Brief Answer:
Kindly elaborate the concern.

Detailed Answer:
Hello,

Welcome and thanks for posting your query to the forum.

I can understand your concern for the problem dandruff. I completely agree with you as "dandruff" is definitely a very difficult situation to treat completely.

Let you understand few basic medical facts regarding dandruff: Our skin is multi-layered structure. It gets renewed every day. The layer which is present today on the top will not be present tomorrow and would be dead skin in form of scales which are not actually visible on normal skin. So we can say we are just one day old from our skin most superficially.

In some persons it is renewed at a faster pace or because of hygiene and scalp hair this dead skin in form of scales gets entangled and trapped in form of visible of scales known as dandruff. It varies from person to person and also on other of factors which makes the difference inter-individually.

Before I guide you any further I would like to ask you certain relevant question to this condition:

1. Do you feel lots of scales or excessive heaps of scales deposited on your scalp that forms the mounts like appearance or is it simple flaking only.

2. Had you got infection or boils in scalp any time in past. If yes how many times.

3. Do you feel an urge to itch repeatedly on scalp.

4. Do you use any type of hair oil on your scalp.

5. Do you wash your scalp daily (frequency of washing your scalp ).

6. Any skin problem in addition to dandruff such as acne or anything.

7. Your occupation or any continuous outdoor activity.

Hope to hear soon from your side.

Regards,

Dr. Sanjay Kumar Kanodia
MD (Dermatology & STD)

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Brief Answer:
Proper washing regime to reduce flaking.

Detailed Answer:

Hello young man welcome again to the forum.

Thanks for your detailed reply. The various related things which I asked in the previous mail was to measure the severity of the problem. I have gone through the pictures sent and can judge the extent and grade of dandruff.

Now you have to understand the basic fact (which I discussed previously also) that your type of dandruff is part of normal phenomenon skin renewal.

Coming on to your problem which is scientifically and medically known as “pityriasis capitis” is highest in twenties and then recedes by itself in later part of life. It is due to the fact that the renewal of skin and the fatty acid secretion in scalp is highest at this part of life because of hormonal upsurge.
For the remedy part follow the things below:

1.Wash your scalp daily. You will say you are already doing it. But my way of application is- it is to be done twice in a single bath. It means when you are washing your scalp apply first time shampoo for washing the hair part only, then rinse it off immediately with water. Reapply the shampoo again immediately, leave it for around 5 minutes, do a good gentle massage by your fingers for around 2-4 minutes and then wash it off. By doing so for around 7 days you will get good benefit.

2.The other way if you cannot do two time wash is apply your shampoo ( diluted with water) for around half an hour before bath like an hair oil. Apply it in dilution with plane water in equal amount. And then rest of the second application and bath as told above. You can reduce the frequency of twice application after 2 weeks and then can optimize it according to your own need. If you are not getting benefit then can also do it two times in day for few days- yes you read it properly two times per day. It is same like how many times you generally brush your teeth- you say one time, but those who have some problem with teeth do brushing twice also. In the same manner to reduce the flaking - the latest dermatological view is you can gently wash your hair two times.

3.Stick to one good shampoo which is suiting your hair, don’t change the shampoos frequently. If you are using any conditioner also then to be used over the strands of hair only and not over the scalp skin.

4.Do not use any kind of hair oil or any oily or creamy stuff any time on your scalp. People do have a myth that applying hair oil makes hair good- but we dermatologists totally disagree with that. On one side there is no direct or indirect benefit of hair oil, on the other side it actually attract more of dirt and grease over the scalp leading to more proliferation of fungus and thence to more dandruff. People do say that this nourishes your hair- but hair nourishment is never provided by oil but by the best of proteins and mineral with vitamin diet.

5.Comb your hair at least 3-4 times a day and most importantly at night time so that the dust particle and other of dead skin is taken off.

6.Eat a lot of good healthy diet, do mild exercises, reduce your work stress as all these have bit impact on skin so also on scalp skin.

7.Finally if you are not getting relief from all these measures done judiciously and prudently then can apply and take certain keratolytics (medicines reduce and removing excess scaling) under dermatological advice.

Hope I have answered your query. If you have any further questions, I will be happy to help.
Wish you good health.

Regards,

Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)

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Brief Answer:
Shampoo + Diet + proper washing and hair care.

Detailed Answer:
Hello young man welcome again to the forum,

Regarding your further queries:

1.     Will the reddish bulbs on the scalp be also cured through this routine or is there anything else that I need to try
@The reddish bulbs on the scalp are normal appearance of more prominent hair roots. There is no need to try anything for the same. So do not worry it will reduce by itself.

2. Kindly suggest a shampoo that I can try for my dandruff
@ In my patients I suggest “Sebowash shampoo” for more dandruff and then maintain with Xgain or 8X shampoo.

3. Although, I strive for a healthy diet, please let me know if I can take certain vitamin, mineral or protein supplements. Kindly do suggest one
@ For the betterment of diet kindly follow the suggestions below:

a. Eat at least 3-4 different fruits saplings per day. Every fruit is good but you can make a combination of sour with sweet fruits such as oranges, papaya and other of seasonal fruits.

b. Pulses are good source of proteins. So everyday have a small bowel full of mixed pulses. Add green leafy vegetables additionally in the pulses which contain lot of iron and vitamins in it.

c. Sprouts are the best source of fibers, minerals especially iron, vitamins and proteins too. so add it at-least alternate day if you cannot make in every-day's part of meal.

d. Over night soaked and peeled almonds will give you good vitamin E which is good for the hair growth.

e. Milk and milk products should be included in every-day's schedule.

4. You have mentioned Keratolytics in case the above routine does not help. Kindly do suggest a shampoo or any other topical solution
@In my patients I suggest to use Topisal 3% lotion for 15 days at night. It is applied in the roots and not over the hair.

Hope I have answered your query. If you have any further questions, I will be happy to help.

Wish you good health.

Regards,

Dr Sanjay Kumar Kanodia
(MD- Dermatology & STD)

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Brief Answer:
Sh apposite can be used according to details below

Detailed Answer:
Hello young fellow,

Welcome again to the forum.

The part of itching is quite normal in this hot humid weather so you shouldn't be worried about the same. A regular washing schedule makes the thing better I few days of period. In case of more itching an antihistamine tablet such as loratadine is best to alleviate the itch.

In my patients itching generally recommend to use the sebowash for daily in firs two weeks then alternative days and then shift to X gain or any other regular shampoos.

I hope these informations will help you. I will be glad to answer any further queries.

With regards,

Dr Sanjay Kanodia

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