I’m having a lot of dandruff. I’m using Head and Shoulders, and it’s only getting worse. What’s wrong with me? Can you tell me how to get rid of it? It’s really embarrassing. (Male, 50)

Dandruff can be a very discomforting skin disorder that affects people of all ages. Having dandruff can cause a loss of self-esteem and lead to lack of confidence. Often individuals with dandruff will not wear dark garments because they worry that others may detect the flakes of dandruff. Dandruff in essence is a problem of dry scalp. Today, there are treatments that can help control the dandruff problem. However, not all individuals respond to the same treatment. It is important not to get disheartened if one shampoo does not work. It is necessary to give sufficient time to the shampoo before trying another product. 

For excessive dandruff, it is important to shampoo at least 2-3 times a week. This involves meticulously massaging the scalp so that all dead skin cells are removed. Since most dandruff shampoos are very harsh it is essential to follow directions. However, in some cases regular shampooing may not prevent irritation or itching of the scalp. Since many dandruff shampoos further dry the scalp it is important to use a conditioner after rinsing the dandruff shampoo. 

If head & shoulders has not worked, one may want to try a shampoo that contains selenium sulfide, such as Selsun Blue or Exsel. If this still does not reduce the dandruff in 3-4 weeks, then one may try shampoos containing salicylic acid (e.g. Sebex). If this fails, the next step is to use Nizoral AD, which is an anti fungal shampoo available over the counter. Some experts do recommend coal tar dandruff shampoos but these products often stain the linen, discolor hair and have a bad odor.

It is also important to alternate the shampoos since they lose efficiency over time. If shampooing does not help your dandruff, it is important see a doctor to make sure that you do not have a skin disorder like seborrhea dermatitis or psoriasis.

Whatever method of shampooing you select, it is important to be persistent. All dandruff treatments take time. Remember, what may work for one individual, may not work for you.

Myths about Hair loss

Hair loss has been associated with more myths and folklore all which are based on superstition and ignorance. Everyone has an idea about how hair loss occurs. The internet is inundated with so called hair experts who speculate on why hair loss occurs.

Some of the nonsense speculated about why hair loss occurs include the following: Excess shampooing (esp. with head and shoulders shampoo), daily washing of hair, the type of shampoo, use of hair dryer, the type of soap, use of towel, the hardness or softness of the water, the geographical area where one lives, ethnicity, eating herbs, cleansing the bowels once a week, not cleaning the backside after poop and even excessive masturbation has been blamed on hair loss.

Like I mentioned before-bad genes, bad hormones and a lot of bad luck are the real answers to hair loss.
How does hair loss occur?

At any one point in time, the majority of hair on the scalp is in a growth phase anagen). This growth phase lasts anywhere from 2-6 years. About 10% of the scalp hair is in a resting phase (telogen) which lasts about 2-4 months. After this time, the hair is shed and a new cycle begins. Most individuals shed about 30-150 hairs everyday. After a single hair is shed, a new hair follicle replaces the same hair and the cycle begins again. Most hair grow at about 10 mm per month

In any individual who sheds hair faster than the hair regrowth, then baldness will occur. Initially the hair loss is gradual and then suddenly increases.
Types of hair loss

Hair loss is known as alopecia. The most common type of hair loss is known as male pattern baldness (androgenic alopecia). This is the most common type of hair loss in men and affects nearly 40-50% of males. The hair loss is permanent. The other type of hair loss is called alopecia areata- which commonly affects hair growth on different parts of the body besides the scalp and the disorder is temporary.