Suffer from excessive dandruff? Everyone suffers from dandruff to some degree. Dandruff, medically known as seborrheic dermatitis, is often mistaken for dry itchy scalp.  In fact, it occurs in normal to oily skin areas.  It more commonly occurs areas of the scalp and along the hairline; in and behind the ears; along side the nostrils, eyebrows or T-zone of the face; mid-chest; the in the beard and mustache of men, beginning in puberty and persisting throughout a lifetime. Seborrheic dermatitis involves the accelerated turnover of the top or epidermal layer of the skin and to a degree, is considered a normal process of the skin. The epidermal layer turnover is compromised by the overproduction of oil which causes the cell layers to clump together to form a noticeable flake. Applying pomades, oils and lotions to the areas only exacerbates the condition.  Another common problem seen in seborrheic dermatitis is the changes in skin color at the sites of flakiness.

Treatment for seborrheic dermatitis includes topical medications and dandruff shampoos that are formulated to slow down the formations of scales and/or remove existing scales.  Active ingredients in shampoos include selenium sulfide, coal tar, sulfur, salicylic acid pyrithione zinc, ketoconazole and mild steroids.  In order to be effective, shampooing of the scalp needs to be for at least 5 minutes and it is recommended that the shampoos need to be used often such as daily or every other day.  Unfortunately, dry hair can’t withstand frequent shampooing especially with medicated shampoos. Frequent shampooing can lead to dry brittle hair and subsequent breakage. I generally recommend topical preparations with active ingredients containing ketoconazole or corticosteroids that can be applied directly to the scalp several times a week until the excessive flakiness is under control.  Topical preparations can allow for more flexibility in the treatment of seborrheic dermatitis and limits the need to shampoo the scalp on a daily basis and with proper treatment, the skin discoloration will return to normal.

Did you know….?  Dandruff is not contagious.

Dr. Cheryl M. Burgess is the founder, medical director and president of the Center for Dermatology and Dermatologic Surgery, P.C. in Washington, DC.  She is an Assistant Clinical Professor at Georgetown University Medical Center and George Washington University Hospital located in the District of Columbia. www.ctr4dermatology.com