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Especially since he's got another thread going about his extremely chapped lips--it sounds like something more systemic is going on that isn't going to be fixed with drugstore shampoo and proper hydration.
Just in case it might relate to someone…..my husband was plagued by a pink splotchy rash on his upper chest for years. Various doctors prescribed different meds and anti fungals. The rash would go away, but then come back.
At his annual dermatologist check he happened to have the rash and she took one look at it and said it was the same thing that causes dandruff, even though he didn’t have dandruff on his head. She prescribed a lotion he put on his head a couple of times a week and hasn’t had the rash since. Weird, huh?
As a hairdresser/esthetician, I'd also suggest you see a dermatologist, mainly as you've said you've had it for years & nothing you've used has worked. It's got to be uncomfortable for you & very likely is something you don't need to live with once it's addressed.
No one can diagnose online, especially sans pics & it could be a yeast infection or Rosacea or psoriasis or excema which is what causes the dandruff, so trying to treat just the dandruff isn't effective. I know someone who always had scalp skin flake issues, which worsened as he aged & lost his hair on the entire top of his head. Sunshine seemed to make it worse. He also treated it with Head & Shoulders, then Selsun Blue for decades, even though neither worked & he had very noticeable dandruff as his hair was black. Someone gave him very bad advice that it might be as he was washing/combing his hair too often & irritating his scalp, so he'd wash/brush it once wk & I can't tell you how unpleasant that looked... oily, disheveled black hair covered in flakes.
His dermo gave him a pill for a couple of months (turns out he had some sort of follicle infection) & he then put him on a long trial & error period of using different medicinal creams to tackle itching & reddness. He was then diagnosed with Rosacea... it's more common on the face, but he only ever gets it on his scalp. No matter what shampoo or conditioner he used, it would never have addressed the infection or Rosacea, so that's why I'd advise that you let a professional look at it.
It could be a simple diagnosis that would only take a few wks of a med or cream to fix.
By the way, my friend still has flare ups now & again & returns to using his cream for a week & is fine for a few months. The main thing is he doesn't have skin flakes any longer. He didn't really have dry skin dandruff, he had an infection & Rosacea which was causing his "dandruff".
Good luck. I'm sure a dermo will fix you right up. Please let us know how it works out for you.
As a hairdresser/esthetician, I'd also suggest you see a dermatologist, mainly as you've said you've had it for years & nothing you've used has worked. It's got to be uncomfortable for you & very likely is something you don't need to live with once it's addressed.
No one can diagnose online, especially sans pics & it could be a yeast infection or Rosacea or psoriasis or excema which is what causes the dandruff, so trying to treat just the dandruff isn't effective. I know someone who always had scalp skin flake issues, which worsened as he aged & lost his hair on the entire top of his head. Sunshine seemed to make it worse. He also treated it with Head & Shoulders, then Selsun Blue for decades, even though neither worked & he had very noticeable dandruff as his hair was black. Someone gave him very bad advice that it might be as he was washing/combing his hair too often & irritating his scalp, so he'd wash/brush it once wk & I can't tell you how unpleasant that looked... oily, disheveled black hair covered in flakes.
His dermo gave him a pill for a couple of months (turns out he had some sort of follicle infection) & he then put him on a long trial & error period of using different medicinal creams to tackle itching & reddness. He was then diagnosed with Rosacea... it's more common on the face, but he only ever gets it on his scalp. No matter what shampoo or conditioner he used, it would never have addressed the infection or Rosacea, so that's why I'd advise that you let a professional look at it.
It could be a simple diagnosis that would only take a few wks of a med or cream to fix.
By the way, my friend still has flare ups now & again & returns to using his cream for a week & is fine for a few months. The main thing is he doesn't have skin flakes any longer. He didn't really have dry skin dandruff, he had an infection & Rosacea which was causing his "dandruff".
Good luck. I'm sure a dermo will fix you right up. Please let us know how it works out for you.
That's great. Sorry you dealt with this for so long, but let us know in a couple of months when you're all better, what worked for you.
Something else I thought of was that many are allergic to chemicals in OTC shampoos & conditioners & even soaps. A dermo will better be able to find the exact culprit... there are so many ingredients in most toiletries, we may never find it on our own.
I've never had dandruff but boy oh boy do I itch/burn like I ran into a cactus if I use certain body soaps or shampoos. Even body/face moisturizers can make my skin burn & itch.
The worse ones for me are products from beauty supply stores or health food stores... you'd think it would be the opposite since they all claim to be natural or organic. For me it's an exaustive list of products that cause skin irritation including laundry detergents, certain fabrics like wool or nylon... but trial & error helped me find a handful of products I can use without side effects. Actually, I make most of my own moisturizers, dishwashing liquid, laundry soap, etc... I'm like an old prairie woman. And, the shampoos that work best for me are in cream formula that don't suds up. Sadly, they're very pricey, as well.
And, likely not an issue for you but when I was working with hair, it wasn't uncommon for someone to tell me their young daughter had a very badly red & irritated scalp... it looked red & angry, skin was peeling & burning. It was always a girl now old enough to take her own showers without the assistance of an adult & she wasn't rinsing her hair of all the shampoo. Easy to fix by rinsing the hair with tea (tannic acid cuts through soap) & application of a bit of a therapeutic essential oil a time or 2.
My point is, that's why dermotologists are so good, cuz they might be able to quickly narrow down 1 simple ingredient in most shampoos that's causing your issue. Just like with my friend, one visit & he quickly identified the 2 issues he had... it did take a couple of visits to get the proper products & meds to use, but within a few months, he wasn't uncomfortable any longer & occasional flare-ups are manageable.
The underlying issue has to be determined. I like natural remedies so would make a special shampoo - would purchase an organic Tea Tree Oil shampoo then would add essential oils: Rosemary, Tea Tree, Lavender & others (10 to 20 drops to the shampoo bottle - shake it up). The rubber scalp massagers feel great - cheap on amazon. Wash hair daily.
I would also make sure I was taking a multivitamin, Vitamin D3 and B12. And I do think a little sun exposure is good.
See a dermatologist. You may have psoriasis, which has other implications.
Nizerol has a stronger prescription counterpart, if you have certain conditions.
FWIW, my brother has a strange "cure" that worked for him. He shaved his head and then purposely got strong sun exposure. It apparently killed off an underlying fungal issue, that did not recur when he grew his hair back.
Regular Nizoral works for me while none of the other shampoos do anything. I've considered asking a dermatologist for the 2% prescription version, but the regular version works if I use it 3-4 times a week.
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