Dandruf

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Dandruff

Fight Feisty Flakes

Compared with earthquakes, floods and other natural disasters, dandruff is a minor problem. But walking around with white flakes on your head and shoulders is embarrassing--doubly so if your dandruff flares up just before an important job interview or romantic encounter.

A short lesson in the biology of dandruff can help you select the remedy that works best for you.

"Dandruff can be associated with oily hair," says Diana Bihova, M.D., a dermatologist in New York City and author of Beauty from the Inside Out.

Another cause is yeast infection of the scalp, adds Yohini Appa, Ph.D., director of product efficacy at the Neutrogena Corporation in Los Angeles. And while they don't cause dandruff, hormonal and seasonal changes can also exacerbate the problem, she says.

Dandruff is characterized by accelerated cell turnover--in other words, the cells on the surface of your skin build up like crazy.

"Typically, it takes 21 days for new cells to migrate to the surface of your scalp, where they are shed," Dr. Appa says. "Ideally, it's an invisible process. But with dandruff, the cell reaches the surface in half the time." As a result, cells build up on your scalp in clumps before they're shed. And when they do shed, they look like tiny white flakes.

ANTI-DANDRUFF STRATEGIES

Fortunately, dandruff can be conquered with these tips from experts.

Use a dandruff shampoo. Choose an anti-dandruff shampoo that contains coal tar, salicylic acid, pyrithione zinc, sulfur or selenium sulfide, says Patricia Farris Walters, M.D., clinical assistant professor of dermatology at Tulane University School of Medicine in New Orleans and a spokesperson for the American Academy of Dermatology.

Each ingredient reduces dandruff in a different way, explains Dr. Appa. The tar-based shampoos slow cell production, while salicylic acid-based shampoos slough off dead cells before they clump. And both shampoos have antifungal properties and help fight invading yeast microbes, which is one of dandruff's most persistent triggers. Pyrithione zinc and selenium sulfide reduce cell turnover, while sulfur is believed to cause slight skin irritation--just enough to lead to the shedding of flakes.

When To See A Doctor If tiny white flakes appear on your shoulders, use a hand mirror to help you check your scalp carefully in a wall mirror, says Patricia Farris Walters, M.D., clinical assistant professor of dermatology at Tulane University School of Medicine in New Orleans and a spokesperson for the American Academy of Dermatology. Persistent scaling that's accompanied by redness and itching could be seborrheic dermatitis, an inflammation of the oil glands. You should also consult your doctor anytime that dandruff is severe or is accompanied by redness or itching, says Dr. Walters. Your doctor will probably prescribe a medicated shampoo containing the antifungal agent ketoconazole, or a cortisone preparation.

Some shampoos on the market contain more than one ingredient, adds Dr. Walters. Trial and error is the only way to sort out which one will work for you. (It doesn't matter which one you pick first, says Dr. Walters.)

Rub vigorously. Regardless of which dandruff shampoo you're using, a little elbow grease can enhance its effectiveness. When you wash your hair, lather once, rinse, lather a second time and really rub your scalp as you shampoo, says Dr. Appa. Your fingers will help dislodge excess cells.

Let it sit and soak. After you lather a second time, let the shampoo sit on your head for at least five minutes, suggests Dr. Bihova. That way, you give the anti-dandruff ingredients time to work.

Rinse well. Now that you've loosened all those little cells, rinse and rinse again, says Dr. Appa. If you don't rinse them all out, they'll end up on your clothes as dandruff.

Shampoo daily. "The more frequently you shampoo, the better," says Dr. Walters. It prevents your scalp from accumulating dead cells that will precipitate a major outbreak.

Rotate your shampoo. "If you've been using one shampoo successfully for several months, and your dandruff suddenly returns, just switch shampoos," says Dr. Walters. No one knows why a perfectly good dandruff shampoo suddenly stops working, but they sometimes do.

Alternate dandruff shampoos with regular ones. Shampoo every other day with a regular nondandruff shampoo suited to your particular natural hair type--dry, oily or normal, says Dr. Walters. This will protect your hair from the harsh chemicals in dandruff shampoos, which, over time, have a tendency to dry your hair.

Condition with tar. If your hair starts to feel dry after you've been using a dandruff shampoo for a while, don't reach for a heavy after-shampoo conditioner. Instead, switch to a tar-based shampoo like T-Gel, suggests Dr. Walters.

"Tar softens and conditions," says Dr. Walters. "So you can use it to get soft, tangle-free hair without having to use the heavier conditioners that can exacerbate dandruff."

Spray on sun protection. Since sunburn can cause dandruff by drying out your scalp, it makes sense to spray a sunscreen--one made especially for hair--on your hair and scalp before you hit the beach or jump in the pool, says Dr. Bihova. A light spray will protect your hair and scalp from both sunburn and the nasty, drying effects of chlorine. Just spray it on, comb it through and go. Reapply according to package directions.