malassezia, which is a key factor in dandruff
development.
● Helps maintain the balance of the scalp's microbiota, preventing dysbiosis that plays a role in the
pathogenesis of seborrheic dermatitis.
● Proper moisture management of the scalp ensures it doesn't become too dry or too oily, both of which are
triggers for seborrheic dermatitis.

The long-term effects of untreated dandruff

- The main complication of untreated dandruff and seborrheic dermatitis is secondary bacterial infections,
which can lead to increased redness, exudate, and local irritation
- Over time, these infections may worsen scalp health, causing more severe inflammation and discomfort,
potentially resulting in hair thinning or hair loss if left unmanaged

Wikanto et al. Haircare Practice and Dandruff Problems Among Indonesian Medical Students [Internet]. Vol. 6, Journal of General - Procedural Dermatology & Venereology Indonesia. Universitas
Indonesia, Directorate of Research and Public Service; 2022. Available from: http://dx.doi.org/10.7454/jdvi.v6i2.1000
Clark GW, Pope SM, Jaboori KA. Diagnosis and treatment of seborrheic dermatitis. Am Fam Physician. 2015 Feb 1;91(3):185-90. PMID: 25822272.
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.
Poling 1

Manakah pernyataan yang benar?

a. Dandruff tidak ada hubungan/ tidak berdampak pada kualitas

hidup seseorang
b. Dandruff sedikit berdampak menurunkan kualitas hidup
seseorang.
c. Dandruff dapat menurunkan kualitas hidup seseorang secara
signifikan.
Poling 1

Manakah pernyataan yang benar?

a. Dandruff tidak ada hubungan/ tidak berdampak pada kualitas

hidup seseorang
b. Dandruff sedikit berdampak menurunkan kualitas hidup
seseorang.
c. Dandruff dapat menurunkan kualitas hidup seseorang secara
signifikan.
 How Dandruff Affect a Patient's’ Quality of Life

In a study conducted by Agustin et

al., nearly all research subjects
(seborrheic dermatitis patients) felt
that their skin condition affected
their lives, with almost half of the
subjects reporting a moderate effect
on their daily lives. The second and
third most common responses were
"very large effect" and "small
effect," respectively.

Agustin et al. Quality of life assessment in patients with dandruff and scalp seborrheic dermatitis at a tertiary hospital in Indonesia. Iranian Journal of Dermatology Vol
22(1). 2019
 Definition

Pityriasis Sicca: mildest form of seborrheic dermatitis, usually called as dandruff. It is

characterized by non-inflammatory flaking of the scalp, presenting as white or yellowish scales
without erythema

Seborrheic Dermatitis: chronic relapsing dermatitis manifesting in the seborrheic area,

affecting infants or adults

Seborrhiasis: clinical overlap between seborrheic dermatitis and psoriasis. It combines

features of both conditions, such as thick, red, scaly patches in the same seborrheic areas
typically affected by seborrheic dermatitis.

Psoriasis: autoimmune skin disorder characterized by rapid keratinocyte turnover, leading to

thickened patches of skin with silvery scales, inflammation, and parakeratosis

Singh R, Madke BS, Bose S. Seborrheic dermatitis and pityriasis sicca: A review. CosmoDerma 2022;2:36.
Borda LJ, Wikramanayake TC. Seborrheic Dermatitis and Dandruff: A Comprehensive Review. J Clin Investigat Dermatol. 2015;3(2): 10.
 Epidemiology Comorbidity: Higher in AIDS patients especially with
T cell cd4+ count 200-500/mm, with prevalence
30-83%. Also high in neurological problems like
Percentage in Indonesia, Asia, and the World Parkinson

● Seborrheic Dermatitis (SD) affects 1-5% of the Urban vs Rural Area

global population.
● In Asia, adult population affected by SD is around - Severe and very severe forms of dandruff and
1-5% also. seborrheic dermatitis (SD) are more prevalent
● The prevalence of SD in India is 18.7%, while in in rural populations due to a lack of attention to
Singapore it is 7%. scalp hygiene.
● In Indonesia, the prevalence of SD is 0,99-5,8% in all - A study by et al. indicated that SD can
cases between 2013-2015 manifest at a very young age (~11 years),
● Men affected more than women particularly in individuals frequently exposed to
● Bimodal distribution on age group: agricultural activities and open environmental
○ Happens in 2 month old baby with peak on 2
conditions. This exposure to dust, pollutants,
months, teenagers, young adult (while
and varying climate conditions contributes to
sebaceous glands are active) with peak on
30-40 years of age. the early onset and severity of scalp issues

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.
Prasanna et all Sociodemographic characteristics and spectrum of Malassezia species in individuals with and without seborrhoeic dermatitis/dandruff: A comparison of residents of the urban and
rural populations, Medical Mycology, Volume 59, Issue 3, March 2021, Pages 259–265, https://doi.org/10.1093/mmy/myaa0
 Pathogenesis

Etiopathogenesis of Dandruff

Dandruff and seborrheic dermatitis (SD) are caused by the interaction between the skin's flora, particularly
Malassezia species, and sebaceous lipids, seborrhea, immune dysfunction, neurogenic factors, and emotional
stress. The relationship between Malassezia spp. And SD varies. For example, a study in Iran found that only
24.5% of SD patients had a positive Malassezia culture, while in India, 84% of patients tested positive for the
same culture.

The role of the scalp microbiome in the pathogenesis of scalp disorders

The scalp microbiome plays a crucial role in maintaining the homeostasis of scalp health. Dysbiosis, or an
imbalance in the scalp's microbiome, can lead to inflammation and the development of various conditions such as
seborrheic dermatitis, androgenetic alopecia, and other scalp disorders. Maintaining a healthy balance of
microorganisms on the scalp is essential for preventing these issues.

Cheong WK, Yeung CK, Torsekar RG, Suh DH, Ungpakorn R, Widaty S, et al. Treatment of Seborrhoeic Dermatitis in Asia: A Consensus Guide [Internet]. Vol. 1, Skin Appendage Disorders. S. Karger AG; 2015. p. 187–96. Available
from: http://dx.doi.org/10.1159/000444682
Widaty, S., Surachmiati, L., Legiawati, L. et al. Scalp microbiome of healthy women wearing hijab compared to those not wearing hijab: a cross-sectional study. Sci Rep 13, 11797 (2023). https://doi.org/10.1038/s41598-023-38903-2
Pathogenesis

Genetic & Environmental Factors Affecting Development of SD

Hot temperatures, humidity, sweat, sunlight, and high UV index in tropical climates can exacerbate the symptoms
of seborrheic dermatitis (SD). Genetic factors determine skin constitution, sebum production, and the degree of
inflammation, all of which contribute to dandruff susceptibility

Wearing hijabs and the occurrence of SD

A study by Widaty et al. found that women who wear hijabs have a higher presence of Staphylococcus capitis and
Malassezia restricta on their scalps, while non-hijab wearers tend to have more Staphylococcus cohnii and
Malassezia globosa. This suggests that women who wear hijabs are more prone to seborrheic dermatitis (DS),
while non-hijab wearers may be more susceptible to bacterial skin infections.

Cheong WK, Yeung CK, Torsekar RG, Suh DH, Ungpakorn R, Widaty S, et al. Treatment of Seborrhoeic Dermatitis in Asia: A Consensus Guide [Internet]. Vol. 1, Skin Appendage Disorders. S. Karger AG; 2015. p.
187–96. Available from: http://dx.doi.org/10.1159/000444682
Widaty, S., Surachmiati, L., Legiawati, L. et al. Scalp microbiome of healthy women wearing hijab compared to those not wearing hijab: a cross-sectional study. Sci Rep 13, 11797 (2023).
https://doi.org/10.1038/s41598-023-38903-2
Pathogenesis
The pathogenesis can be categorized
into five different phases:

1. Sebaceous glands secrete

lipids onto the skin surface.
2. Malassezia colonizes areas
that are covered with lipids.
3. Lipase is secreted by
Malassezia, resulting in the
generation of free fatty acids
(FFA) and lipid peroxides that
activate the inflammatory
response.
4. The immune system generates
cytokines, such as IL-1α,
IL-1β, IL-2, IL-4, IL-6, IL-8,
IL-10, IL-12 and TNF-α. This
stimulates keratinocyte
proliferation and differentiation.
5. Skin barrier disruption with
resulting clinically evident
erythema, pruritus and scaling.
Adalsteinsson JA, Kaushik S, Muzumdar S, Guttman‐Yassky E, Ungar J. An update on the
microbiology, immunology and genetics of seborrheic dermatitis [Internet]. Vol. 29, Experimental
Dermatology. Wiley; 2020. p. 481–9. Available from: http://dx.doi.org/10.1111/exd.14091
CLINICAL MANIFESTATIONS AND
DANDRUFF DIAGNOSIS

13
Poling 2

Manakah kondisi gangguan kulit kepala yang dapat menyerang usia

remaja dan dewasa muda, pitiriasis sika atau dermatitis seboroik?

a. Pitiriasis sika
b. Dermatitis seboroik
c. Keduanya benar
Poling 2

Manakah kondisi gangguan kulit kepala yang dapat menyerang usia

remaja dan dewasa muda, pitiriasis sika atau dermatitis seboroik?

a. Pitiriasis sika
b. Dermatitis seboroik
c. Keduanya benar
 CLINICAL SPECTRUM

Seborrheic
Pityriasis sicca
dermatitis

Starts at puberty, Triphasic peak during

reaches its peak in infancy, puberty, and
the 20th year of life the 4–6th decade of
life

Borda LJ, Wikramanayake TC. Seborrheic Dermatitis and Dandruff: A Comprehensive Review. J Clin Investigat Dermatol. 2015;3(2): 10. 16
Poling 3

Manakah kondisi gangguan kulit kepala dibawah ini yang merupakan

inflamasi?

a. Pitiriasis sika
b. Dermatitis seboroik
c. Keduanya benar
Poling 3

Manakah kondisi gangguan kulit kepala dibawah ini yang merupakan

inflamasi?

a. Pitiriasis sika
b. Dermatitis seboroik
c. Keduanya benar
 Seborrheic dermatitis (SD)
Chronic inflammatory skin disorder that affects areas rich in sebaceous
glands

Infants Adolescent
Adults
s

range from a mild scalp

mainly occurs on the
scaling to diffuse white,
scalp as yellowish, scaly
yellowish patches in
patches (“cradle cap”)
sebaceous areas (scalp,
face, trunk, intertriginous)

Dall’Oglio et al. An Overview of the Diagnosis and Management of Seborrheic Dermatitis. Clin Cosmet Investig Dermatol 2022:15 1537–1548
19
 Seborrheic dermatitis - Infant

Euis Mutmainnah

Euis Mutmainnah

Younger brother, at 1 month old

Elder brother, at 2 weeks old

Siblings with SD

Suh D. Seborrheic Dermatitis. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, Orringer JS. eds. Fitzpatrick's Dermatology, 9e. McGraw-Hill Education; 2019. 20
 Seborrheic dermatitis –
ADOLESCENT/ADULT Euis Mutmainnah

• Erythematous, scaly patches on sebaceous gland–rich

sites, including scalp, face, upper trunk, and intertriginous
areas

• Various appearances from mild pinkish and sometimes

greasy scaling to solid adherent crusts
Male, 25 y.o, thick hair, scaly erythematous
patches
• The inflammation alters the anchoring of hair fiber in the
follicle, increasing the proportion of telogen and dysplastic
anagen hair -> hair loss

• Complain of discomfort, with symptoms of itching and

burning, and also have some serious cosmetic problems,
leading to psychosocial distress that has a negative impact
on their quality of life

Suh D. Seborrheic Dermatitis. In: Kang S, Amagai M, Bruckner AL, Enk AH, Margolis DJ, McMichael AJ, Orringer JS. eds. Fitzpatrick's Dermatology, 9e. McGraw-Hill Education; 2019.
Piérard-Franchimont C, Xhauflaire-Uhoda E, Loussouarn G, Léger DS, Piérard GE. Dandruff-associated smouldering alopecia: A chronobiological assessment over 5 years. Clin Exp Dermatol 2006;31:23–6.
Naldi L, Rebora A. Seborrheic dermatitis. N Engl J Med 2009;360:387-96 21
 Dermoscopy
Pityriasis sicca Seborrheic dermatitis
• white-yellowish scales in • diffuse erythema and white-yellowish scales in
perifollicular distribution perifollicular distribution
• dotted vessels in a patchy, along with follicular plugs,
orange-yellowish areas, whitish structureless areas
and linear branching vessels

Euis Mutmainnah

Euis Mutmainnah

Wikramanayake TC, Borda LJ, Miteva M, Paus R. Seborrheic dermatitis—looking beyond Malassezia. Experimental dermatology. 2019;28(9):991-1001.
Dall’Oglio et al. An Overview of the Diagnosis and Management of Seborrheic Dermatitis. Clin Cosmet Investig Dermatol 2022:15 1537–1548 22
 Dandruff
pityriasis sicca = pityriasis simplex capitis = pityriasis capitis
Noninflammatory and mildest manifestation of seborrheic
dermatitis limited to the scalp

• cluster of corneocytes and presents as white or yellow,

diffuse, mild to dense, non-adherent flaking on the
scalp without erythema or inflammation

• Itching (+) / (-)

• Scales are usually noticed falling on the dark clothes.

Euis Mutmainnah

Female, 40 y.o., wearing hijab

Singh R, Madke BS, Bose S. Seborrheic dermatitis and pityriasis sicca: A review. CosmoDerma 2022;2:36.
23
 Diagnosis
Diagnosis mainly based on clinical observation
•Dandruff, erythematous patches w/wo itch, chronic and recurrent
Anamnesis •Lifestyles
•Underlying diseases

Physical •White-yellowish oily scales w/wo erythematous lesions in sebaceous areas (scalp, auricular,
face (eyebrows, nasolabial) parasternal, intertriginous)
Examination
Dermoscopy •Diffuse erythema and white-yellowish scales in perifollicular distribution

Microscopic •Potasium hydroxide (KOH)

•SD: round or oval spores (Malassezia sp.) -> not a diagnostic criteria
examination •Differential diagnosis of tinea capitis, candidiasis, demodex dermatitis

Laboratory •Severe or recalcitrans cases : investigate underlying diseases

examination
•Acute phase: spongiosis, hyperplasia psoriasiformis, shoulder parakeratosis, perifollicular infiltrats
•Chronic phase: hyperplasia psoriasiformis, shoulder parakeratosis, follicular plugging, lymphocyte
Biopsy exocytosis
•Differential diagnosis of psoriasis, lupus erythematosus, others
Tucker D, Masood S. Seborrheic dermatitis. StatPearls. Treasure Island (FL): StatPearls Publishing, 2024.
Widaty S, Bramono K, Kariosentono H, et al. Pedoman nasional pelayanan kedokteran tata laksana dermatitis seboroik [in Indonesian]. Jakarta: Central Communications; 2017. p.1-29. 24
 Diagnosis

Widaty S, Bramono K, Kariosentono H, et al. Pedoman nasional pelayanan kedokteran tata laksana dermatitis seboroik [in Indonesian]. Jakarta: Central Communications; 2017. p.1-29.
25
 The severity of SD can be determined using Seborrheic Dermatitis Area Severity Index (SDASI)

• Determination of the local area score on each area, which is the percentage of SD symptom on the
affected area compared to the surrounding area
1: ≤10%
2: 11%–30%
3: 31%–50%
4: 51%–70%
5: >70%
• Assessment of the degree of erythema (E), papules (P), and scales (S) on each area:
0: None
1: Mild
2: Moderate
3: Severe
• Calculation of SDASI score of each area (E+P+S) × Local Area Score
• Quantification of all three SDASI scores
• Classification of SD severity according to the SDASI score
Mild : 0–7.9
Moderate : 8–15.9
Severe : >16

Widaty S, Bramono K, Listiawan MY, Yosi A, Miranda E, Rahmayunita G, et al. The management of seborrheic dermatitis 2020. J Gen Proced Dermatol Venereol Indones. 2020:5(1);19-27. 26
Widaty S, Bramono K, Listiawan MY, Yosi A, Miranda E, Rahmayunita G, et al. The management of seborrheic dermatitis 2020. J Gen Proced Dermatol Venereol Indones. 2020:5(1);19-27.
27
 Differential Diagnosis

Borda LJ, Wikramanayake TC. Seborrheic Dermatitis and Dandruff: A Comprehensive Review. J Clin Investigat Dermatol. 2015;3(2): 10. 28
 Differential Diagnosis

Psoriasis Tinea capitis Contact Lupus

• Silvery white scales • Grey patch, black dermatitis erythematosus
• Dermoscopy: bushy dots, kerion • Contact history to • Other LE symptoms
capillaries with • Dermoscopy: allergen or irritant • Dermoscopy: yellow
twisted loops comma, corkscrew, • Patch test dots, keratotic
• Biopsy zigzag, morse code follicular plugs, thick
hair arborizing vessels
• KOH: hyphae, • Biopsy
arthrospora

Hwang JC, Beatty CJ, Khobzei K, et al. Allergic contact dermatitis of the scalp: a review of an underdiagnosed entity. Int J Women’s Dermatol 2024;10(3):p e167.
Scandagli B, Rosi E, Di Cesare A, et al. Discoid lupus erythematosus affecting the scalp. JAAD Case Reports 2024;48:72-3. 29
PREVENTION & MANAGEMENT OF
DANDRUFF

30
Poling 4

Apa tujuan utama/goal dari manajemen dermatitis seboroik?

a. Untuk mengurangi tanda dan gejala dermatitis seboroik

b. Untuk memperbaiki struktur dan fungsi kulit kepala
c. Untuk meningkatkan kualitas hidup pasien
d. Semua benar
Poling 4

Apa tujuan utama/goal dari manajemen dermatitis seboroik?

a. Untuk mengurangi tanda dan gejala dermatitis seboroik

b. Untuk memperbaiki struktur dan fungsi kulit kepala
c. Untuk meningkatkan kualitas hidup pasien
d. Semua benar
Dandruff Management

● Management goals in Seborrhoeic Dermatitis:

- to alleviate signs & symptoms
- to promote normalization of scalp skin structure & function
- to improve patient’s quality of life

Pityriasis Sicca: Mild grade of Scalp Seborrhoeic Dermatitis

33
Dandruff Management

● Adult Mild Seborrheic Dermatitis:

TOPICALS:

a. Antifungals:
○ Ketoconazole 1-2% shampoo
2-3x/weekly
○ Ketoconazole 2% foam
○ Ketoconazole 20 mg/g hydrogel
○ Ciclopirox 1-1.5% shampoo
34
Dandruff Management
● Adult Mild Seborrheic Dermatitis:

TOPICALS:

b. AIAFp (anti-inflammation with antifungal activity)

○ Piroctone Olamine
2-3x/weekly
○ Bisabolol
○ Glycyrrhetic acid
○ Lactoferrin

35
Dandruff Management
● Adult Moderate to Severe Seborrheic Dermatitis:
Systemic:
a. Antifungals:
○ Itraconazole 100 mg caps:
1st month: 200mg/day (1 week) → 200mg/day for 2
days/month up to 11 months.
○ Terbinafine 250 mg caps:
- continuous regimen: 250 mg/day (4-6 weeks)
○ Fluconazole 50mg caps: 50 mg/day (2 weeks) or 200-300 mg
weekly for 2-4 weeks

36
Dandruff Management
● Infantile Seborrheic Dermatitis:
TOPICALS:
a. Antifungals:
○ Ketoconazole 2% shampoo: 2x/weekly for 4 weeks

b. AIAFp:
○ Piroctone olamine cream every 12 hours
○ Alglycera cream
○ Bisabolol cream

c. Emollients:
○ white petrolatum ointment: daily 37
Therapeutic Algorithm for Adult SD of the Scalp & Hairy Areas

Cheong, Wai Kwong et al. “Treatment

of Seborrhoeic Dermatitis in Asia: A
Consensus Guide.” Skin appendage
disorders vol. 1,4 (2016): 187-96.
doi:10.1159/000444682

38
Dandruff Management

Antifungal Mechanism

- Azole: inhibiting fungal cell wall synthesis

- Selenium Sulfide: cytostatic and keratolytic agent and

fungicidal properties against Pityrosporum ovale

- Zinc pyrithione: increasing the cellular levels of copper which

in turn interferes with the iron-sulfur cluster of proteins
essential for fungal growth and metabolism

39
- Ciclopirox olamine: inhibit metal-dependent enzyme such as
cytochromes, catalase, and peroxidase by chelating with metal
cations such as ferric and aluminium result in the disruption of
multiple cellular activities of the fungal cell.

- Piroctone olamine: cytostatic, enter fungal cell wall and chelates

with iron ions. This complexes→inhibition of energy metabolism
resulting in fungicidal effect

40
Dandruff Management
Non-Pharmacology
Maintain a healthy scalp condition:
- Restore scalp barrier condition
- Maintain a normal sebum production
- Maintain a healthy scalp microbiome
- Maintain a healthy balance of commensals scalp
microorganism
-Reduce scalp barrier disturbances
- Maintain optimum scalp moisture
- Reduce any irritative substances use (hair styling
gels, hair color, harsh detergents & chemicals) 41
Dandruff Management
Non-Pharmacology
Maintain a healthy scalp condition:
- Antioxidant (topicals and oral supplements) to
reduce inflammations
- Avoid extreme temperature changes
- Maintain a healthy and balanced nutritions
- Use UV protections
- Healthy lifestyle
- Avoid unhealthy hair styling
42
Dandruff Management
Challenges:
- The condition cannot be completely cured
- Patient compliance and adherence to dandruff
management
- Multifactorial cause
- Indonesia climate: Hot temperature and high humidity
- Culture (foods, clothing/clothing accessories)
- Antifungal resistance

43
Dandruff Management

Recommendations:
- Right diagnosis → the right treatment
- Treatment is not a cure
- Have good habits & hygiene to eliminate dandruff
- Work together with your dermatologists or health
professionals to eliminate dandruff

44
Poling 5

Siapa saja yang berperan menjaga kesehatan scalp barrier?

a. Individu masing-masing
b. Tenaga kesehatan
c. Semua benar
Poling 5

Siapa saja yang berperan menjaga kesehatan scalp barrier?

a. Individu masing-masing
b. Tenaga kesehatan
c. Semua benar
 The Importance of Education in Maintaining a
Healthy Scalp Barrier
Edukasi mengenai bagaimana menjaga scalp barrier yang sehat merupakan hal yang penting dan
perlu dilakukan secara berkelanjutan oleh Tenaga Kesehatan.

• Kulit kepala yang sehat menyediakan nutrisi dan pasokan

oksigen yang cukup ke folikel rambut, mendorong
pertumbuhan rambut yang lebih tebal dan kuat.
• Kesehatan Scalp Barrier yang Optimal = Berkurangnya
risiko gangguan di kulit kepala.
• Peningkatan Kualitas Hidup: Kulit kepala yang sehat
mendukung kesejahteraan individu secara umum. Masalah
scalp barrier akan membuat seseorang merasa kurang
percaya diri, yang akhirnya berujung pada penurunan
kualitas hidup seseorang.

47
 Summary

• Menjaga scalp barrier yang sehat sangat penting untuk pertumbuhan rambut dan
mencegah kondisi kulit kepala seperti ketombe dan dermatitis seboroik.
• Kebersihan kulit kepala yang teratur, termasuk keramas yang tepat dan pengelolaan
kelembapan, adalah kunci untuk menjaga kesehatan kulit kepala.
• Faktor lingkungan dan pilihan gaya hidup, seperti diet dan stres, mempengaruhi
kesehatan kulit kepala dan harus dipertimbangkan dalam strategi pengobatan.
• Edukasi tentang perawatan kulit kepala dan pentingnya kebersihan, terutama pada
kelompok berisiko tinggi, dapat secara signifikan mengurangi prevalensi dandruff dan
kondisi terkait.

48
THANK YOU

49