Scaly scalp: Itch now or never
It’s not exactly a monster type of story: You move your head and suddenly, your shoulders are covered in a dust of white flakes. But those who experience it definitely don’t enjoy it. Take Marty, for example, who went out on a date with the girl of his dreams. Of all the shirts that he owned, he liked wearing his dark blue shirt the most. Knowing he had a persistent flaky scalp, he promised not to scratch his head the whole time he was out on a date. His date Elsa was a very attractive young lady who was in the same organization he was in. A lot of guys were dying to take her out because she was not only pretty, she was also intelligent, kind, and super rich. So when he had the opportunity to date her out, he made sure it was going to be a perfect romantic rendezvous. But in the middle of the dinner, his scalp started to itch, forcing him to start poking on his scalp and hair. He felt so uncomfortable but luckily for Marty, the date was set in a dimly-lit fine dining venue, enough to camouflage his snowlike flakes. All he had to do was to go to the restroom and sweep out everything away.
Visual perception of distinguishable flakes on the scalp, in the hair, or on one’s clothing is considered an abnormal condition frequently referred to as dandruff or seborrheic dermatitis. This condition is, however, most often referred to as seborrheic dermatitis (SB) by dermatologists and as dandruff by laymen. The two, although similar in appearance, are not exactly the same.
SB is a widespread problem that affects most of us at some time in our lives. For some, it is an embarrassing but temporary inconvenience, but for many, it is a persistent problem. It is a common disorder experienced by an estimated 11 million people every year in the UK.
Most cases of SB are mild, and easily treated using medicated shampoos that can be purchased at any supermarket or chemist. However, in severe or particularly stubborn cases, it may require professional treatment. SB is characterized by the formation of dry, white or greyish scales on the scalp. These may eventually flake off, sticking to the hair and sometimes left on clothing, particularly around the shoulders. Sometimes, SB remains stuck to the scalp, forming a thick layer over the scalp’s surface. It is often said that SB is due to a dry scalp, but the real cause is often more complex. It normally takes 28 days for a cell to move from the deeper layers of the skin to the surface where it is shed — a process known as epidermal turnover. In people who are experiencing dandruff or psoriasis, this process is faster than normal, with cells moving up through the skin in only 12 to 15 days. This leads to a build-up of dead skin cells on the surface of the scalp, which creates a breeding ground for bacteria and fungi, in turn causing yet more skin to flake away from the scalp, and making the problem even worse. But let me just tell you that not all flaking and scaliness is SB.
In fact it can mean so many things, like a person could have: psoriasis; atopic dermatitis; Leiner’s disease, a rare skin disorder characterized by the appearance of a thick, reddish rash; systemic lupus erythematosus, a chronic disease that can affect almost any organ system; icthyosis, an inherited skin disorder in which dead skin cells accumulate in thick, dry scales on the skin’s surface; a simple candida or tinea infection.
Having seborrhea may also be associated with changes in hormonal levels and skin lipids. Fifty percent of SB patients have oily sebum-rich skin which means increase in sebum lipids essential for the growth of malasezzia (fungi) which increase pro-inflammatroy factors that provide a permissive environment for seborrheic dermatitis development. SB may also be associated with nutritional deficits, or a nervous system (brain or spinal cord) problem — that is why it is also associated with Parkinsonism, a condition which relates to a decline in the production of a brain chemical called dopamine. Many of the cells which produce dopamine are in the basal ganglia located in the middle of the brain. This lack of dopamine means people can have difficulty controlling their body movements and moving freely. Postcerebrovascular accidents or stroke, epilepsy, facial nerve (Bell’s) palsy and syringomyelia in which a fluid-filled cyst develops within the spinal cord can also lead to the appearance of SB. Over time, the cyst may enlarge, damaging the spinal cord and causing pain, weakness, and stiffness, among other symptoms.
In conclusion, seborrheic dermatitis may look less complex for a non-dermatologist and may simply appear as dandruff, but bear in mind that this is not always the case. So, if you have dandruff like skin rash that does not go away for weeks, gets worse with time by spreading further to different parts of the body, better think twice because it may not be just dandruff!
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For questions or inquiries, call 09174976261, 09998834802 or 263-4094; email gc_beltran@yahoo.com.
