Q. I’ve suffered from dandruff most of my life (even had cradle cap). I have used a number of products, ranging from the supermarket stuff (Head & Shoulders, and other brands offering anti-dandruff versions), to products you get at your pharmacy or high street drugstore (Selsun, Neutrogena’s coal tar-bsed product, Vichy and many others). I’ve found that the best solution is Selsun though it doesn’t completely solve the problem, only alleviates symptoms, and in addition all these shampoos dry the hair out. I wondered if you could enlighten me on why dandruff occurs (in my case I guess it’s genetic as my father has it too) and if you know and effective (and non-drying) cure for it? Will I ever be able to stop using the foul-smelling stuff and use an ordinary shampoo…?
A. The most common dandruff, which affects 75 per cent of people during their life, is pityriasis capitis, which means ‘scaly head’, consultant dermatologist Dr Tony Chu tells us. It’s caused by a minute yeast-like fungus called pityrosporum ovale (also known as malassezia).  People with dandruff have higher amounts of pityrosporum than usual; they often have a history of childhood eczema.  The flakes seem dry and the scalp is dry and itchy.  It’s rare in children but increases in the teens and twenties.  We do worry that the problem isn’t ceasing:  have you asked your GP for a referral to a dermatologist or trichologist? Or maybe considered consulting a trichologist privately, if funds are available?  (Institute of Trichologists/08706 070602, www.trichologists.org.uk)  If your father has the same, we wonder if the problem might be an intolerance to something such as dairy products.  You could consider giving up dairy products for a month to see if it makes a difference.  It won’t help everyone but trichologist Dr Hugh Rushton has seen patients with an eczematous type of dandruff improve with this dietary shift.

Also, if you work in a very dehydrating environment such as an aeroplane, take care to drink lots of water and use moisturising products on hair and skin.  If you work in an airconditioned office, try putting bowls of water around your desk.  Integrated medicine expert Dr Mosaraf Ali recommends avoiding yeast products, citrus fruits, coffee, alcohol, excess salt and sugar.  He also suggests using a neem-based shampoo and eating plenty of oily fish and/or consider a fish oil supplement such as LifeTime Vitamins Fish Oils.

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