Question:
I am a 32-year-old male and I love my social life but I think I have dandruff. My self-esteem has taken a knock, as my shoulders constantly appear as if someone has snorted cocaine off of them. I wear black shirts and black jackets frequently and these flakes are certainly not subtle, despite me brushing my hair thoroughly before going out. When I dance, my scalp seems to itch more. I use some sculpting gel on my hair and I am a hygienic and well-groomed man.
I need to get rid of this curse immediately. Is it a disease? Can it affect the rest of my body? Is it contagious, and can I spread this by touching my hair and then touching others? How long does this take and is it curable ?
Answer: Dandruff is a common skin condition that nearly all people experience at some point in their lives, regardless of age or ethnicity – so don’t feel bad.
It was always thought that dandruff was caused solely by a fungus – particularly due to the association of favourable milieu for the growth of fungi of the genus Malassezia.
It does not affect the scalp alone, it also affects the ears, eyebrows, sides of the nose, beard and, less commonly, the central (often hair-bearing) part of the chest.
Sebaceous glands appear to be necessary for the development of dandruff, as indicated by the predilection for body sites with increased numbers of sebaceous glands. Dandruff can affect any hair-bearing area and any area with even the smallest hair follicles. The other name for dandruff is seborrheic dermatitis.
The condition is common in all age groups. In infancy, scalp dandruff is commonly known as “cradle cap”. Teenagers often use the term “druff” for short. Animals and pets, such as dogs, cats, rabbits, and hamsters can also have dandruff. The typical features are: dry, fine, flaky skin on the scalp with areas of pink or red, inflamed skin. More advanced cases may cause intense itching, burning and unstoppable scratching.
What is the cause? Is it curable?
Doctors don’t know exactly what causes dandruff. It’s not the result of a bacterial or fungal infection, and certainly not “ringworm” of the scalp. Postulated theories about why we develop dandruff include increased oil production of the skin, increases in specific skin secretions and increased numbers of normal skin yeasts.
Common factors that may trigger dandruff include:
* Weather conditions,
* Concurrent yeast or fungal infections,
* Suppressed immune system and stress
l Poor hygiene with infrequent hair washing.
* Often common in families suggesting a genetic vulnerability.
* Severe cases of dandruff often have chronic medical conditions.
Seborrheic dermatitis has been associated with HIV infection, Parkinson disease, and use of neuroleptic medications.
How do I control and beat the problem?
Meticulous grooming practices including the correct shampoo and proper anti-dandruff care. A few flakes might be visible from time to time in a susceptible person, despite diligent care.
For moderate to severe cases that do not respond to typical dandruff shampoos, a variety of prescription creams and shampoos are available.
Very rare and severe cases may even be treated with a short-term course of oral steroid medications. Your doctor can help you decide what level of dandruff care is necessary for your individual case.
Severe dandruff can be a very difficult and frustrating condition.
A combination treatment of multiple shampoos, washes, creams and lotions may be required to treat resistant cases.
Most treatments are safe and effective. The best shampoos are antifungal, such as ketoconazole products. The best shampoos for adult dandruff include nizoral ketoconazole shampoo, Head & Shoulders and Selsun Blue selenium sulfide shampoo. Lithium succinate or gluconate topical preparations are available in Europe, and have been shown to be effective in treating seborrheic dermatitis in areas other than the scalp, probably because of their anti-inflammatory properties.
Local irritant reactions have been reported in about 10 percent of patients using topical lithium salts.
The use of topical corticosteroids or antifungals for the treatment of seborrheic dermatitis of the face is supported by a few randomised trials comparing specific agents with a placebo or with each other.
Avoid oily hair and skin products. Avoid tightly fitting hats, caps, head wraps, or helmets.
“Cradle cap” in babies may be treated with more frequent scalp washing using Johnson & Johnson baby shampoo.
A small, soft toothbrush dipped in warm olive oil can be used to very gently massage away some of the flakes on alternate days.
No aggressively rubbing as this can harm the fragile scalp skin. A paediatrician or dermatologist may be important in the guidance of care for infants.
Can I prevent it?
A genetically susceptible person may not be able to prevent having it, but for most people, good skin and hair hygiene will help prevent flares of dandruff and reduce its unsightly symptoms.
Natural dandruff remedies
Lemon juice and coconut oil
Blend together 1 tbs of lemon juice and 5 tbs of coconut oil. Apply to the scalp to get rid of dandruff. Lemon juice is a natural home remedy for dandruff and will clear away flakes from your scalp. There is a myth that lemon juice can lead to hair greying. However this is not true. Leave this remedy on the scalp for 20 to 30 minutes and then wash with shampoo.
Rosemary
Mix vinegar in oil of rosemary leaves (squeeze them). You can also apply mixture of rosemary oil and coconut oil to your scalp to treat dandruff.
* Dr Darren Green, a trusted figure in the field of media medicine, is a University of Stellenbosch graduate who adds innovative spark to health and wellness issues.
He features on 567CapeTalk, and is a regular guest on SABC3 and the Expresso show. Dr Green works as an emergency medical practitioner at a leading Cape Town hospital and completed four years of training as a registrar in the specialisation of neurology.
If you’ve got medical problems, contact the doctor at [email protected], 021 930 0655 or Twitter @drdarrengreen. Catch him in Cape Town on 567 CapeTalk, most Fridays at 1.30pm.
The advice in this column does not replace a consultation and clinical evaluation with a doctor. - Daily News