Dear Readers,

Rashida is a 15-year-old student who attends a high school in Kingston. Her concern for a year now is that her scalp itches and flakes quite badly. Rashida says she uses a comb and scratches out her scalp at least once a week, getting rid of a head full of flakes this way, but her scalp is dry and the flakes always recur.

She asks Lifeline why this is occurring and what can she do to properly treat the condition. She would like to see the flakes disappear permanently!

What Rashida is referring to is Dandruff, also known in its worst presentation as Seborrheic Dermatitis of the scalp. This is a chronic scalp disease which causes flaking of the scalp to occur and is usually associ-ated with itching of the scalp.

Our scalps cells are always dying and renewing. Dead cells leave off the surface of the scalp quite regularly and are removed with regular brushing and washing of the hair. Dandruff occurs when this turnover of scalp cells becomes rapid, excessive and visible. Dandruff can be chronic (long term) or short term, and triggered by emotional and self-esteem problems. A fungal scalp infection (Malassezia), is often the culprit and also, changes in hormonal balance can influence the occurrence of dandruff.

not contagious

Dandruff is never serious and is often associated with psychological problems such as stress. Dandruff is also not contagious. A significant number of people with dandruff find that it improves with age. It is more often found in males. When dandruff is severe it is referred to as Seborrheic Dermatitis which is also associated with flaking of other areas such as the eye brows and ears.

Some studies show that diets which are too salty, contain too many sweets, or are too spicy can worsen dandruff. Dietary modifications may help to control the condition. Often, dandruff flakes can be seen on the shoulders over clothes and may even be seen as a rash about the border of the scalp, following the hair line.

treatment

Most cases of dandruff will respond to medicated shampoo. Ketoconazole shampoo is often used successfully in the treatment of Dandruff. Where flakes are excessive then an ointment containing Salicylic acid and/or steroid cream, when applied twice daily with antifungal preparations, will often successfully treat the condition. Some people also find coal tar preparations and zinc preparations are useful in treating this disorder. One home remedy which has had some success is washing the scalp with Apple cider vinegar.

Lifeline hopes Rashida's scalp problem will quickly resolve with the suggestions made. Hydrocortisone cream is available as an over-the-counter preparation, but several other creams do require a medical prescription. When the problem persists a physician should be consulted.

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LIFELINE,

PO Box 1731,

KGN 8