Dandruff and Seborrheic Dermatitis
- Posted on: Oct 16 2022
Dermatologist refer to noticeable dandruff as seborrheic dermatitis which is caused by an over reaction of the body to commensal (normally present) yeast that lives on the skin and one can use steroids or other anti-inflammatory agents to suppress the immune system or anti-yeast medication to decrease the burden of yeast. They have done dietary studies to see if there is a correlation and found none. Some people’s bodies just seem to react to yeast that are found in everyone. You cant cure a person even with pills because everyone has yeast just like they have bacteria in their mouth and gut. We often think of dandruff as greasy scaling though patients may complain of dry scalp but they mean flaky scalp.
Anti-yeast medication to decrease the burden of yeast like Head and Shoulders or Selsun blue shampoo are the most popular over the counter (OTC) dandruff shampoos. Many patients claims great results with Tea Tree Oil shampoo. Intensive strength head and shoulders has the same ingredients as Selsun blue while regular head and shoulders is milder. Ketoconazole and Cicloprox shampoo are good prescription shampoos
The key is that you are treating the skin of the scalp and not your hair. So leave the shampoo on a couple minutes, not a few seconds) for it to work. Typically you can use a dandruff shampoo one to two times a week if you leave it on as opposed to every day
In a true dry scalp, (unlike typical dandruff) the skin feels tight and uncomfortable . This is typically from too much hot water and too frequent shampooing which removes natural moisturizing factors. Also as we get older our bodies change and we make less oil so the frequent showering can be irritating to skin and scalp and cause dry skin
in psoriasis the flakes tend to be harder and thicker. The scalp appears redder and more itchy patients may have rash elsewhere Tar based shampoos like Pentrax, MG217 or Neutrogena T gel work better. For more tips head over to our instagram page @goldmandermatology for an extended discussion.
Seborrheic dermatitis can also causes redness and flaking on the eyebrows, nasal folds, beard and ears seen in the phot. Anti-yeast medication like ketoconazole cream and topical steroids like hydrocortisone cream are helpful
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