An Updated Review of Dandruff: Pathogenesis, Conventional Treatments, and Novel Therapeutic Approaches

Dandruff is a chronic scalp condition characterized by flaking and itching. It is frequently associated with seborrheic dermatitis and can significantly impact a sufferer's quality of life. The development of dandruff involves several interconnected factors, including an overgrowth of Malassezia yeast, increased sebaceous gland activity, a compromised skin barrier, and individual susceptibility. Therapies against dandruff are numerous and target various factors of the disease. Traditional therapies are topical antifungal drugs like ketoconazole and zinc pyrithione, keratolytics like salicylic acid, and anti-inflammatory agents like corticosteroids. Natural or herbal preparations like tea tree oil, neem, and aloe vera are gaining popularity because of their perceived safety and overall benefits. The latest developments have brought in new modality like probiotics, microbiome-targeted therapy, and nanotechnology-based formulations that can increase efficacy and limit side effects. This review extensively discuss the present situation of anti-dandruff treatments, assessing their modes of action, clinical efficacy, safety, and patient acceptability. It also identifies emerging trends and future strategies in treatment design, emphasizing personalized, long-term management approaches. By combining existing evidence and areas of knowledge gap identification, this review will facilitate dermatologists, scientists, and product developers in maximizing the management of dandruff and promoting better patient outcomes.