DANDRUFF is a common name for a medical condition called seborrhea. Seborrhea is a lifelong condition in which there is episodic irritation and inflammation of the skin.  The most common area of involvement is the scalp. However, the face, chest or genital areas may also be affected.

The cause of seborrhea is unknown.  There is some evidence that favors benign fungal involvement by an organism called Pityrosporum ovale.  Bacteria and other fungal organisms have also been considered as possible causes.  Some scientists take a different approach and feel that seborrhea is a result of overactive skin cells and oil glands.  Personal hygiene, perspiration and emotional stress can trigger or aggravate this condition.  Males are affected with greater frequency than females. There also seems to be a seasonal relationship with symptoms being worse during the winter months.

Recommendations:

Although dandruff can be bothersome, it can often be controlled with over-the-counter shampoos or topical medications.  Shampoos can be used in conjunction with topical steroids, tar preparations and anti-fungal agents.  The most common shampoos are selenium sulfide and zinc pyrithione. Often tar shampoos work when other preparations do not.  Salicylic acid and sulfur shampoos are less commonly used. The affected areas must be shampooed four to five times per week, rubbing the shampoo into the scalp for at least five minutes. These shampoos may be used on all affected areas of the body such as the face, chest or genital areas. 

For the face, chest and genital areas, over-the-counter anti-inflammatory lotions or hydrocortisone creams are readily available and effective.  These preparations must be used twice daily until the problem is under control. Care must be taken to prevent any cortisone from entering the eyes. If the above is ineffective, a physician may recommend prescription strength medications including shampoos, cortisone creams or anti-fungal agents.