How to treat severe dandruff (seborrheic dermatitis)

Hair Scalp S4 Yellow Dandruff

Ever had a bad hair day?  More specifically, a bad scalp day?  You know the word…DANDRUFF!  Most of us sooner or later will have a case of dandruff, usually mild and responsive to occasional use of over-the-counter shampoos such as Head & Shoulders, Selsun Blue, T/Gel or Scalpicin.  However, some of us will battle a more severe and persistent case, medically known as seborrheic dermatitis (see photo).  This is similar to the cradle cap seen in many infants.  The cause is poorly understood, and men seem to be affected more than women.

For these more severe cases, apply one of the above shampoos on a daily basis until the seborrhea is controlled, then treat 2 to 3 times per week to keep the flaking away.  Gently lather the shampoo into the scalp and let it sit for 5 to 10 minutes, then rinse out.  If this is not effective, your physician can prescribe Nizoral 2% shampoo and/or a topical steroid lotion to massage into the scalp between shampoo applications.  Cradle cap in infants usually resolves on its own by 3 months of age, but can be treated with a mild over-the-counter baby shampoo.  Flaking can be gently removed with the use of a soapy, soft bristled toothbrush.  Nizoral 2% shampoo is also prescribed for infants that do not respond to the standard treatment regimen…Richard R Samuel, MD     Family Practice and Urgent Care   Hayden, ID  USA

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