Dear Ms McDaniel

I was very captivated by your article on dandruff. I read about the various types of dandruff and the suggested treatment. However, I am seeking your assistance in trying to get the right shampoo for me. My problem is that I have a bad case of dandruff for which I have used the various shampoos which you have suggested but I am yet to find a cure.

Can you suggest something that I can use? I am a male and cannot deal with this problem. Thanks in advance.

Dear Reader

Thanks so much for reading my article on dandruff. You have only mentioned your scalp as the problematic area and you mentioned itching but no scales nor flakes. I am beginning to wonder if you have simple dry scalp which would require more moisture (an emollient) or if you have a more intense condition like seborrhoeic dermatitis, a form of eczema.

Extensive dandruff is considered to be a mild form of seborrhoeic dermatitis, which is marked by red, greasy skin covered with flaky white or yellow scales. The scalp, eyebrows, sides of the nose, breastbone, armpits, groin area or the inside or back of the ears are usually affected. In such cases, an underlying allergy is also treated with antihistamines like chlorpheniramine (Histal).

Add corticosteroid lotion

Psoriasis on the scalp is another condition which could cause the itching you described, but flakes would be produced by that condition. I commend you in doing the best that you can to help yourself with over-the-counter treatments, since you stated that you have tried all of the shampoos which I mentioned in the article, like selenium sulphide (Selsun Blue), zinc pyrithione (Head and Shoulders, Selsun, Keracare), coal tar-based shampoos (Neutrogena T-Gel, Polytar), salicylic acid preparations (Acneflex, Tinasol) and ketoconazole (Triatop and Nizoral).

Get a medical examination

However, it seems like the time has come for you to complement the products you currently use with some corticosteroid lotions or gels which are effective in relieving the itchy rash by reducing the inflammation of the underlying skin of your scalp.

Betamethasone (Betnovate) is one product which comes to mind. Fortunately, a medical doctor's prescription is needed to acquire these (steroid) products which will give you the opportunity to get a formal medical examination and diagnosis of the annoying condition which you are experiencing. The visit may also save you the additional expense of buying more and more anti-dandruff shampoos which apparently are not helping you on their own.