Hello. I'm Dr. Christensen.
I'm sorry you're having problems with dandruff. Although your condition can't be diagnosed without an examination, it sounds like you might be dealing with seborrheic dermatitis, or simply "seborrhea." The cause of seborrhea is unknown, but a fungal organism that normally lives on human skin is believed to play a role. Stress and immune dysfunction are also common factors in people who have seborrhea.
The most notable characteristic of seborrhea is flaking, but redness and itching are also common. Seborrhea usually involves the scalp but can also affect the face (particularly the eyebrows and the folds between your nose and mouth), armpits, chest and groin.
Seborrhea is a chronic condition. Treatment usually keeps it under control, but there is no therapeutic modality that permanently cures it. It isn't unusual for flaking to get temporarily much worse when treatment is discontinued.
Antifungal shampoos and lotions (e.g.,
ketoconazole or
terbinafine) are helpful, as are
corticosteroids (
hydrocortisone,
betamethasone, etc.),
selenium sulfide (e.g., 2.5% selenium shampoo), coal tar, and zinc pyrithione. Depending on your location, some of these products are available over the counter, while others require a prescription. Calcineurin inhibitors, such as tacrolimus or
pimecrolimus, are prescription creams that are recommended for short-term treatment of seborrhea that doesn't respond to other therapies.
Seborrhea isn't dangerous, and it doesn't impact your overall health. However, it can be frustrating to deal with, and it is occasionally associated with underlying conditions that affect your immunity, such as HIV infection. If you can't get this condition under control with over-the-counter agents, see your doctor for further evaluation and treatment recommendations.
I hope that answers your question, and good luck!