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DANDRUFF - SEBORRHOEIC DERMATITIS - CRADLE CAP

What is Dandruff ?

Seborrhoeic dermatitis is a chronic inflammation. It commonly affects the scalp, the eyebrows, the beard area, and the skin behind the ears and around the nose. More rarely, it can involve the centre of the chest and back, armpits and groins. In infants it causes cradle cap and may be a cause of severe nappy rash. In infants it can affect the whole body, which becomes red, scaly and itchy. Mild seborrhoeic dermatitis causes a fine scaling of the scalp, known as dandruff. With more severe forms, the scalp becomes covered in greasy thick scales and tender small pustules develop over the scalp. Around the nose and behind the ears, skin becomes red and scaly. If it occurs within the ears, they can become itchy, and a lot of dead skin accumulates in them.

How does Dandruff occur ?

Current evidence suggests that seborrhoeic dermatitis is due to over-sensitivity of the skin to a fungus called Pityrosporum ovale . This fungus needs oil to be able to grow. It is therefore found on the skin of infants (where the oil- producing glands are stimulated by their mothers' hormones). It is then present after puberty when the oil-producing glands are triggered by sex hormones. In those who develop seborrhoeic dermatitis, the skin reacts strongly to the fungus, causing the redness and greasy scaling.

Why does Dandruff occur ?

The underlying cause of seborrhoeic dermatitis is unknown. There does not seem to be any familial or inherited tendency.

Treatment Involved for Dandruff

Seborrhoeic dermatitis can be treated with shampoos, creams and tablets, depending on the site and severity of the condition. A variety of shampoos will help to control the scalp symptoms of itching and scaling. In very mild disease, over-the-counter antifungal shampoo may help. In most cases tar-based shampoos and those containing the drug selenium sulphide are used. These are available at your chemist and some can be obtained on prescription. You can also use the newer antifungal shampoos containing drugs like ketoconazole. These are available on prescription or over the counter. An ointment containing a drug called lithium succinate may be given to you. It is very effective in treating seborrhoeic dermatitis on the face, back and chest. It tends to be too greasy to use on the scalp but you can use it behind the ears and on the hair margins. Symptoms of the disease will also be reduced by the use of steroid (cortisone-like) creams or scalp lotions which may be combined with salicylic acid or an antifungal agent. Creams based on hydrocortisone are quite safe to use and may be used for long periods of time, even on the face. On the scalp, stronger steroids are needed. In severe seborrhoeic dermatitis affecting the body or the scalp, a short course of antifungal tablets such as ketaconazole may help to reduce the level of the fungus present.

During Treatment for Dandruff

Seborrhoeic dermatitis is a chronic condition and treatment may be necessary for long periods of time. It is important that you persist with treatment until all signs of the condition have gone.

After Treatment for Dandruff

Seborrhoeic dermatitis invariably recurs even after successful treatment. It is not possible to predict how long it will take to come back.

If Dandruff is Left Untreated

Seborrhoeic dermatitis is a chronic condition. Even without treatment, there will be fluctuations in the intensity of the skin problem. Without active treatment, the condition is more likely to persist, with periods in which it is much worse.