SCRATCHING HEAD ABOUT DANDRUFF

We all know dandruff when we see it. How annoying is it to keep brushing off those unsightly snowflakes that accumulate on your hair, shoulders and clothing? Despite what television advertisements might have you believe, dandruff is simply an overabundance of a natural process that occurs in everyone. 

Throughout our lives, the skin cells covering our bodies are constantly "dying" and being replaced by new skin cells. When old skin cells die, they dry up and fall away, or "shed." Generally, this continuing process occurs at a slow enough pace so as to remain invisible. 

Dandruff occurs as this process is accelerated. In most people, the skin over the entire scalp replaces itself approximately once per month. At this pace, the process remains invisible as long as you wash your hair and scalp regularly (at least two to three times per week). In some people however, this replacement of old skin cells speeds up, making it more difficult to keep up with the pace. When the process accelerates to every 10-15 days, visible dandruff occurs; and if it accelerates further (to every five days or less), severe dandruff results. 

WHAT STARTS THE EXCESSIVE SHEDDING ?

In most instances, a mild case of dandruff is likely just an outgrowth of dry scalp skin. In more severe cases of dandruff, the culprit is seborrhea dermatitis--a skin condition that, in addition to causing an itchy, scaly rash, also causes an acceleration in the process of shedding and replacing old, dead skin cells. Though most often found on your scalp, seborrhea dermatitis can also occur elsewhere on the body, usually on the eyebrows, eyelids, nose, around the ears, or on the chest. 

What causes seborrhea dermatitis? It's not known for sure. However, many believe that the cause is Pityrosporum ovalae, a naturally-occurring, yeast-like organism present in all human skin which, in overabundance, can accelerate the rate at which old skin cells are shed and replaced. 

STOPPING THE FLAKES

Because it results from a naturally occurring process, dandruff cannot be cured. However, it can be controlled. The first step is to simply increase the rate at which dead skin cells are removed from the scalp. In mild cases of dandruff, this can be accomplished by washing your hair more frequently--for example, every day rather than every two or three days. In moderate, and in some more severe cases, the increased frequency of shampooing must be combined with the use of medicated, over-the-counter dandruff shampoos. 

SHAMPOOING TECHNIQUES

Whether using a regular or anti-dandruff shampoo, a specific shampooing regimen should be followed in order to help further control dandruff. 

Massage the scalp with the shampoo to loosen flakes of dead skin cells. 

Let the shampoo lather remain in your hair and on the scalp for three to five minutes (or, in more severe cases, 15-30 minutes) before rinsing it out. 

Rinse your hair and scalp very thoroughly to remove as much of the dry, dead skin as possible. 

Over-the-counter medicated shampoos.

These anti-dandruff shampoos help control dandruff by: 

Pulling the dead skin cells away from the scalp so they can be rinsed away. 

Killing the Pityrosporum organisms in the scalp and slowing down the process of shedding and replacing dead skin cells. 

Decreasing the rate of scalp skin turnover.

To accomplish this, anti-dandruff shampoos use any one of a number of dandruff-fighting ingredients approved by the Food and Drug Administration, including:

Products containing salicylic acid (Sebulex) and coal-tar (Tegrin), which help remove dead skin cells from the scalp and/or slow down the rate at which these cells are created. In some folks, however, salicylic acid--due to its "harsh" nature--may actually increase the rate at which dead skin cells are created. 

Products containing zinc pyrithione (Head and Shoulders), which kill pityrospora. 

Products containing selenium sulfide (Selsun Blue), which slow down the creation of dead skin cells and kill pityrospora. 

Which type of anti-dandruff shampoo should you choose? Since different people tend to have success with different products, experiment with several anti-dandruff shampoos until you find one that works for you. 

WHEN OVER-THE -COUNTER PRODUCTS DON'T WORK

If your dandruff is severe and/or seborrhea dermatitis has affected other areas of your body in addition to the scalp, you should see a dermatologist. He or she can evaluate the condition and prescribe one of a number of stronger treatments, which include:

Prescription-strength anti-dandruff shampoos that contain ketoconazole--an antibacterial ingredient that is stronger than zinc pyrithione. 
Prescription-strength salicylic acid or prescription strength coal-tar, which comes in a lotion that is applied to the skin and left on for a number of hours. 
Prescription-strength steroid preparations that are applied to the skin. 

STILL SCRATCHING

If you suffer from severe dandruff, realize that the shorter you wear your hair, the easier it is to control your dandruff. And, even in the most severe cases, nearly all degrees of dandruff can be controlled with proper treatment. Get the help you need, because life's too short to worry about your hair.