Dandruff is not a new problem. According to the "aquatic ape" theory, our
excessive scalp skin shedding is a result of our previous adaptation to lots of water (they also think it explains earwax).
In a 1900 book, Raymond Sabouraud devotes 280 pages to a history of dandruff. It seems that for the longest time physicians
could not agree on the cause or nature of dandruff, and just recently the fungus involved (which is also present in lesser
amounts on healthy scalps) has been reclassified as a yeast. Malassezia furfur is an anthropophilic fungus that belongs to
the physiological skin flora (normal skin). The fungus can grow in a yeast phase as well as in a mycelial phase, so it is
both yeast and fungus. Family studies have shown an autosomal dominant transmission of susceptibility to certain kinds of
dandruff.
The skin cells shed during dandruff are inflammatory in nature, with a
higher proportion of immune cells present. Dandruff was associated with a dramatic decrease in free lipid levels, with significant
decreases in ceramides, fatty acids, and cholesterol. The quality and resilience of the epidermal skin water barrier is impaired
in the scalp of dandruff sufferers. The perturbed barrier leaves dandruff sufferers more prone to the adverse effects of microbial
and fungal toxins, and environmental pollutants, thus perpetuating their impaired barrier. While not tested, the anti-inflammatory
nature of fish oil and its provision of essential fatty acids should be beneficial.
Alternative Therapies:
Orally administered low-dose, homeopathic mineral therapy (Potassium bromide
1X, Sodium bromide 2X, Nickel sulfate 3X, Sodium chloride 6X) improved the dandruff and scaling of the active patients significantly
over that of the placebo patients after 10 weeks of treatment. At those concentrations, the homeopathic remedies may simply
be supplying necessary trace minerals.
Sulfur and salicylic acid (aspirin) in combination have also proven to
be effective as a topical treatment for dandruff. Orally, sulfur 30X homeopathically may be effective.
Tree tree oil has an established antifungal effect, and is especially effective
against Malassezia furfur strands that make up much of common dandruff. In a double-blind study the 5% tea tree oil shampoo
group showed a 41% improvement compared with 11% improvement in the placebo group
Advanced cases of dandruff and scaling have been treated effectively with
solutions of watered honey. (Honey is also effective in the treatment of athlete's foot). If the honey is left to dry for
three hours and then washed off (initially daily), itching was relieved and scaling was disappeared within one week. Skin
lesions were healed and disappeared completely within 2 weeks. In addition, patients showed subjective improvement in hair
loss. None of the patients ( 15 patients) treated with honey application once weekly for six months showed relapse while the
12/15 patients who had no prophylactic treatment with honey experienced a relapse of the lesions 2-4 months after stopping
treatment.
Conventional Therapies:
Since propylene glycol has antifungal properties, it in a water/alcohol
mix was also effective against dandruff. Non-tar shampoo (2% salicylic acid, 0.75% piroctone olamine and 0.5% elubiol) was
more effective than 0.5% coal tar shampoo.
The most effective conventional prescription treatment is 2% Ketoconazole
(an antifungal), which was superior to and had less side effects than (Selsun Blue) selenium sulfide 2.5% shampoo. Among the
over the counter brands, the 2% Nizoral (Janssen) shampoo was 10X better than the Nizoral 1% product and 100 times better
than any of the other products tested (All products tested: (a) Head & Shoulders (Proctor & Gamble); (b) Gard Violet
(Colgate-Palmolive); (c) Nizoral 1% (Janssen); (d) Nizoral 2% (Janssen); (e) Pantene Blue (Proctor & Gamble); and (f)
Selsun Blue (Abbott)).
Whatever is used on the scalp must be absorbed to some extent, because
using a dandruff shampoo affected the trace mineral content of hair.
