Flaky scalp is so embarassing

Q. For a few months now, I've been having a problem with dandruff. The itching and flaking scalp causes me severe discomfort and embarrassment. I've tried some anti-dandruff shampoos but they don't work. What should I do?

A. Dandruff is a common scalp condition that involves itchiness and flaking of the skin. A normal healthy scalp sheds skin cells constantly, but in dandruff, the process is accelerated, leading to dead skin clumping into flakes.

Dandruff could be due to the growth of a fungus which causes scalp irritation and leads to increased shedding of skin cells. An oily scalp is predisposed to such fungal growth. Shampooing the hair and scalp daily will help remove excessive oil and prevent dandruff.

If that fails, using an appropriate anti-dandruff shampoo will be useful. Not all anti-dandruff shampoos work for everyone, and you might need to try different types to find one that works best for you. When the dandruff is under control, the treatment has to be continued at least twice a week.

Anti-dandruff shampoos that contain coal tar decrease cell turnover and scalp inflammation. But they have a strong smell and may stain the skin and hair.

Salicylic acid shampoos help to loosen dandruff scales, rendering them easier to remove during shower or bathing.

Shampoos containing zinc pyrithione and selenium sulphide slow down fungal growth and reduce cell turnover.

Anti-fungal shampoos that contain agents like ketoconazole could be effective in some cases.

If one type of anti-dandruff shampoo seems to lose its effectiveness over time, you might need to alternate between a few different types. Do remember to leave the shampoo on for at least five minutes before washing it off.

If the dandruff persists even after a few months of using the shampoo, or you've tried all shampoos without any effect, or you have spots of hair loss or redness of scalp, it is advisable to consult a doctor.

More information can be obtained from your pharmacist.