Dandruff

Dandruff / Flaky Scalp / रूसी 

Feeling flaky ? Normal pregnancy hormonal fluctuations can lead to an itchy, flaky scalp.

Has a flaky scalp become a permanent woe for you?

When you have dandruff, your scalp may look scaly or red and feel itchy or raw. Scratching or rubbing your head loosens the flakes. You may notice them more when you wear dark clothes.

Introduction

Dandruff is a common condition that causes the skin on the scalp to flake. It isn't contagious or serious. But it can be embarrassing and difficult to treat. Mild dandruff can be treated with a gentle daily shampoo. If that doesn't work, a medicated shampoo may help.

Those with dry scalp should shampoo only 1-2 times a week with a sulphate free shampoo. And make sure that you condition your hair before shampooing.

Dandruff can be the result of a scalp that's either too dry or too oily. Dry flakes (the kind that rain down into your shoulders can be eased by rubbing coconut or olive oil. on your scalp before shampooing. 

                  "Dandruff flakes are dead skin cells that fall off your scalp"

Winter might be making way for hotter days, but there is one irritant that's not ready to part with most of us as yet. Yes flaky scalp or dandruff and that's because it's as much a summer woe. Winter only worsen the problem.

Who's the culprit : Dry Scalp Or Oily

Skin cells are formed continuously on the scalp, so the shedding of dead cells is a normal process. But a flaky, itchy condition could be both due to a dry scalp or an oily scalp. 

Causes

• Yeast (a common fungus)  among expected moms ) can also flake up scaling. Malassezia a microbe that lives on the scalp  survives of the natural oils in one's scalp and it is harmless for most of us. . The over growth of this lipophilic yeast like fungus can happen on an oily scalp and an cause dandruff.
• Shampooing too often or not enough. 
• Fungus
• Pollution too worsen scalp oiliness. 
• Stress
• Build up if oil 
• Dry skin
• Winter Season
• Weakened immune system
• Neurological disorders like Parkinson's Disease
• Hormone or problem with immune system
• An overdose of shampooing is also to blame. It's a vicious cycle of sorts. Seeing dandruff, one starts shampooing the hair more often, causing dryness and  that, in turn, facilitates more flakes.  Those with a dry scalp should shampoo only 1-2 times a week with a sulphate free shampoo. And make sure that  you condition your hair before shampooing.
• Chemicals in hair products wreck havoc. Many hair sprays, mousses and gels are saturated with chemicals that dry out the scalp and lead to dandruff. "Hair dyes themselves don't create dandruff. However if anyone is already prone to  getting dandruff, hair dye could contribute to a flare up. Chemicals in hair dyes can remove the protective lipids /  oil from your scalp, leaving it exposed and vulnerable to  damage and developing dandruff. Certain chemicals in hair color such as Paraphenylenediamine (PPDA) are known sensitizers, which means that people could develop an allergic reaction to them after repeated exposure.

Symptoms

• Itching
• Scalp may look scaly or red and feel itchy or raw. Scratching or rubbing your head loosens the flakes. You may notice them more when you wear dark clothes.
• Hair breakage

Side effects of the condition

Dandruff can be responsible for itchiness and hair breakage. Oily scalp can also be  a reason for acne on scalp as  well as face.

"Avoid oiling your hair as this can be  the food for  fungus and exacerbate your dandruff."

Prevention

• Cutting down on sugar, refined grains and stepping up healthy fat sources (like avacados and nuts) may also help clear up your scalp and your shoulders.
• Those with oily scalp should shampoo frequently to maintain a scalp hygiene. 
•  Just about 2 times a week is enough to remove flakes. It also helps to reduce oiliness, and prevent dead skin cells buildup.  When selecting an over the counter shampoo, look for anti dandruff ingredients such as ketoconazole, selenium sulfide, salicylic acid, sulfur or zinc parathion.
• The first and foremost thing to remember is  to avoid taking a bath with very hot water, as this can severely dry out your scalp.

What to consider as alarm bell?

If the scalp appears radish and yellow or white thick scales and plague is evident,  do visit a dermatologist as soon as possible.

Do dietary changes reduce problem?

Eating lots of leafy green vegetables, and fresh fruits and reducing excessasive yeast and sugar, combines with  healthy levels of zinc, omega 3 fatty acids and vitamin E and B will nourish your body and strengthen your scalp against drying. Keep yourself well hydrated in winter.

Treatment

                     "Regular cleansing with a gentle shampoo to reduce oil and skin cell buildup".

Rule out HIV and Parkinson's disease.

• Savlon liquid
• Head & Shoulders shampoo
• TGel Shampoo
• Cetavlon concentrate - 2 teaspoons to a glass of water to be used as shampoo twice a week.
• Selsun Shampoo or Ketodan or Nizral or Zocon- shampoo scalp twice a week for 4 weeks. (Dandruff shampoos typically loosen flakes or target fungal overgrowth) 
• Canesten or Candid lotion or cream. To be applied on a scalp daily for 10 days. than alternate days for 10 days, than once or twice a week for one month.(This lotion can also be applied on the face)
• Tacrolimus 0.1% ointment to be applied BD
• Cicloporox olanine 1% shampoo and 1% cream
• Low potency steroids for local use.
• Metronidazole gel  1%
• Dry flakes (the kind that rain down into your shoulders can be eased by rubbing coconut or olive oil. on your scalp before shampooing. 
• 
  

If severe

• Tab Ketoconazole (Nizral)1-0-1 X 2 Days than 1 for 8 days
• Tab Itraconazole 200 mg/day  x 7 days or pulse therapy 200 mg/d x 7 days of each month. 

Instructions

• Tacrolimus 0.1 ointment to be applied BD
• Cicloporox olanine  1 % shampoo and 1% cream
• Tab Itraconazole 200 mg /day x 7 days or or pulse therapy 200 mg/d x 7 days of each month.

Chemical Peeling

• Tab  Glycolic acid 10% or
• Salicylic acid 10% repeated
• Glycolic acid peeling neccessary for acne scars and cystic lesions. Hormonal therapy for girls not desiring conception. Estrogens in 2 weeks cycle from 14th day of cycle for 14 days without progesterone or in 3 weeks cycle with progesterone as oral contraceptive pills.

Peel Before Acne

• Isotretinoin
• Cyproterone acetate + ethinyl estradiol
• Flutamide
• Spironolactone
• PDT (blue) light

Naturopathy

• Probiotic : Hair wash with curd twice a week.
• Application of besan locally
• Aloe vera
• Coconut oil as it moisturize the scalp skin
• Consider diluted apple Cider vinegar to cleanse the scalp a few times a week and a charcoal mask (for oily scalp) to remove pollution related damage.

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