What Causes Dandruff?
Dandruff (pityriasis capitis) affects up to 50% of adults. It is primarily caused by the overgrowth of Malassezia — a naturally occurring yeast-like fungus on the scalp that feeds on sebum. When Malassezia metabolises sebum, it produces oleic acid, which triggers scalp inflammation and accelerates skin cell turnover. The result: flaking, itching and visible white or yellowish scales.
Contributing factors
- Oily scalp — provides Malassezia's nutrient source
- Infrequent shampooing — allows sebum and dead cells to accumulate
- Stress and fatigue — can alter immune response and sebum production
- Cold, dry weather — common in Kathmandu winters
- Certain skin conditions — psoriasis, seborrheic dermatitis
Dandruff vs. Seborrheic Dermatitis vs. Scalp Psoriasis
| Condition | Flake Type | Scalp Redness | Itching |
|---|---|---|---|
| Dandruff (mild) | White, dry, small | None to mild | Mild to moderate |
| Seborrheic dermatitis | Yellow, oily, larger | Pronounced | Moderate to severe |
| Scalp psoriasis | Thick, silvery plaques | Vivid red | Severe, burning |
For scalp psoriasis management, see our Scalp Psoriasis Treatment Guide.
Evidence-Based Treatment
Anti-Dandruff Shampoos — Active Ingredients
- Ketoconazole (1–2%) — the gold-standard antifungal for Malassezia. Shown in multiple RCTs to outperform zinc pyrithione and selenium sulfide in severe dandruff.
- Salicylic acid — keratolytic, removes accumulated scale and dead cells, improving penetration of antifungal agents.
- Zinc pyrithione — broad antimicrobial, controls Malassezia and bacteria.
- Selenium sulfide — antifungal and reduces scalp cell turnover.
Kezil SL Anti-Dandruff Shampoo
Kezil SL Anti-Dandruff Shampoo combines Ketoconazole 2% and Salicylic Acid for a dual-action approach: the ketoconazole targets Malassezia directly while salicylic acid clears the scale build-up. This combination is particularly effective for moderate-to-severe dandruff and seborrheic dermatitis of the scalp.
How to use Kezil SL effectively
- Apply to wet hair and scalp, lather thoroughly
- Leave on for 3–5 minutes (contact time is important for antifungal action)
- Rinse thoroughly
- Use twice weekly for 4 weeks, then reduce to once weekly for maintenance
- Do not discontinue immediately when flaking stops — finish the treatment course
Scalp Care Tips for Long-Term Control
- Shampoo regularly — infrequent washing aggravates dandruff
- Manage stress with exercise, adequate sleep and relaxation techniques
- Eat a balanced diet — vitamin B, zinc and omega-3 support scalp health
- Avoid extreme heat styling on the scalp
- Consult a dermatologist if dandruff is severe, painful or unresponsive to 8 weeks of anti-dandruff treatment
Summary
Dandruff is a treatable condition with the right antifungal therapy. Kezil SL Anti-Dandruff Shampoo by Aurelderma delivers ketoconazole + salicylic acid for effective scalp control. Available from Stellar Healthcare in Nepal. See also hair loss prevention guide.