Q: My 9-year-old daughter has flakes in her hair. This has been happening for almost two years. We have inquired with her pediatrician, numerous hair professionals, etc. We have tried many suggestions such as T-Gel, Sebulex, Sea Breeze, Neurogena Moisturizing Shampoo, new brushes, and more. We have washed her hair with special shampoos, massaged her scalp and waited five minutes. None of these remedies seem to be making a difference. The flakes are near her bangs and the part in her hair and are off white in color. I see no lesions on her scalp. She feels that the flakes are unsightly and is frustrated because none of the recommendations are helping. Do you have any suggestions?
A: Common causes for the scalp to become dry and itchy include scalp psoriasis, seborrhea, eczema, poor diet, and more. Scalp psoriasis can cause itching and flaking that resembles dandruff but is not the same. This condition occurs when the immune system causes too many skin cells to grow. The first line of defense is topical in nature – medicated shampoos, creams, ointments, and soaps, while the first line of defense in prescription form includes steroid creams and ointments. Over-the-counter products that contain either salicylic acid or coal tar have been approved by the FDA for this condition. Seborrhea or seborrheic dermatitis is a skin condition that can appear on numerous areas of the body but when it is on the scalp, it is known as dandruff. This common condition causes the skin to become red, itch and flake. Cases difficult to treat may benefit from prescription-strength shampoos and steroid creams. Eczema is a skin condition that causes the scalp to itch and flake. While the cause remains unknown, moisturizers and prescription-strength steroid creams can help reduce symptoms. Stress may play a role in causing eczema to occur. A poor diet may also cause flaking, although there is no proven link for this occurrence; however, a review of your daughter’s diet or a trip to a nutritionist might help. Speaking of a healthy diet and not zeroing in on dandruff-related issues, she may benefit from increasing her essential fatty acid intake or from taking a daily multiple vitamin. She’s very young so I wouldn’t do this without the approval of her pediatrician who may first choose to order some testing to see if any deficiencies exist.
You don’t mention having seen a dermatologist who may have been or still may be able to shed some light on the situation. I mention this because the flaking appears difficult to treat without knowing the underlying cause which must be determined and which may be something that hasn’t been touched on by me or the physicians she has seen. Once determined, your daughter should receive some relief from a problem that obviously embarrasses her immensely.
Because you have already tried countless products, I will suggest some home remedies if it is dandruff that just might do the trick; however, they shouldn’t be attempted for relief from psoriasis or certain types of eczema. A white or apple cider vinegar rinse will remove built-up residue from hair follicles and may help restore the scalp’s natural pH level. The initial recommended mixture is one cup of water to two tablespoons vinegar. Spritz the solution onto the scalp and let it sit for two to three minutes, followed by rinsing her hair with warm water. You may ultimately increase the vinegar portion; however, be careful not to use too strong a solution because of the risk of further scalp irritation. Another home remedy involves fenugreek seeds. Fenugreek is an annual plant cultivated worldwide as a semi-arid crop. It has three culinary uses – as an herb, as a spice, and as a vegetable. It is harvested in India, Iran, Bangladesh, France, Spain and other countries – with India being the largest producer. The seeds are a common ingredient in Indian dishes. Preparation includes soaking the seeds over night and grind them into a paste the next day. Apply the mixture to the scalp, leaving it on for 15 minutes. Wash it off gently and add a few drops of lime juice to her bath water for a rinse. A mixture of olive oil, one teaspoon lemon juice and two eggs rubbed onto the scalp might be tried. Leave it on for between 15 and 20 minutes. Gently shampoo the hair and rinse well. Next she might try wetting her hair with warm water. Gently massage in (without using fingernails) a natural/organic shampoo in an attempt to remove the flakes. Rinse with COLD water which will close the skin pores. Have her shampoo every other day at first, then even less frequently than that. While results may not be seen immediately, the scalp will not be as oily and the flakes will (hopefully) disappear.
Your daughter may try some of the remedies listed herein; however,I recommend you make an appointment for her with a dermatologist. Be sure to bring a list of all products that have been tried unsuccessfully. Good luck.
