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Finding the cure for dandruff

Dear Readers,

K.C. from Harbour View, Kingston, is a 19-year-old female who suffers with dandruff. She is embarrassed by the copious white scaly flakes which affect both the hair line as well as the full head of hair. Her scalp often itches and although some shampoos improve the condition temporarily, she is looking for a cure.

Dandruff, or seborrhoeic dermatitis, refers to an increase in the normal amount of scaling of the epidermis of the scalp which is often associated with an acute, subacute or chronic inflammation. Itchy, greasy flakes and scales of dead skin are seen on the scalp, in the hair and also fall on to the shoulders and clothing.

The root cause is a disorder of the sebaceous glands in the scalp which produce too much of the oil, sebum, which dries into flakes and plugs the glands resulting in scaling, flaking and itching. Dandruff is often complicated by a yeast scalp infection. This organism lives in the hair follicles and when the condition is severe, scaling can also be seen in the eyebrows and ears.

Several over-the-counter anti-dandruff shampoos are effective. They contain selenium, salicylic acid, menthol and zinc pyrithione (ZPT). If after a period of usage and control the condition flares up, the person should try regular shampoo which, if used often, may help as much as any that is prescribed to some persons.

Shampoos containing coal tar are also effective against seborrhoeic dermatitis (but if shampoos don't work the family doctor will need to be consulted as a scalp yeast fungal infection could be complicating the disorder and the condition will not resolve without treating the yeast infection. An anti-fungal shampoo, Nizora (ketaconazole), shampoo can be prescribed along with oral anti-fungal preparations and topical anti-fungal creams. Occasionally, when the scalp is very inflammed and oozing and crusting occur, a topical steroid application can also be applied in combination with an antibiotic.

A healthy diet which minimises the intake of refined sugars and processed foods is useful in treating stubborn dandruff as both bacteria and yeast enjoy a sweet environment. Yogurt and other ferreted foods help to clear yeast infections generally, including those involving the scalp. Selenium and vitamin A can also be taken orally while vitamin E oil can be applied to the scalp directly to soften scales and nourish the scalp. To avoid an accumulation of the scales and flakes, the hair should be brushed thoroughly at least two times daily.

A.J.M.