. Wednesday, November 5, 2008
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Intelligent and hardworking, Dusty Chalders has a good job, a loving wife and healthy, obedient children. He also has a little problem.

“Hey, Dusty, is it snowing out side?”
“Say, Dusty, did you drop your powder puff?”
“Yo, Dusty, have you been painting today?”

After fielding hundreds of personal comments from a few insensitive “friends,” Dusty went to his doctor for help. “Doc, you’ve got to help get rid of this dandruff,” he pleaded. “I can’t even wear my good blue suit.”

Getting A Little Flaky

Doctors aren’t sure why, but sometimes skin cells on the scalp proliferate-form, die and flake off-at an accelerated rate. “Dandruff is skin that comes off as a cohesive chunk,” says Guy F. Webster, M. D., an assistant professor of dermatology and director of the Center for Cutaneous Pharmacology at Thomas Jefferson University Hospital in Philadelphia. “It gets worse in the winter, when the air is dry, because each individual flake is less prone to stick to your scalp if it’s not moist.”
While dandruff can be itchy, and perhaps a little unsightly, the biggest concern you probably will ever have is putting up with its appearance-and perhaps a few jokes. Because dandruff is present in nearly everyone, it’s hard to call it a disease.

Dermatitis by Another Name

The problem with dandruff, however, is that it can be a serious problem cosmetically. Some people get dandruff so badly that it can dump a veritable snowstorm on their shoulders day after day. This type of flaking is called seborrheic dermatitis, a disease characterized by a profusion of flaky, itchy head scales.

In fact, dandruff and seborrheic dermatitis are so much alike-they’re even treated alike-that some doctors believe they simply are variations of the same condition. “Some people believe they’re part of a spectrum, that the most mild form of scaling disease is dandruff and that if it’s a little worse, it becomes seborrheic dermatitis,” Dr. Webster says.

But there are differences. Dandruff usually stays at home on the scalp, but seborrheic dermatitis can wander to the eyebrows, outer ears and other parts of the body. It is also accompanied by inflammation and can be quite itchy as well.

Both, however, are needless embarrassment, says Dr. Webster, because it isn’t necessary to bear either of them on your shoulders. Dandruff and seborrheic dermatitis can easily be controlled. All it requires is a little attention to your hair a little more often than you are currently used to.

The Soap and Water Cure

If you have dandruff, says Dr. Webster, chances are you are not washing your hair often enough. Since dandruff is nothing more than flaking skin, washing it away will get rid of it. How fast the flaking proliferates should determine how often you wash your hair, not whether or not your hair feels dirty. The same goes for seborheic dermatitis. The more you wash away, the less you have to display.

Every day is best. Some people can wash their hair once a week and still be dandruff-free, Dr. Webster says. People with dandruff problems usually have a problem only because they let it go too long. The notion that shampooing causes dandruff by drying out the scalp is simply not true. Washing your hair-every day, if possible-can be the cure. But you also need to know how to wash it right.

Get the right shampoo. Over-the-counter dandruff shampoos work quite well, Dr. Webster says. The best are those containing selenium sulfide (Selsun blue) or zinc pyrithione (Head & Shoulders), both of which help slow cell growth. You might also try shampoos containing salicylic acid, which can help soften and remove itchy scales.

These shampoos work best if you leave them on for 5 to 10 minutes. Whip up a good head of lather at the beginning of your bath or shower, then thoroughly rinse it out when you’re nearly done. Since these shampoos can dry your hair, you might want to use a good conditioner for the crowning touch.

Treat it with tar. Tar-based shampoos not only, well, beat the tar out of dandruff, they pump in extra body as well. You should, however, use these preparations only if you’re dark haired, Dr. Webster warns. “If you are very fair haired, tar-based shampoos may turn your hair green.”

Oil it up. If you have thick scales on your scalp that create a lot of flaking, try loosening them up by rubbing them with a little warm mineral or olive oil. Let the oil soak in for a few hours, then shampoos as usual.

Finger the fungus. It hasn’t been convicted yet, but a fungus called Pityrosporum ovale may somehow be involved in triggering dandruff. A cream containing ketoconazole, rubbed into the scalp, can exterminate the fungus and perhaps some of the dandruff as well. For most people, the less expensive anti-dandruff shampoos will work just as well, Dr. Webster says.

Get used to it. Even though you can control a flaky scalp, it’s impossible to eliminate it. Don’t even try, Dr. Webster says. “No good is served by stirring up the scalp to see if you can get the last scale off,” he says. “You can always stir up another scale.”


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