Dry scaly material shedding from the scalp is called the Dandruff.  It applies to the normal shedding of scaly materials from the scalp epidermis and as well as excess shedding associated with diseases. Shedding of scales or flakes from the scalp is only a natural mechanism but when it exceeds in quantity it becomes prominently noticeable. The excess shedding of scales are not compensated by new scales and it causes inflammation in the scalp and a clinical picture with itching and irritation is appeared. Usually the flakes are white or grey in color.

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Severe form of dandruff is called seborrheic dermatitis of the scalp. It not only affects the scalp but also other areas in the body. In this condition that the scalp or skin becomes inflamed, enormous amount of flakes are shed with greasy appearance of flakes. Usually the symptoms comprise of white flakes with greasy looking, the scalp is itchy, scalp with irritation or sore, reddish scalp and with scaling rashes or even with swollen scalp in extreme conditions.

The causes of this condition are many and some of which are explained herein. Natural shedding of scales is promoted by regular combing and brushing of hair and those who do not have this habit may have the risk of getting this condition. Temperature plays an important roll in dandruff and somebody is affected by this disease only in particular seasons. It is said that yeast play a part in causing this disease. Yeast sensitive people feels that it is better during summer and worsened by winter. People with dry form of skin are prone to get this condition often and people are more prone whose scalp is having moisture due to excessive sweating. Seborrheic dermatitis is the affections of the various skin areas other than the scalp.

People with seborrheic dermatitis are more often prone to dandruff. Seborrheic dermatitis affects most of the skin areas in ear, nose, breast and eyebrows. They usually have red and oily skin covered with flakes of white or yellow in the affected areas. When enough shampooing is not performed this condition may develop. People who have psoriasis and eczema lesions will have frequent dandruff than others. Patients with neurological defects, patients after heart ailment and strokes are often seen with dandruff. Excessive use of shampoo and certain skin care products come under the causes of dandruff. Fungus infection of the scalp causes this condition in some people. Improper Diet takes its part in causing the disease. It is believed that mental stress also causes this condition and recent studies show that about 10% of HIV patients are having dandruff of the scalp and sebbhoreic dermatitis.

The diagnosis is very simple and it can be done by self. It needs no experts help and simply by seeing the white scales on the scalp or rarely with itching and reddish, swollen scalp. Self medication is enough to treat this and when it does not have any better relief it is essential to visit a doctor. Shampoos are very effective in curing this disease. Shedding is controlled by stopping enormous quantity of scales. The following ingredients are used in shampoos. They are selenium sulphide, zinc pyrithione, coal tar, ketoconozole, tea tree oil and salicylic acid. Every ingredient is having their own mode of action in removing and reducing shed of flakes of scalp and skin. Dandruff is always a curable disease by natural remedies except in rare cases where medication is required. Fenugreek seed is one of the successful natural remedy in treating this condition.

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Daily use of this seed in cleaning the scalp will cure this disease. About two teaspoons of seed soaked in water for about twelve hours and it is ground into paste form. This paste is applied to scalp and hair should be washed neatly on a daily basis with soap nut powder or solution. Longer usage of this paste with soap nut helps in curing this disease in all the cases. Using a little lime juice while washing the hair in daily routines will prevent dandruff.

Green gram powder is one of the most effective and commonly available natural remedy available in the market. Using about two to three teaspoon of this powder on a daily basis with one cup of curd will definitely cure this disease. Boiled water of both tops and roots of beets are used in massaging the scalp which gives better results. (White beet is largely used.) Snake gourd juice is applied and rubbed over the scalp before washing and it is most beneficial in prevention and treatment of dandruff. Usage of cider vinegar and Indian gooseberry juice are also effective. Diet plays an important part in treating dandruff.  Certain foods such as strong tea or coffee, pickles, refined and processed food, fast foods, excess meat and sugar should also be avoided.

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Most importance and care to be given in keeping the hair clean on a daily basis to avoid accumulation of dead scales.  Time should be spared to brush and clean the hair and scalp systematically to improve the blood circulation in the scalp. Exposure of head to sun rays for few minutes to be practiced daily and care should be taken in avoiding constipation and if necessary with daily warm water enema to clean the bowels. A great hair care to be taken to maintain the general health to avoid dandruff.

Dandruff filled hair is neither a pleasant view nor a healthy sign from medical health point of view. This recurring feature should not be ignored or also it may become complicated. The more extreme cases could need intensive medication. So take care of your hair to avoid bad conditions by “Managing Dandruff”.

Medically dandruff is termed as “Pityriasis Capitis”. The skin decay on the scalp dries and gets entrapped in the hair roots. This is a normal phenomenon. When the head is washed and the hair thoroughly rinsed, the Dandruff is washed out. The less thorough hair wash or long intervals in between head washes, is the basic cause of this disease besides infection.

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The small white specs of the dead skin stick to the scalp and grow thick with further skin decay. These white flakes stay entangled in the hair roots. Yeast present on the skin absorbs oil gland’s secretions to produce fatty acids.

These fatty acids react with the surface to cause irritation. The normal human reaction is to scratch the head to dislocate the more congested areas for temporary immediate relief. The scratching also loosens the white dandruff layer and some is showered on the clothes above the shoulders, causing embarrassment when among friends. More information on dandruff is available on SkinCareGuide.ca/articles/general_skin_care/dandruff.html

Dandruff Treatment

The common dandruff is mostly washed away by proper rinsing. For safer precautions anti yeast shampoos are very helpful. These shampoos area available and can be bought off the shelf from stores easily. These help clean the skin hair better. For Managing Dandruff that persists, better shampoos are advised with higher medicinal properties and contain ingredients like salicylic acid, coal tar or antifungal properties that dislocate the dandruff from hair roots. The new developments have made them give pleasant cleansing. In difficult cases, newly developed Zinc Pyrithione shampoos are found effective. This is applied daily, rinsed properly till the dandruff is cleared. The treatment duration is for 2 to 3 weeks.

Dandruff shampoos advised usually

• Head and Shoulders (antifungal)
• Selsun (antifungal)
• Nizoral (antifungal)
• Sebcur (Salicylic acid)
• T-Gel (coal tar)

Dandruff severe conditions indicate rash:

• In between the two eyebrows
• On both sides of the nose
• Both the ears, inside and around
• Chest centre
• On the upper back
• On overlapping of skin surfaces such as under armpits and breasts

Seborrheic dermatitis – risk factors:

• Neurological conditions such as Parkinsonism or after strokes
• HIV-AIDS (AIDS can increase sensitivity and inflammation)
• Antipsychotic drugs

Seborrheic dermatitis can confuse for different skin disorders:

• Scalp psoriasis (more info is available at www.psoriaisisguide.ca/basics/types/scalp_psoriasis.htm)
• Tinea Capitis    (more info is available at http://www.fungalguide.ca/types/fungal_hair_infections.html)
• Facial Rosacea
• Atopic Dermatitis
• Intertrigo
• Erythrasma

Seborrheic dermatitis – Treatment

Shake the dry hair at the roots intensely, before the bath, to loosen the dandruff as much as possible. This will now expose the inner skin surface to the shampoo treatment. Use anti yeast shampoos to cure Seborrheic dermatitis. Apply the shampoo in reasonable quantity so as to form a good lather. Rinse the hair roots very thoroughly allowing the dandruff to absorb the medicated lather and to wet the scalp skin underneath for better exposure. Continue for 30 seconds, then rub this lather downward on the face and chest and if needed into the armpits for another 30 seconds. Then wash off thoroughly so that nothing from the skin waste is left as residue on the body. Continue the treatment daily and if condition does not impose by self diagnosis, then consult a doctor, who will prescribe creams or pills.

Managing Dandruff – treatment recommendations:

• Ketoconazole cream or pills
• Hydrocontisone cream
• Lithium Succinate ointment with 15% propylene glycol in water
• Zinc Pyrithione shampoo

For persistent – Seborrheic dermatitis:

• Betamethasone Valerate solutions (Betnovate)
• Flucinonide gels
• Clobetasone shampoo (Clobex)
• Pimecrolimus Cream (Dlidel)
• Tacrolimus Ointment (Protopic)

When the dandruff has become uncontrollable by use of shampoos, it is best to consult a doctor for proper diagnosis.