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The Doctors receive an email from a viewer, Jocelyn, who complains of terrible dandruff. She says when she awakes in the morning, it is all over her pillow. All day long her clothes are covered and she’s itchy all the time. “Colleagues at work always ask me when the last time I washed my hair was,” she writes. She wants to know the best way to treat this extreme dandruff.
Watch: How Much Daily Hair Loss Is Normal?
Dermatologist Dr. Sonia Batra explains that dandruff, or the medical term, seborrheic dermatitis, is a condition caused by an overgrowth of normal yeast that’s meant to be on the skin. The overgrowth causes red, scaly, flakey patches and the body then mounts an immune response to it.
The Doctors see a video of Jocelyn's hair, filled with white flakes. Dr. Batra notes that in a severe case, such as this one, a lot of inflammation on the scalp can disrupt the normal immune response and can sometimes lead to a secondary bacterial infection. Dr. Batra recommends that Jocelyn gets a culture swab to make sure it’s only the normal yeast that is supposed to be there.
Jocelyn has tried many ways to combat her dandruff including different oils, Listerine, over-the-counter shampoos, and tea tree oil. Dr. Batra says people often assume using oil will help the dryness and flaking, but actually, the yeast feeds on the oil so it’s just fueling the fire.
Dr. Batra suggests those with dandruff should try over-the-counter shampoos with zinc or selenium in them. However, in Jocelyn’s case, Dr. Batra advises her to try a prescription shampoo. Jocelyn tried one prescription shampoo, Ketoconazole, that she says didn’t work. Dr. Batra advises her to try another one, called Ciclopirox. Also, Dr. Batra noticed that Jocelyn has synthetic hair mixed in with her natural hair, and this could also be contributing to her inflammation.