Q. I am 20 and have suffered with quite a bit of dandruff over some time. I need help ASAP please.

A. The first thing we asked is whether the writer was sure it was dandruff rather than a dry scalp. As consultant trichologist Anabel Kingsley explains the two are often confused because they look similar.

‘Dandruff is a recurring, chronic scalp condition that tends to be a long-term issue although it may come and go, as this reader suggests,’ Anabel says. ‘It commonly flares up when you are stressed, when hormone levels fluctuate, and when you eat certain foods such as full fat dairy products, like cheese. A dry scalp, however, is often a one-off occurrence, or something that occurs due to an easily identifiable trigger. For instance, being exposed to the sun, very cold weather, or central heating.’

There are differences, Anabel explains. ‘Dandruff is almost always oily, and not dry. Dandruff flakes can also be slightly sticky and yellow in colour, whereas a dry scalp will produce dry, white flakes. Depending on the cause of a dry scalp, the flakes may be super fine (usually due to central heating), or quite large with hair sized holes in them (usually caused by sun exposure).’

So what’s going on? Skin cells on our scalp (just like the rest of our body) are constantly being replaced and shed. This is part of normal cell turnover and usually isn’t noticeable. ‘However, it can become noticeable if skin cells begin to divide too rapidly – and this is what occurs with dandruff,’ says Anabel.

‘In the case of dandruff, skin cells on the scalp are replaced much faster than they can be shed, leading to a buildup of the telltale flakes and itching. The trigger is an overgrowth of a certain yeast naturally found on the scalp, called malassezia furfur,’ she explains.

‘Natural skin secretions, such as sweat and sebum, usually protect the scalp and keep these levels in check,’ adds Anabel. ‘However, metabolic shifts, such as hormonal changes and stress, can disrupt skin secretions allowing malassezia furfur to thrive.’

Sometimes, however, people think they have dandruff when they just aren’t washing their hair often enough so skin cells build up on the scalp and are visible to the naked eye. (That’s a bit of a man thing, in our experience, and fortunately very rare nowadays.)

Frequent shampooing, preferably daily, helps to keep the scalp clean and healthy, and to remove dead skin cells.

Anabel, who is now Brand President of Philip Kingsley, the eponymous company founded by her late father, says the best solution is consistent daily treatment. ‘At our clinics in London and New York, we find that daily use of a soothing, antimicrobial shampoo with a targeted post-shampoo scalp toner is the most effective and fastest way to clear dandruff.’ (See below for Philip Kingsley products.)

She recommends this regime daily until the flaking and itching subside, then reducing it to alternate days for ten days. Applying an exfoliating scalp mask once or twice a week helps to lift away flakes and normalise the rate of skin cell turnover. Be patient and consistent - it may take a bit of time to clear completely.

Don't forget that dandruff can be triggered by stress so Anabel recommends weekly sessions of yoga, Pilates, and/or meditation. Moderate exercise and any activity you find relaxing can also help. (See Maria Cristofi’s tips for natural healing here.)

A final point: certain foods and drinks may exacerbate flaking and itching. The most common, according to Anabel Kingsley, are full fat dairy products, white wine and champagne but they’re not the same for everyone so you may need to turn detective and work out your trigger foods by a process of elimination.

PRODUCT RECOMMENDATIONS

For dandruff…

• Philip Kingsley Flaky/Itchy Scalp Anti-Dandruff Shampoo/£12 for 75ml

• Philip Kingsley Flaky/Itchy Scalp Anti-Dandruff Toner/£10 for 75ml

• Philip Kingsley Flaky/Itchy Scalp Anti-Dandruff Mask/£19 for 20ml

• Philip Kingsley Flaky/Itchy Regime Kit/£30

For dry scalp…

Botanical Therapeutic Shampoo and Shower Gel/£25 for 500ml from victoriahealth.com – this extra mild, natural formulation contains natural antibacterial and anti-fungal properties. It may also help with dandruff, according to pharmacist Shabir Daya.

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