Dandruff Got You Down? Posted Thu, Mar 13, 2008, 5:12 pm PDT

Do you suffer from seborrheic dermatitis? Would you change your answer if I told you that's the technical term for dandruff? 

While the condition most commonly affects the scalp, it can cause itchy, scaly, or flaky skin on other parts of the body too; affected areas may also appear greasy, as excess oil production tends to accompany seborrheic dermatitis.

Flaking in the eyebrows or redness and flaking at the sides of the nose and behind the ears, for example, could all be manifestations of seborrheic dermatitis.

It affects men more than women, and adults age 30-60 more than any other age. (Even babies, though, can develop a form of seborrheic dermatitis known as "cradle cap" - Mustela's Stelaker and Foam Shampoo for Newborns are gentle products specially designed for little ones.) 

The bad news is that we don't know exactly what causes seborrheic dermatitis, although certain types of fungus clearly play a role. Recently, research has begun to clarify which types of fungus we're dealing with, and I expect that dandruff treatments will become increasingly targeted and effective in the coming months and years.

Seborrheic dermatitis is also known to worsen with stress. The good news is that we do know effective ways to treat seborrheic dermatitis. When it comes to dandruff, there are two classes of treatment products: the first is over-the-counter shampoos that contain ingredients like pyrithione zinc (like Head and Shoulders), selenium sulfide (like Selsun Blue), or ketoconazole (like Nizoral).

Coal tar-based dandruff shampoos are also effective, but keep in mind that they can dry hair and damage hair color. You may also consider the second type of available treatments, prescription-strength steroid foams or liquids that are applied directly to the scalp.

Steroid products you could discuss with your doctor include Olux Foam, Cormax, and Clobex Shampoo. The scalp gets used to treatment products, though, so your best bet for continued dandruff-control is changing brands every two months.

For example, you could use Head and Shoulders for a couple of months, then switch to Selsun Blue for a couple of months (making sure to leave any shampoo on your scalp for five minutes to give it a chance to work).

If your dandruff is particularly stubborn, you might then add a steroid-based product to the mix for another couple of months. Then, just start the cycle over again. When it comes to seborrheic dermatitis on parts of the body other than the scalp, steroid lotions are generally the most effective treatment; oral medications may also be effective for more extensive cases.

Talk to your dermatologist about your prescription options. For mild cases, you can also try over-the-counter anti-fungal creams on the affected areas. Don't use steroids on the face for more than a week, though - they can thin skin and lead to stretch marks or wrinkles. It's best to alternate steroid products with non-steroid creams like the prescription product Elidel.

Wishing you great skin!