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White flakes and white dots in hair, using Ketoconazole shampoo. Is this dandruff? Other possibilities?

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Practicing since : 2006
Answered : 520 Questions
Hello Doctor,
I am 26 year old girl and i have this troublesome issue of dandruff. I presume it is dandruff, though i am not very sure. Its mostly white small dots, but at times its white and flaky. It increases when i travel or go out. It increases when skip a day of bath , not washing my hair.
My concern is that whether it is dandruff at all. Because at times it seems like desqamation of white flaky things, at times small white dot like things.

I tried using Ketokonazole shampoo. Things are better for few days, and then it recurs. Same with non medicated shampoos, but better with medicated shampoos

So, do you think this is dandruff at all ? What are the other possibilities ?What other treatments do you suggest?
Thank you
Posted Mon, 21 May 2012 in Skin Hair and Nails
Answered by Dr. Gaurang Krishna 29 minutes later
Thanks for writing in.

I think that your problem is one step ahead of dandruff. It is called seborrhoeic dermatitis.
Your symptoms fit well with this diagnosis.

It is a common problem and easily controllable as well.

Just using ketoconazole shampoos is a bit of undertreatment.

I would suggest you to start using a shampoo containing tar and salicylic acid.
Use it twice a week for a month or so. Your problem will be a lot better.

Then use a shampoo having tar and ketoconazole once a week for maintenance.

I think you will be fine..

Should you have any further questions, feel free to ask!me.
Above answer was peer-reviewed by
Follow-up: White flakes and white dots in hair, using Ketoconazole shampoo. Is this dandruff? Other possibilities? 30 hours later
Hello Doctor,
Thank you for your reply.

Can you please suggest a shampoo name available in India ? (tar and salicylic acid). I will get it after consulting with a doctor here.
Also what kind of precautions shall i take to avoid this ? Any food that i should avoid ? What about using a cap ?

How often shall i was my hair ?

Also can this condition cause hair fall ? I am having hair fall occasionally. Sever XXXXXXX fall once or twice in few months, which automatically stops.

Is there any other modalities of treatment other than the use of above said shampoo ?

Thank you
Answered by Dr. Gaurang Krishna 16 hours later

The brands available in India are Protar, Silkin.

There is precaution as such. Just shampoo your scalp regularly..3-4 times a week, do not use too much hair oil.

This condition may cause hair fall because of the inflammation. But this hair loss is reversible.

There are other modalities, but they are used only if the above treatment fails.

Above answer was peer-reviewed by
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