General Description

The medical term for dandruff is seborrheic dermatitis. This condition tends to affect hair-bearing regions and facial furrows; it is not a disorder of hair but of the underlying skin. Seborrhea literally means “freely flowing sebum,” and the problem occurs in those areas with a large number of oil glands. Common sites include the scalp, eyebrows, central face, external ear, mid chest, upper back, belly button, and genital areas.

The most common form of seborrhea consists of slight redness coupled with an itchy, greasy, scaling dandruff, with white flecks that rain down on dark-colored clothing. Seborrheic dermatitis may become more severe, producing bright-red, inflamed, scaling patches on the face and chest that may spread under the arms and even to the groin.

Seborrheic dermatitis is common in infants under the age of 3 months and is called “cradle cap”.

Causes

The cause of seborrheic dermatitis is unknown. A relationship to hormones and superficial yeast infections has been postulated. Interestingly, the condition is associated with Parkinson’s disease and epilepsy.

The primary cause of dandruff is thought to be a yeast called Pityrosporum ovale.

• Over activity of oil glands is another possible cause. Shampooing daily will eliminate the oil and help prevent the dandruff.

• Stress can trigger or exacerbate dandruff.

• A high sugar intake may be another major cause. Sugar requires B vitamins in order to metabolize and can cause a deficiency. To compensate take a high potency B-complex to relieve the dandruff. Related to the sugar problem is the fact that diabetes may be the cause of your dandruff. If you have diabetes the high sugar levels result in dehydration of the tissues as the body flushes out fluids in an attempt to rid itself of the sugar. One of the end results is dry skin.

• Shampooing in hot water may strip out the natural oils and dry out your scalp. Using cool water will close the pores and will relieve the flaking problem.

• People on low or no fat diets may be deficient in unsaturated fats called essential fats, such as omega-3 and omega-6 fatty acids.

• Blow-drying your hair may dry out the scalp and cause dandruff. Hold your hair dryer at least 10 inches from your scalp.

Medical Treatments

No cure exists for seborrhea, but in most cases, the disorder is easily controlled. Seborrheic areas are very sensitive and readily irritated. Scratching and rubbing the skin only serves to prolong the condition and may lead to infection. People with excess oil and scaling of the scalp must shampoo regularly. A shampoo especially formulated to control dandruff should be used at least twice weekly. Active ingredients in dandruff shampoos include selenium sulfide (Head & Shoulders Selenium, Selsun Blue), zinc pyrithione (Denorex Daily Protection, DHS Zinc, Head & Shoulders, Health911 Zinc Shampoo), tars (Denorex, DHS Tar, Health911 Tar Shampoo, Neutrogena T/Gel, Pentrax, Tarsum), ketoconazole (Nizoral), ciclopirox (Loprox), and topical steroids (Clobex). The latter two are available only by prescription.

To be effective, a dandruff shampoo should remain on the scalp for at least five to ten minutes before rinsing. Over time, a shampoo may lose effectiveness. Should this occur, the best course of action is to switch to another type of shampoo. Those with a more severe form of seborrhea may require cortisone in the form of a gel, foam, spray, or lotion prescribed by a physician.

Changes to Make 

Dietary

• Cut out or greatly reduce your sugar intake. Read the food labels carefully. There are many different types of sugar and sweetening agents to look for: sucrose, fructose, glucose, lactose, maltose, corn syrup, molasses, sorghum and maple syrup.

• Reduce or, hopefully, eliminate all foods containing yeast. Examples are: bread and baked goods, cheese, soy sauce, fermented condiments, wines and alcoholic beverages. Even with a yeast-free diet it may take a month or so to relieve the dandruff.

Shampoos

• As mentioned above, don't shampoo in hot water. Try lukewarm showers and rinse with some cool water. Start by shampooing daily with a very mild shampoo. If this doesn't work after a few weeks, begin using an anti-dandruff shampoo with ZPT (zinc pyrithione) or selenium sulfide as the active ingredient. Coal-tar shampoos or those with salicylic acid may also be beneficial. If one works for a while, then loses its effectiveness, switch to another one with a different main ingredient. You should notice improvement in four to six weeks. After that time if the flaking hasn't subsided, see a dermatologist as you may have another kind of skin problem, such as psoriasis or ringworm, which will require a different treatment. The dermatologist may also prescribe an anti-dandruff shampoo with 2% ketoconazole. If you notice fish-like scales or waxy, tan flakes, you may have seborrhea or psoriasis, and should see a dermatologist.

Other Changes

• Avoid alcohol-based styling products as they tend to dry out the scalp. The styling gels, sprays and mousses can build up on your scalp.

Black currant/evening primrose oils Add black current or evening primrose oil to your diet. These oils contain gamma linolenic acid (GLA), an essential fatty acid hard to get in the diet that helps hair, skin and nails look healthy. Many people who are on low or no-fat diets lack essential fatty acids. Start with 500 mg twice a day. If the dandruff starts to clear up, cut the dose in half. It may take up to two months to begin seeing results.

Vitamin E To relieve itching and reduce scaling, rub vitamin E oil into your scalp.

Remedies