bubble_chart Concept

Scalp dandruff refers to the shedding of skin fragments from the scalp. It appears like chaff, either dry or greasy, scattered diffusely, shedding and regenerating.

Waike Zhengzong states: "Seborrheic dermatitis often occurs on the head, face, ears, and neck hair. Initially, it causes slight itching, and over time, white dandruff gradually forms, piling up and flying off, shedding and regenerating." Seborrheic dermatitis is a disease that includes this condition.

Scalp skin edema, scabs or crusts formed after the rupture of pustules, are distinctly different from this condition; normal people have a small amount of fine dandruff on the scalp, commonly known as "scalp shedding," which is a physiological phenomenon. These are not within the scope of this article.

bubble_chart Pattern Analysis

1. Wind-heat Transforming into Dryness︰The scalp sheds grayish-white, bran-like, dry scales, with circular or oval patches on the affected skin, appearing light red or white in color. It is often accompanied by mild systemic symptoms such as feverish discomfort, scalp itching, dry mouth and throat, thin and slightly yellow tongue coating, and floating or slightly rapid pulse. This condition is caused by exposure to wind while the muscles are feverish, allowing wind pathogens to invade and stagnate, eventually transforming into dryness over time. The shed scales are dry and fine, and the hair also becomes dry and prone to falling out, often accompanied by mild systemic symptoms like fever. The treatment should focus on {|###|}dispelling wind and moistening dryness{|###|}, and the modified Wind-Dispersing Powder can be selected.
2. Dampness-heat Generating Wind︰The scalp sheds thin, greasy scales that adhere to the hair, with ill-defined erythema in the desquamated areas. The hair appears shiny and oily. It is often accompanied by a sticky and dry mouth without thirst, scanty and dark urine, a white and greasy tongue coating, and a slippery or slightly rapid pulse. This condition is caused by internal dampness-heat that stagnates over time, generating wind and manifesting on the scalp. The shed scales are greasy and thin, the scalp is shiny, the hair falls out easily, and there is excessive scalp oil, along with symptoms of dampness-heat such as a sticky sensation in the mouth and dark urine. The treatment principle is to eliminate dampness, clear heat, and dispel wind. Commonly used formulas include Powder for Ascending and Descending and Gentian Liver-Draining Decoction with modifications.
3. Blood-heat Transforming into Dryness︰Desquamation piles up, with erythema in the desquamated areas, scratching leads to bloodstains, and scalp cutaneous pruritus. Accompanied by dry mouth and desire to drink, dry stool, yellow urine, red tongue texture, thin yellow or scanty coating with little moisture, and wiry-rapid pulse. Commonly seen in individuals with excessive yang-heat, nutrient-blood latent heat, pathogenic heat consuming yin and damaging blood, transforming into dryness and generating wind, thus causing desquamation. The clinical features include piled-up desquamation, recurring shedding, erythematous skin, scalp itching, red tongue, yellow coating, and wiry-slippery pulse. Treatment involves cooling blood Four Ingredients Decoction with modifications to moisten dryness.
4. Toxin Invasion and Infiltration︰The scales are fine, grayish-white in color, with intense scalp itching, dry and brittle hair, and bright red circular patches on the skin where scaling occurs. This condition is commonly seen in children and is rarely accompanied by systemic symptoms. It is often observed in children due to the invasion of toxic pathogens into the pores, eroding the skin. The clinical features include fine, grayish-white scales, dry and brittle hair, severe scalp itching, and rarely any systemic symptoms. Treatment involves the method of dispelling wind and removing toxins, commonly using the internal administration of Wind-Dispelling Muscle-Renewing Pills, along with the external application of Sweeping Away Powder.

Scalp desquamation is mostly attributed to excess pattern and heat pattern. The apoplexy heat transformation causing dryness and the invasion of pathogenic toxins leading to desquamation are mainly caused by the influence of six excesses pathogenic qi. The generation of wind due to dampness-heat and the blood heat transformation causing dryness and desquamation are primarily due to the dysfunction of the zang-fu organs' qi and blood functions. Therefore, in treatment, the former two focus on expelling pathogenic factors, while the latter two focus on regulating the qi and blood functions of the zang-fu organs.

bubble_chart Documentation

1. Yizong Jinjian Waike Xinfa Key Points. Head: "This syndrome initially appears within the hair, spreading to the face, ears, and neck, causing dryness and itching. Over time, white scales fly off, and when they fall off, they grow back again. It is caused by the skin being exposed to wind while hot, allowing wind pathogens to invade the pores. Over time, the blood becomes dry, and the skin loses its nourishment, transforming into dryness pattern."