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Healthy Scalp, Healthy Skin

By Brandice Brazell. MMS, PA-C

Maintaining healthy skin year-round is essential to one’s overall health. Have you ever noticed white flakes on your shoulders or shirt collar? Have you dealt with “dandruff” for most of your adult life? Is your over-the-counter shampoo no longer keeping the flakes at bay?

This condition is clinically known as Seborrheic Dermatitis and occurs within two percent to five percent of the population. Adults tend to experience seasonal remissions and flare-ups, and breakouts are precipitated by stress, fatigue, and climate changes. It is a chronic, superficial, inflammatory disease and may be related to the presence of the oil-loving yeast Pityrosporum ovale. It is commonly found on the scalp, ears, eyebrows, lips, chest, and folds of the cheeks. The scaling often has a greasy appearance and may be very itchy. Scratching, of course, only aggravates the condition as it compromises the skin barrier and leaves the skin open to potential bacterial infections. The symptoms of dandruff can also resemble symptoms of other conditions that require alternative treatments.


Topical corticosteroids may be initially used to reduce the inflammation and redness associated with this condition but may permit yeast overgrowth when used for long periods of time. Thus, antifungal medications are the mainstay of treatments. They are offered in a variety of forms such as creams, gels and shampoos to best suit the needs of the patient. Anti-dandruff shampoos and soaps containing zinc pyrithione (ZNP) or selenium sulfide (Selsun) can be equally effective, especially for maintenance after flares. This condition can be chronic, so once you stop using the medications, the symptoms may return. You may need to continue your treatments occasionally, such as once a week, to prevent the condition from flaring. Resolution is not immediate, but with consistent treatment you can once again feel confident about your skin, scalp, and hair!


Topics and Subtopics: Skin Health

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