Dear Doctor, In spite of the fact that I shower every morning, I always find dandruff in my hair when I go for a haircut. What could be the cause of this and what can I do about it? Opobo Dear Opobo, Dandruff is a condition of itching along with flaking of scalp. It is a fairly common condition world over. Though benign, it becomes a source of embarrassment for affected person due to powdery flakes falling from scalp over shoulders. Scratching the itchy scalp can lead to secondary bacterial infection causing multiple boils. A dry scalp is said to be one of the reasons for dandruff. Not shampooing enough, poor hygiene, not combing enough or regularly can also lead to dandruff. Use of shampoos with harsh chemicals can also lead to dryness of scalp and dandruff. Medical conditions like hypothyroidism can also make the scalp dry. Seborrhoiec dermatitis is a condition of dryness and flaking of skin which commonly occurs over eyebrows, back of ears and also scalp, precipitating and aggravating dandruff. It can be due to fungal infection of the scalp. Allergy to some bodycare products, medical disorders like eczema and psoriasis are also causes of dandruff. Mental stress is also implicated in causing and aggravating dandruff. Treatment consists of improving hygiene of scalp. Avoid shampoos with harsh chemicals. Drinking adequate amount of water helps prevent dryness. Air conditioners tend to cause dryness and if one has to use air conditioners they should be the ones with humidifiers. Regular oil massage of the scalp with natural oils like coconut oil or olive oil is beneficial. Diet containing enough of B complex like whole grain and nuts also helps to prevent dryness. Antidandruff shampoos containing substances like selenium sulphide help in clearing the fungus. But one should leave it on the scalp for about 5 minutes before washing it off. The contact time helps in making it effective. This shampoo can be used once or twice every week or as per advice of a dermatologist. However, if any problem recurs or persists after using the shampoo like itching over scalp, one should consult a doctor. If dandruff persists after adopting the above measures, it is advisable to get investigated for any underlying cause and take proper treatment. Last but not the least, it is important to remain stress free. Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital
