A Family Doctor's Tale - DANDRUFF

DOC I HAVE DANDRUFF

Dandruff is very frequent in many patients. However the number of patients who requests for treatment are low unless their dandruff are very bad. Most people would go for treatment by their hairdressers or beauticians.

Dandruff is an acute to chronic inflammatory scaly disease of the hairy areas of the scalp endowed with sebaceous glands.
As a result scales that are shedded from the the dead skin cells of the scalp are called dandruff or pityriasis capitis.


The cause of Dandruff is not completely known but are related to three possible factors:


1.Excessive sebaceous or oil gland secretions from the skin


2.the fungus Malassezia furfur has been known to be a poosible cause of dandruff. It metabolizes the oils present in sebum to a lipid byproduct oleic acid .This oleic acid can cause an inflammation in the epithelium of the scaly resulting in the shedding of dry scales.


3. allergic reaction to chemicals in hair oils, cream or gel
Certain oily foods may trigger the production of dandruff


Stress has been known to trigger off dandruff


Onset is usually gradual.
Symptoms:
1.Flaking of scales from the scalp.
2.Itchiness of the scalp
3.Redness of the skin on scalp, forehead and eyebrows


Signs:
1.Dry, rounded, greyish macular or papular lesions on the scalp.
2.The surface consists of dry scales which can be rubbed off
3.Sometimes the lesions can become crusted
4.Some lesions may become purulent with yellow exudate.


1.Dandruff shampoo such as Sebutone, Genisol, Selsun will help to remove flakes and reduce the lesions.


2.fungus infection  should be treated with antifungal orally and topical antifungal lotion and shampoo such as salicylate acid lotion, nizoral or ketoconazole shampoo.


3.For more severe cases with bacterial infection a combination of hydrocortisone and tetracycline ointment can be used to remove infected crusts.


4.General hair hygiene -
shampoo hair daily
Avoid too strong hair cream or gels


Generally good with treatment.


However recurrences are not uncommon.


General hair hygiene is important.