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Dandruff (pityriasis capitis) is mainly a physiological process, the result of normal desquamation of scale from the scalp. It is most prevalent in adolescence and worst around the age of 20.
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Treatment (if necessary) Shampoos: zinc pyrithione (e.g. Dan-Gard, Head and Shoulders) or selenium sulfide (e.g. Selsun)
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Method: massage into scalp, leave for 5 mins, rinse thoroughly twice wkly
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Persistent dandruff with severe flaking and itching indicates seborrhoeic dermatitis or psoriasis in which the scalp skin feels lumpy.
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Treatment Shampoos: coal tar + salicylic acid compound (Sebitar) shampoo or Ionil-T plus shampoo
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Method: T Gel/Ionil-T plus shampoo, followed by Sebi Rinse or ketoconazole (Nizoral) shampoo
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If persistent, esp. itching, and Nizoral shampoo ineffective, use a corticosteroid (e.g. betamethasone scalp lotion).