Severe dandruff

BY GEORGE NAVA TRUE

I have red, itchy, and scaly skin on the scalp and body. This started during the lockdown. I was told not to eat fish, use Lidex cream, and was advised to consult a dermatologist. However, I have no money to see one or buy medicines. Please help me. My skin is so itchy and I can’t sleep. I don’t know how I got this since I take good care of my body. – Jonreal of Nueva Ecija

I’m sorry to hear about your condition. It appears you have seborrheic dermatitis, a chronic form of eczema that appears in parts of the body where there are a lot of oil-producing or sebaceous glands.

Although this skin disease mainly occurs on the scalp, the Mayo Clinic said it can also affect the face, sides of the nose, eyebrows, ears, eyelids, chest, beard, or mustache. Seborrheic dermatitis may also spread above the breastbone, on the back, armpit, under the breast, and genital area.

About three to 10 out of 100 people have seborrheic dermatitis, which is also called dandruff, seborrheic eczema, and seborrheic psoriasis. In infants, the condition is known as cradle cap, but this is usually limited to scaly patches on the scalp.

Common in men

More men than women have the disease which is common in young adults or in people over 50.  While it looks bad, the condition is harmless and not contagious. However, seborrheic dermatitis can be embarrassing, especially to those who have no idea what it is.   

No one knows the exact cause of seborrheic dermatitis, but the Mayo Clinic said it may be due to a yeast or fungus called malassezia that thrives in oily parts of the skin, or it may be caused by an irregular response of the immune system. Those at risk include people with neurologic and psychiatric conditions, like Parkinson’s disease and depression, and a weak immune system (such as organ transplant recipients, HIV/AIDS patients, and people with cancer).

The disease may be triggered by stress, hormonal changes or illness, and strong detergents, soaps, or chemicals. Seborrheic dermatitis also grows worse in cold weather and clears up in the summer.   

Preventing flare-ups

While seborrheic dermatitis may disappear without treatment, it can be stressful to others who are concerned about their appearance and are bothered by itchiness. To prevent flare-ups, use over-the-counter dandruff shampoos and a gentle soap to reduce oiliness and the buildup of dead skin.

The Mayo Clinic recommends the following over-the-counter shampoos: pyrithione zinc (Head & Shoulders), selenium sulfide (Selsun Blue), ketoconazole (Nizoral), tar (Neutrogena T/Gel), or salicylic acid (Neutrogena T/Sal). Use your preferred shampoo daily until symptoms subside and then use it three times a week as needed.

For best results, try alternating between two or more products. Leave the shampoo on for a few minutes before rinsing. These products may also be used on the face, ears, and chest.  

Home remedies

If you have no money to buy these products, follow these simple tips from the Mayo Clinic:

* Wash your skin regularly to remove excess oil. Use a gentle soap and moisturizer.

* Apply mineral or olive oil to the scalp for an hour to soften and remove scales from hair. Use a comb or brush, and wash the scales off.  

* Avoid hair sprays, gels, and other styling products that contain alcohol while the condition is active.

* Wear smooth cotton clothes to reduce irritation.

* Shave off your beard or mustache, or shampoo these areas with ketoconazole daily until symptoms disappear.

* Never scratch itchy areas to avoid infection.

If nothing happens, the doctor may prescribe prescription shampoos, lotions, or creams to control the condition. Corticosteroids are effective and include hydrocortisone, fluocinolone, clobetasol, and desonide that can be applied to the scalp or other affected areas. Follow your doctor’s prescription and use these products sparingly to avoid side effects like thinning skin or streaks or lines on the skin.

While unproven, some alternative treatments may help. These include tea tree oil shampoo, fish oil supplements, and aloe vera. The gel from a cut leaf can be applied to affected areas.

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National Press Club and Philippine Dental Association awardee George N. True II has written two bestsellers based on his popular column which has been running for almost 40 years. For questions about health, email georgenavatrue@yahoo.com./PN

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