Ask the Doctor: What can I do to stop my scalp from itching and flaking?
Question: I suffer from a really itchy and flaky scalp and have tried every shampoo under the sun, but to no avail. It’s uncomfortable, not to mention embarrassing. Is there anything I can do?
Answer: Dandruff results in flaking and scaling of the scalp and is often a chronic condition. It isn’t dangerous, but whitish scales that fall from the scalp are often a source of embarrassment and concern to those who suffer.
Dandruff causes white greasy looking scales visible on the scalp. It can also be worse in the winter as skin may be drier.
The most common cause of dandruff is dry skin. Seborrhoea dermatitis, which causes a greasy irritated scalp, is a common cause. Other skin conditions, such as eczema and psoriasis can also cause dandruff. Infrequent washing of your hair or sensitivity to hair care products may lead to dandruff.
Dandruff tends to start in early adulthood, but can occur at any age, and it is more common in men. Malassezia, a yeast like fungus that lives on the scalp, may cause irritation, which can lead to dandruff. Those who have oily hair and scalp are also at risk. Other less understood risks are chronic neurological conditions, HIV, stress and those with compromised immune systems.
Most dandruff treatments are available to buy over the counter. Zinc pyrithione is the active component of the best-known anti-dandruff shampoos and may help. Coal tar can be found in a number of different shampoos. This slows the speed at which skin cells flake off. Salicylic acid base preparations will allow the scales to flake off, but can lead to quite a dry scalp. Selenium sulphide is another product that may help, but as it can discolour blonde, grey or chemically treated hair it should be used with care. Ketoconazole works on the fungus found on the scalp and can be very effective in some cases. When using the shampoos use them daily or alternate days until the scaling is under control. Then using it once or twice a week. If none of these remedies have worked and the scalp is particularly irritated adding in a prescription steroid-based lotion may help.
If you suffer with recurrent bouts of dandruff wash your hair regularly with a product designed for dandruff. As with many chronic medical conditions, healthy lifestyle can help. Try and keep stress to a minimum. Dermatitis, psoriasis and irritation often flare in times of stress or anxiety. Eat a healthy diet. Foods high in zinc, B vitamins and healthy fats are an essential part of this. Limit the use of styling products, which may irritate the scalp and exasperate the condition. Exposure to some sunlight may help, but avoid intense sun exposure, which could further irritate and damage the sensitive scalp skin.