Dandruff and itchy scalp is a medical condition known as seborrheic dermatitis. This problem is very common in men, affecting at least one third of all adults. It is caused by skin inflammation triggered by an excess of oil (sebum) and an overgrowth of a normally-occurring yeast commonly found on the scalp and face.
Other oily skin areas can have dandruff symptoms too—such as eyebrows, creases around the nose, behind the ears and ear canals, and chest.
Worsening dandruff symptoms happen when men skip washing their hair everyday or have increased prolonged sweating during exercise or periods of emotional stress. Certain neurological conditions (such as Parkinson’s disease and spinal trauma) are also associated with increased dandruff.
One trick to control dandruff is to increase the frequency of hair washing (daily may be necessary) and to use an anti-yeast shampoo such as Nizoral 1% or 2% shampoo which contains ketoconazole. Other dandruff shampoos including Neutrogena’s T Gel Shampoo (which contains tar) and Head and Shoulders (which contains pyrithione zinc) are also effective. Of note, the tar ingredient in T Gel shampoo is photosensitizing and will cause skin to sunburn more easily.
If scalp itching persists despite the above recommendations, applying a few drops of prescription-strength cortisone solution to the scalp (eg, fluocinolone 0.1%) after shampooing can be very helpful. Another helpful product is roflumilast topical foam (0.3%), a prescription, steroid-free medication.
