Getting rid of stubborn dandruff isn't always easy. A flaking, itchy scalp isn't usually a sign of a serious medical condition, but it certainly can be embarrassing. While drugstore dandruff shampoo may help keep mild dandruff in check, excessive or persistent dandruff may require evaluation and treatment by a doctor.
Identification
Dandruff occurs when too many dead skin cells accumulate on the scalp. The condition usually worsens in the fall and winter and improves in the summer, according to the American Osteopathic College of Dermatology. Dandruff shampoos and medications may control the condition, but cannot cure it. If you have excessive dandruff, you may need to use dandruff preparations or medications on a regular basis to help prevent scaling and flaking of the scalp.
Symptoms
Symptoms of dandruff include white or yellow flakes that adhere to the base of hair follicles. Crusting or scaling may also occur on the surface of the scalp. Dandruff accompanied by red, itchy skin on the scalp is called seborrheic dermatitis. If you have seborrheic dermatitis, you may also notice that your skin flakes around your nose, eyebrows, ears, eyelids, navel, groin, breasts or buttocks.
Causes
Although the cause of dandruff is not always known, some people develop excessive dandruff due to a yeast infection found in the oil produced by the hair follicles in the scalp. Certain diseases, such as the humane immunodeficiency virus (HIV), acquired immune deficiency syndrome (AIDS) and Parkinson's disease may cause seborrheic dermatitis. Recovery from a heart attack or other serious medical condition can also trigger seborrheic dermatitis, according to the American Academy of Dermatology. Dandruff seems to run in some families and can worsen due to stress, anxiety or fatigue.
Treatment
If you have excessive dandruff that is not controlled by over-the-counter shampoos, your doctor may recommend that you begin using a stronger prescription dandruff shampoo. Flaking, itching skin caused by seborrheic dermatitis is treated with a topical corticosteroid or anti-fungal cream to control the inflammation that causes the problem. The prescription medication terbinafine may be prescribed if seborrheic dermatitis affects a large area of your skin. Terbinafine is taken orally. Immunomodulator medications may be used if you have severe seborrheic dermatitis that has not improved following treatment with other medications.
Considerations
Dandruff symptoms can be confused with other skin conditions, such as ringworm, psoriasis and atopic dermatitis, a chronic condition that causes itchy or inflamed skin. Visiting your doctor when dandruff symptoms don't resolve with home care will ensure that you receive proper treatment if you have one of these conditions.
