Life can be dandRuff

​From an early age I suffered from dandruff. I recall my roommate in college shaving my head and noticing the patches of red and angry skin found under my hair. After my undergrad, the girl I was dating would scratch my head and find clumps of dead skin and oil that had hardened and pick them off. Something she seemed to find satisfaction from, but I am sure it didn’t particularly increase my attractiveness. When flares of my dandruff erupted, it was first painful, then very itchy with significant amounts of dead skin flying off my head as I scratched my scalp. It was in medical school I learned that dandruff was a term used to describe flakes of skin shedding from the scalp and the true nature of the disease for my and most others’ dandruff was seborrheic dermatitis. Thought to be the overgrowth of naturally occurring fungus on the skin, seb derm, as I often refer to it, presents in children as Cradle Cap and in adults demonstrates a peculiar distribution on the scalp, forehead, chin, and groin region. The disease loves areas where hair is commonly distributed since the responsible yeast known as Malassezia, must love the conditions created by the presence of hair. This conclusion I’ve reached after many years of dealing with the disease myself. After my friend had shaved my head, those red rashes disappeared. if I found myself maintaining a beard when suffering from seb derm on my chin, shaving my face always helped. The hair, I believe, helps to keep sebum, oil secreted from the face that can be fed upon by microorganisms, in the areas affected. The forehead, where the disease loves to rear its ugly head, tends to be a place where oil is frequently found, maybe coming from the number of sebaceous glands in that region or a simply a byproduct of lying just below the hairline where the disease will also frequently present. Obviously, shaving your whole body is not the answer so one might question what treatments exist. Treatments that include anti-fungal chemicals such as ketoconazole will not always be effective due to most organisms’ tendency to become resistant to these approaches. Steroidal medications might help the inflammation but will also induce growth of fungal organisms. Steroidal medications also will lead to thinning of the skin when topically applied long term. Even natural shampoos containing tea tree oils have not always been effective in my patient population, though I would say personally I think when used occasionally it has helped reduce itch in my own scalp during flares. Acids are also commonly used, such as Salicylic acid shampoos. There may be something to this approach, as often it is the by-product of microorganisms and our own sweat that acidifies regions of the body to inhibit the overgrowth of things such as yeasts. Using a solution of vinegar in water to spray into your hair while showering could potentially help in returning balance to your skin microbiome. When attempting this, it is important to keep the concentration of acid low enough, approximately ten percent of the overall solution, to prevent the potential of a significant burning sensation when applying it to diseased skin. Balancing the flora of the skin may also potentially begin by addressing the microbiota that reside in our intestinal tract. The gut-skin axis has been well documented in peer-reviewed publications. My own treatment of the disease is one I have worked a long time to figure out, but I can predictably heal my own scalp and keep it healthy when I maintain a good diet. My dietary recommendation for most is that of a whole food plant-based diet with as close to locally grown organic vegetables as possible. Things get complicated of course when you don’t know how to convert those whole foods into something delicious for everyone to enjoy. I usually recommend to simply start with good ingredients, and with the addition of some salt, fat, and sugar, most things become tasty and satisfying. Animal products are a special consideration as well since most of those in existence don’t maintain the quality required to keep healthy. Sourcing one’s food should be a top priority for those who want to live free from disease. The food chosen for a healthy lifestyle does not need to be the most expensive or elaborate. Reduce your exposure to inflammatory foods like those in many restaurants and frozen food isles and the cost of your living might even get smaller. If you still have questions, book a consultation for your personal health journey to begin.

​In summary:

1. Dr. Arrington suggests using natural remedies to treat seborrheic dermatitis, such as vinegar solutions with low acid concentration to help balance the skin microbiome.
2. Dr. Arrington recommends addressing the gut-skin axis by considering the microbiota in the intestinal tract as part of the treatment plan.
3. Dr. Arrington advocates a whole food plant-based diet, emphasizing the importance of sourcing high-quality food to promote a healthier lifestyle and reduce exposure to inflammatory foods.