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Suggest treatment for severe dandruff

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Posted on Wed, 2 Nov 2016
Question: Hi Dr, I am having dandruff for past 5 years due to that many hair loss , like as i attached photo copies for reference in current dandruff ( oily scalp , black color dandruff on scalp and white patches on back side ear) yearly or 8 months once I will do clean shave on head ,after clean shave if I use shampoo first wash itself that black dandruff will gonna and free for nxt few months after that slowly start a oily scalp and lightly increase dandruff and it will increase and so , I have consulted dermatologist and took medical but not at all help to remove complete dandruff or not yet reduced ....for the past one year as per DR advice I m taking follihair tablet daily one , Juene hair oil (enriched with toctotreinal) applied on night, every 15 days once washed by sebhoowash shampoo by cipla .
but not yet see any good results... I wanted to know I m taking right medicine for past one year ? and also pls suggested to me to complete removal for dandruff....I feeling bad about this dandruff.... does any scanning too find out exactly wht happen on my scalp? this is what kind of disease on my scalp? pls help me nd your advice
doctor
Answered by Dr. Dinah Levillard (47 minutes later)
Brief Answer:
Treat dandruff as advised, continue previous treatment.

Detailed Answer:
Hello sir and welcome to HCM
I'm Dr Dinah and I'll be answering your queries today.
I have gone through your images, and also previous complaints. You seem to be suffering from a severe long case of seborrheic dermatitis or dandruff of the scalp. You must also note that oily scalp and dandruff gets easily infected with fungal infections, that is why it is necessary to take the antifungal medication as well.
I have noted your current medication. The capsules and hair oil are mainly to reduce hair fall and help new hair growth. But the cause of your hair fall must be treated first.
For the dandruff, please continue an antidandruff shampoo regularly at least twice a week, such as Arcolane or Nizoral. After bath apply antifungal-steroid cream like Keto-B regularly for around 2 weeks till the rashes heal. The shampoo must be continued atleast once weekly even after healing, to prevent it coming back, as your skin is oily and prone to dandruff. It is your skin type and it may reduce with age. Avoid oiling scalp or applying gels, styling products. Keep hair clean and dry and try to avoid pollution. it may also be affected by weather/climate change etc.
Continue your other medication to help with hair growth.
Other fungal tablets can be considered later if needed.
If your condition is not getting better, and there are very thick areas, leaving white scars, you must visit a dermatologist to check if it is just dandruff or fungal infection, or to rule out other similar diseases on the scalp like psoriasis, other sun sensitive conditions. But do not worry, they will advise you such skin tests after examining, if they feel it is necessary.
Start with this treatment. Be sure to re check with a doctor regarding the improvement in 2 weeks, to advise regarding further treatment and definite diagnosis.
Do get back to me regarding any doubts or clarifications you have. Hope this helps you.

Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Dinah Levillard (35 hours later)
Hi Dr,Thank you for your valuable results,Really happy about your way of explained based on your message I asked all queries to my Dr and i told him due to dandruff i was personally impacted and past one yr treatment was not happy bcz no improvement ,so he investigated me again ...and i showed the dandruff photos which I shared you and I explained about current situation of dandruff and scalp stage, I specifically asked mine is SD or psoriasis , he checked my hands elbow, knee ,knos and any white flakes are there in scalp ..nothing was there, finally Dr confirmed tht disease is SD and function of my body is generating more oily due to that oily scalp and dandruff. Then he said to stop to applying oil and follihair tablet, first need to control the dandruff.. The new medicine has given .1) Kenz 200 mg - 4 tablets  2)Exizollotion to apply on daily night for nxt 2 week 3) sebhoowash shampoo which I used already to continue ths shampoo And next visit after 2 weeks. I would like to know above medicines are right one that similar to your prescribed medicines or can I use your given medicine like arclonae and keto-b ... and due seborrheic dermatitis am really feeling bad because long term which I have...so please give me some diet which one i should take and avoid and right way to cure pls give me your inputs and medicine , suggestion are eagerly waiting on it
doctor
Answered by Dr. Dinah Levillard (7 hours later)
Brief Answer:
Continue the treatment as advised with regular follow up.

Detailed Answer:
Hello Sir
Thanks for getting back to me and thank you for the kind feedback.
I have gone through your treatment advised. You can continue the tablets and application as advised by your doctor. Do review with him after 2 weeks to check the improvement. He may extend the tablet course further. Follow his advice. Once the active disease cures you can easily keep your scalp clear by avoiding oiliness and using the antidandruff treatment at intervals.
In case you get new rashes that are spreading or red and itchy at any time, you can apply the Keto-B cream for 5-7 days till it reduces. Other wise it is not necessary.
There is no particular diet to avoid but eat healthy, lot of fluids and fresh foods. Avoid very oily or fried foods often.
Once this is corrected, you can start the hair fall treatment. Remember the other causes for hair fall too such as stress, pollution, genetic or family history, poor diet, fever illness, low iron or hormonal problems like thyroid. You can ask your doctor about checking for these tests later, in case hair growth does not improve.
Hope this helps you. Do not worry, be patient. It takes time to improve and can be irritating as it sometimes comes back easily.
But regular care will go a long way.
take care. Contact me for any further clarifications.
Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Dinah Levillard

Dermatologist

Practicing since :2010

Answered : 261 Questions

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Suggest treatment for severe dandruff

Brief Answer: Treat dandruff as advised, continue previous treatment. Detailed Answer: Hello sir and welcome to HCM I'm Dr Dinah and I'll be answering your queries today. I have gone through your images, and also previous complaints. You seem to be suffering from a severe long case of seborrheic dermatitis or dandruff of the scalp. You must also note that oily scalp and dandruff gets easily infected with fungal infections, that is why it is necessary to take the antifungal medication as well. I have noted your current medication. The capsules and hair oil are mainly to reduce hair fall and help new hair growth. But the cause of your hair fall must be treated first. For the dandruff, please continue an antidandruff shampoo regularly at least twice a week, such as Arcolane or Nizoral. After bath apply antifungal-steroid cream like Keto-B regularly for around 2 weeks till the rashes heal. The shampoo must be continued atleast once weekly even after healing, to prevent it coming back, as your skin is oily and prone to dandruff. It is your skin type and it may reduce with age. Avoid oiling scalp or applying gels, styling products. Keep hair clean and dry and try to avoid pollution. it may also be affected by weather/climate change etc. Continue your other medication to help with hair growth. Other fungal tablets can be considered later if needed. If your condition is not getting better, and there are very thick areas, leaving white scars, you must visit a dermatologist to check if it is just dandruff or fungal infection, or to rule out other similar diseases on the scalp like psoriasis, other sun sensitive conditions. But do not worry, they will advise you such skin tests after examining, if they feel it is necessary. Start with this treatment. Be sure to re check with a doctor regarding the improvement in 2 weeks, to advise regarding further treatment and definite diagnosis. Do get back to me regarding any doubts or clarifications you have. Hope this helps you.