|
 |
|
|
|
You don't need to flake
If you think twice before putting on dark clothing, or you find yourself brushing off your shoulders before walking into a meeting, you're not alone. Dandruff sprinkles itself over the shoulders of about a fifth of the adult population. It's not harmful, certainly. But it can be embarrassing.
It's normal for your scalp to shed its outermost skin cells on a regular basis. When you have dandruff, it means your cells are flaking faster than usual, in larger, more visible clumps.
Altogether different from dandruff, seborrhea also occurs on the scalp, but it is easily distinguished by greasy, yellowish scales that also appear on the forehead, as well as around the eyes and ears. It affects about 12 million Americans.
Both conditions tend to diminish with nonprescription treatment. So arm yourself with the proper products and tell dandruff and seborrhea to flake off.
|
|
|
|
|
Wash Those Flakes Right Out of Your Hair
- Dandruff affects the scalp, with small white or grayish flakes distributed evenly over your scalp at the base of hair shafts.
- Shampooing too often can dry out your skin, making matters worse. First, try washing the hair and scalp with a nonmedicated shampoo every other day.
- If you have no success, use a dandruff shampoo every day to see if that helps. Then level off at two times a week.
- A medicated shampoo can help. The secret to success: wet your hair, lather up with a generous helping of shampoo, then leave it sitting on your scalp the length of time the package advises. Rinse and repeat. Just sing a longer song; your patience should pay off.
- Try a different dandruff-control shampoo if the one you currently use is not working. Check the active ingredients and if, for example, you're using a selenium-based product now, switch to a salicylic acid or sulfur brand in about six weeks.
A Few Words About Seborrhea
- Seborrhea is characterized by patches of yellow, scaly, oily lesions on the head and sometimes even shoulders.
- Emotional and physical stress can aggravate the condition. Take care of your whole self, not just your seborrhea symptoms.
- Other possible factors contributing to seborrhea include vitamin B-complex deficiency, food allergies, climate changes, and low humidity.
- In addition to a medicated dandruff shampoo, try a topical hydrocortisone cream. Part your hair and rub it well into the scalp to relieve red, itchy inflammation. If the ear canal or eyelashes are affected -- see a doctor.
|
|
|
|
|
Cytostatic agents
Cytostatic agents affect the rate at which the cells on your scalp divide. They slow down scalp turnover so there are fewer cells flaking off your head. This translates into less dandruff. These agents are the first line of attack against dandruff.
Coal tar
It is not known exactly how coal tar agents work to suppress dandruff. The theory is that coal tar acts as a cytostatic agent so that the cells on your scalp divide less. This helps to control dandruff.
Keratolytic agents
Keratolytic agents loosen dandruff flakes and break them down. Since the flakes turn into smaller pieces, this allows them to be shed more easily during shampooing. Keratolytics should be used after cytostatic agents have been tried.
Ketoconazole
Ketoconazole is an antifungal agent. Many cases of dandruff are associated with the overgrowth of a tiny fungus called Pityrosporum ovule, or P. ovale for short. Ketoconazole has been medically proven to be effective against P. ovale. It kills susceptible fungi by making their cell walls leaky.
Hydrocortisone
Hydrocortisone is a topical corticosteroid useful for reducing inflammation and should only be used for seborrhea, not dandruff. Hydrocortisone should only be tried after using medicated shampoos without relief. It works by reducing your body's inflammatory response. It should not be used on broken skin or for extended periods of time since it can thin the skin and slow wound healing. Also, prolonged use can lead to tolerance and reduced effectiveness of hydrocortisone.
| Cytostatic Agents | Ingredient | Description |
|---|
| Pyrithione zinc | ? | May be slower acting than selenium sulfide, but has few side effects. | | Selenium sulfide | ? | Works well, but may cause irritation, leave your scalp oily, and have a distinct odor. | | Coal Tar | Ingredient | Description |
|---|
| Coal tar | ? | The mechanism of action is not known, but it has beneficial capabilities in dispersing scales and reducing the size and number of epithelial cells produced. Coal tar agents may have a drying effect on the skin, so emollients may be necessary. Also, it smells unpleasant and may discolor light hair and clothing. | | Keratolytic Agents | Ingredient | Description |
|---|
| Salicylic acid | ? | Facilitates the loosening of skin and its removal. Application over extensive areas should be avoided because of the potential for absorption through the skin and systemic toxicity. | | Sulfur | ? | Often combined with salicylic acid, it is believed to function by an inflammatory process, causing increased sloughing of cells. It should not be used for seborrheic dermatitis. | | Ketoconazole | Ingredient | Description |
|---|
| Ketoconazole | ? | The only over-the-counter antifungal agent effective against a fungus called Pityrosporum ovule, or P. ovale for short. The overgrowth of P. ovale is thought to be associated with many cases of dandruff. | | Hydrocortisone | Ingredient | Description |
|---|
| Hydrocortisone | ? | Topical version is useful in the temporary relief of itching due to body and scalp dermatoses. It has not been indicated for or proven useful in the treatment of dandruff. There is sometimes a rebound when treatment is discontinued. |
|
|
|
|
|
FDA-Approved Uses
Dandruff and seborrheic scalp products
Controls recurrence of skin and/or scalp itching, irritation, redness, flaking, and scaling associated with dandruff; seborrheic dermatitis; and psoriasis.
It's Nothing a Good Shampooing Can't Help- You may be able to treat the symptoms of dandruff, but there is no direct cure.
- Wash hair and scalp with a nonmedicated dandruff shampoo every other day or daily.
- If problem persists, medicated nonprescription antidandruff products may be used twice weekly.
- Wash hair with a nonresidue shampoo (like baby shampoo), which does not leave buildup on hair, before using medicated products.
- When using medicated shampoo, leave it on your hair for one minute before rinsing. This is necessary for effectiveness.
- Make sure all shampoo products are rinsed off thoroughly.
- Your first choice for medicated shampoos should be ones containing cytostatic agents: pyrithione zinc, selenium sulfide, or coal tar.
- If the cytostatic agents do not help, try a keratolytic shampoo containing sulfur or salicylic acid.
- If keratolytic shampoos do not improve your symptoms, consult a physician.
Seborrhea Responds to Topical Treatment- Seborrhea usually responds well to shampoos containing pyrithione zinc, selenium sulfide, salicylic acid, or coal tar.
- To apply, hair should be parted and shampoo should be directly massaged into the scalp until all of affected area is treated.
- Make sure all shampoo products are rinsed off thoroughly.
- Unlike dandruff treatment, seborrhea treatment may involve using a topical corticosteroid medication as well.
- Apply the medication to the scalp after shampooing to improve absorption.
- Apply the hydrocortisone two to three times a day until symptoms subside and then use only occasionally as necessary to treat flare-ups.
|
|
|
|
|
Warnings
Coal tar
Consult a physician before use or do not use if you have:- Allergy to coal tar
- A pre-existing skin infection
- Open wounds or sores on the scalp
- Seborrhea scale that has extended beyond the scalp
Or if you:- Are concerned about increased risk of cancer
- Are under two years of age
- Develop rash or other skin irritation after use
- Plan to have extended exposure to sunlight, coal tar may increase the likelihood sunburn
- Plan to use near your eyes
Or if you are taking:- Other topical medications or treatments for dandruff or seborrhea
Cytostatic agents
Consult a physician before use or do not use if you have:- Allergy to selenium sulfide or pyrithine zinc
Or if you:- Develop rash or other skin irritation after use
- Plan to use near your eyes
Or if you are taking:- Other topical medications for dandruff or seborrhea
Hydrocortisone
Consult a physician before use or do not use if you have:- Allergy to hydrocortisone products
- Open wounds or sores
- Skin infection
Or if you:- Develop rash or other skin irritation after use
- Plan to apply near eyes and mucous membranes
- Plan to apply to wounds, lesions, broken, damaged, or sensitive skin
- Plan to use for more than three days
Keratolytic agents
Consult a physician before use or do not use if you have:- Allergy to salicylic acid, aspirin, or sulfur
- Diabetes
- Poor blood circulation
- Skin conditions such as psoriasis or eczema
Or if you:- Are administering to a child or infant
- Develop excessive skin irritation
- Plan to use near eyes and mucous membranes
Or if you are taking:- Other topical acne agents may add to or increase salicylic acid side effects
Ketoconazole
Consult a physician before use or do not use if you have:- Allergy to ketoconazole or other azoles
- On scalp that is broken or inflamed
Or if you:- Are administering to a child less than 12 years of age
- Develop skin irritation or rash after use
- Condition worsens or does not improve in 2 to 4 weeks
- Plan to use near eyes and mucous membranes
Or if you are taking:- Other topical medications for dandruff or seborrhea
Common Side Effects
Cytostatic agentsCoal tar- Scalp dryness
- Staining of the skin and hair
- Noticeable odor
- Scalp irritation
Keratolytic agents- Scalp burning or stinging
- Scalp redness or peeling
- Sulfur preparations may stain hair
KetoconazoleHydrocortisoneInfrequent to Rare Side Effects
Cytostatic agents
- Allergic skin rash
- Scalp irritation
Coal tar- Allergic skin rash
- Sun sensitivity
Keratolytic agents- Allergic skin rash
- Worsening of the condition with prolonged use
- Long-term use may cause skin peeling and weakening
- Prolonged use of sulfur products may cause the skin to become thick and red
Ketoconazole
- Allergic skin rash
- Scalp irritation
Hydrocortisone- Allergic skin rash
- Skin irritation
Effects of Overdose
Cytostatic agentsCoal tarKeratolytic agentsKetoconazoleHydrocortisoneWhat to Do in Case of Overdose
- For external use only. If swallowed, immediately seek medical attention.
|
|
|
|
|
Websites, Organizations & Manufacturers
Sources & Further Reading
Government Sources
- 1. Food & Drug Administration. Federal Register 12/4/91.
- 2. Food & Drug Administration. Federal Register 1/28/94.
Books
- 1. Covington, TR et al. Handbook of Nonprescription Drugs, Eleventh Ed. American Pharmaceutical Assoc. Washington, DC 1996.
- 2. Kastrup EK et al. Drug Facts and Comparisons. Facts and Comparisons.
- 3. Inlander, CB and Slamans, S. The Over-the-Counter Doctor. Cader Books. New York, NY 1997.
Find more books on health and wellness at  barnesandnoble.com.
| |
|
