Thursday, 4 April 2013

Dandruff- are the flakes freaking you?

Dandruff is one of the most common complaints encountered daily in our clinical practice. People commonly misinterpret it as increased dryness of the scalp skin or increased flakiness which is not only a cause of social embarrassment but also leads to increased  hair loss.

Q What is Dandruff?
Ans  It is an inflammatory condition  of the skin which presents as erythema and greasy scaling in areas which are rich in Sebum( The ‘oil like ‘ thing appearing on face and hair if not washed. Its purpose is to prevent skin and hair from drying and making their surface waterproof)

Q What is the cause of dandruff?
Ans Excess of sebum  in some patients causes overgrowth of fungus known as Malassezia furfur  which is a part of the normal flora This fungus leads to breakdown of sebum into byproducts which activate immunity at the local site causing  flaking of the skin easily mistaken by folks as dryness of skin which is rather a weird reaction

Q What routine practices should we adopt to keep our scalp healthy ?
Ans  a) Keep the scalp  degreased and oil free which entails frequent shampooing and keeping the scalp oil free Regular use of Anti fungal shampoos with Ketoconazole 2% at-least twice or thrice a week is helpful
b) Make sure you apply the shampoo on the scalp skin and not on the hair. Keep the shampoo on for about five minutes and then rinse thoroughly.
It is very important to rinse the hair products thoroughly to prevent a build up which may aggravate the condition.
Do not apply hair oil which increases the fat content hence increasing the Fungal colonization and aggravating the condition . This is in contrary to the popular myth that Oiling will bring down the dryness But in reality It is the other way around.
d)  Dandruff is more of a tendency rather than a disease as it tends to come back if treatment is stopped midway and maintenance treatment is not followed properly.
e)Use of anti dandruff shampoos may  make the hair look dull and frizzy which is of temporary nature. Consult your dermatologist for supportive measures.
f) Consult your Dermatologist before taking up any Hair Spa measures which generally involve hair oil massages . As told above it may not be the best option for long term.
g) Consult your Dermatologist if it still doesn't respond to these measures a or else Dry scaly patches are seen on the face , behind the ears or middle of chest. This could be a severe form of dandruff known as Seborrheic Dermatitis

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  1. Doctor I have heard that anti dandruff shampoos can be very strong and using them too often can damage hair and also lead to graying of hair. Is this true? if yes then what precautions do you suggest?


  2. Anti Dandruff shampoos do make hair frizzy as they also rob the hair shaft of moisture along with the scalp skin, Hence it is advisable to use them twice or thrice a week only initially. Once dandruff is in control you can reduce the frequency to just once a week only. You can overcome this side effect by using a good conditioner after shampooing but apply it only on the hair shaft . Avoid massaging onto the scalp skin and application on the hair roots as this may make the scalp skin oily which is to be strictly avoided.Dandruff is not a cause of graying of hair and in no way anti dandruff shampoos will lead to it . Rather graying of hair is due to altogether different mechanisms mainly genetic in nature. Shortly I will be writing a blog-post on graying of hair too.

  3. Hello Dr.
    Is applying Coconut oil useful while treatment of dandruff?
    I have a lot of dandruff and loss of hair too. Though I am using Ketoconazole 2% shampoo from last 2 years...but no expected results. I am a chemist by profession so i get a good result fr other patients frm ketoconazole but not for myself. Please suggest me something for myself.

    1. Coconut oil or any other oil will only make it worse as I have discussed above too. There are variety of treatments available for dandruff refractory to Ketoconazole2% shampoos. You should get a scalp analysis or examination done by qualified Dermatologist to assess the severity and suitable treatment.

  4. Thanks Dr.
    You helped me eradicating a myth.


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