Q. I am a 19-year-old girl who has had a dandruff problem for years. It started with white flakes.
But now, I sometimes find blood stains under my fingernails when I scratch my scalp. Other times, I get brown flakes which are made up of dried skin stained with dried blood.
I went to a hair-care centre where I had a scalp scan. Results showed that my scalp was dry and inflamed, and I have dandruff. The therapist said some parts of my scalp are raw, without a layer of skin to protect it, and suggested herbal treatment to prevent hair loss.
Are there other ways of curing dandruff? Do I need to visit a dermatologist?
A. Dandruff is a common condition that is characterised by excessive shedding of dead skin cells from the scalp.
It is associated with itching which can be severe. There may be redness of the scalp due to inflammation.
Excessive and frequent scratching of inflamed skin can damage the scalp and lead to wounds which may bleed, like what you have described.
Thankfully, the condition does not affect one's general health, is not contagious and does not lead to permanent hair loss.
When a person does not wash his hair regularly, oil and skin cells from the scalp build up, resulting in dandruff.
Dandruff can also occur when a form of fungus that commonly lives on most people's scalps grows out of control and irritates the skin.
Though this condition may be chronic in many people, it can be treated and kept under control.
Try initial treatment by regularly using over-the-counter medicated shampoo, such as Selsun (containing selenium sulfide) or Nizoral (containing ketoconazole).
The active ingredients in such shampoo kill fungus and control production of the oil that the fungus feeds on.
Other measures to improve the condition of your scalp would be to lead a healthy lifestyle and to reduce stress, which is a known trigger for dandruff occurrence.
If these measures do not help, I would recommend that you consult a dermatologist for thorough evaluation and treatment.
In some cases, the underlying cause of dandruff may be a kind of eczema known as seborrhoeic dermatitis, a greasy skin condition which is a manifestation of underlying skin sensitivity, or a chronic inflammatory skin disorder known as psoriasis.
Your dermatologist will be able to ascertain if you are suffering from these skin conditions.
Prescription topical medication containing cortisone may be required to reduce inflammation and itchiness.
DR CHRIS FOO
Consultant dermatologist at Raffles Skin & Aesthetics Centre at Raffles Hospital
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