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asking for a friend: what can i do about dandruff?

over-the-counter shampoos and diet can help tackle those embarrassing white flakes.

asking for a friend: what can i do about dandruff?
dandruff, which is basically flakes of skin, is usually harmless and affects about one in five canadians. getty
dear asking for a friend,
i have had dandruff or mild psoriasis on my head most of my life. i have tried everything from tar shampoos to specific dandruff shampoos and which seem to work for a while and then they stop. my daily routine includes having a shower, wetting my hair and then using a lice comb to comb out the dead skin. is that the best i can do? i am also wondering if tar shampoos are safe, if there is one shampoo that’s better over another, and how often should i be washing?
signed, tired of the flakes
 
dear tired of the flakes,
those dry flakes accumulating in your hair and falling onto your shoulders can be more than annoying. not only is there the embarrassment of brushing them out of your hair and off your shoulders, but there’s the constant itch that often comes along with the flakes.

dandruff, which is basically flakes of skin, is usually harmless and affects about one in five canadians . and one of the biggest challenges of treating it is figuring out the triggers, says dermatologist dr. andrei metelitsa, co-director of beacon dermatology in calgary and a clinical associate professor at the university of calgary.

“most people hope that if they eliminate something from their diet, or if they use some kind of simple treatment, then it goes away,” he says, adding that there isn’t always a trigger. “but unfortunately, as it is with many chronic conditions, the best that we can do is to mitigate the symptoms and lessen how visible it is.”

why do i have dry flakes in my hair?

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dandruff can be the result of a dry scalp that’s caused by dry air — this is why you may see more flakes during dry winter conditions when you’re spending more time indoors. there are also people who are seriously flaky all year round, which can be attributed to an oily scalp that becomes oilier with sweat in the summer heat and humidity, or when your head heats up with a winter toque and moisture is trapped.

dandruff can be a sign of fungus

there’s a yeast called malassezia , a type of fungus that naturally lives on your scalp and feeds on the oil on your skin. if you have an overgrowth of yeast because of excessive oils produced by your scalp, it can also cause the inflammatory response of dandruff flaking and itching.

scalp psoriasis is not the same as dandruff

take note that while scalp psoriasis may look like dandruff, it’s a different condition altogether. psoriasis is an autoimmune disease where thicker, scaly patches of skin can itch and flake on your scalp and other areas like elbows and knees. when it’s on your scalp especially, it can ooze and bleed when you scratch at it.
“usually psoriasis is a thicker, scaly condition where you can actually see the outline or the borders of the lesions,” metelista says.

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treatment options for psoriasis include topical creams and ointments, light therapy and medications, so see your doctor.
metelista’s typical approach to address more common dandruff complaints is to start with a targeted shampoo — skip the lice comb, though, because while it can remove some of the dead skin cells, it doesn’t address the root cause.

pyrithione zinc, derived from zinc, is a common active ingredient in anti-dandruff shampoos to inhibit the growth of yeast, and it’s found in one of metelista’s preferred brands, head & shoulders . another of his favourites is dercos by vichy that contains selenium sulfide, known to slow skin cell growth on the scalp. and while coal tar shampoos have been widely used to tame flakes, they can be more irritating to the skin, especially with sun exposure, he says.

“if [patients] don’t wear hats and spend a lot of time outside, they can notice sensitivity,” says metelista. “we always tell them to avoid, direct sun exposure within 24 hours post tar shampoo application.”
for ongoing dandruff, he recommends alternating several of the branded shampoos that are specifically designed for dandruff control every few weeks. frequency of washing is a personal preference, he says, so see how your hair responds to treatment shampoos.

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other helpful hints to combat the annoying flakes are reducing stress, which can prompt a flareup, avoiding excessive heat styling for your hair that can make it more brittle and irritate your scalp, and getting more of certain minerals and vitamins, such as biotin and zinc, either as supplements or in foods. you’ll find biotin in eggs, yogurt, tomatoes and carrots, while sources of zinc include crab, oyster and pumpkin seeds.
“peanuts and dark chocolate are also high in both nutrients,” says metelista. and i think most of us would be okay with a little bit of extra chocolate.”
 
is there something about health that you (or a friend, wink, wink) have always wondered about but are too embarrassed to ask? send a note to info@healthing.ca. we promise your ‘friend’s’ secret — and identity — is safe with us!
karen hawthorne is a toronto-based writer.

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karen hawthorne
karen hawthorne

karen hawthorne worked for six years as a digital editor for the national post, contributing articles on health, business, culture and travel for affiliated newspapers across canada. she now writes from her home office in toronto as a freelancer, and takes breaks to bounce with her son on the backyard trampoline and walk bingo, her bull terrier.

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