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You will recall the ad showing a boy asking his sister 'Do I look like a hero?' and the sister says he looks like a zero. Reason? Dandruff! It is one problem transcending the barriers of age, sex or geography. 

Causes 

Skin cells that grow and die off too fast are the cause of dandruff, but doctors do not know why this happens. Some people with severe flaking have overactive sebaceous glands (whose task is to lubricate the skin with oils); others have an elevated level of the fungus Pityrosporum ovale, which is present in most people but it is in excess in people with the problem of dandruff. Other factors include family history, food allergies, excessive sweating, use of alkaline soaps, yeast infections and stress. Even the season of the year can contribute to the problem: Cold, dry winters are notorious for bringing on dandruff or making it worse. 

If dandruff flakes are greasy and yellow, the probable cause is the skin condition known as seborrheic dermatitis; seborrhea is usually associated with redness as well. Dry, thick lesions consisting of large, silvery scales may be traced to the less common psoriasis of the scalp. These forms of dandruff -- as well as the run-of-the-mill variety -- become a hazard only if you scratch to the point of causing breaks in the skin, which can place you at greater risk for infections, particularly from staph and strep bacteria. 

Treatment 

Many over-the-counter shampoos can keep moderate dandruff in check, but consult your doctor about more stubborn forms such as seborrheic dermatitis. Some herbal remedies may relieve the itching and dryness, but it usually takes a medicated product to subdue the greasy scales. 

Conventional Medicine 

If you find that you are still scratching and shedding after trying over-the-counter preparations, see your doctor. You may be using the wrong shampoo for your condition. For really stubborn dandruff cases you may need to use a prescription lotion or shampoo. 

Most doctors recommend that dandruff sufferers use a medicated shampoo daily, leaving the lather on for at least 10 minutes. Be sure to rinse thoroughly; shampoo and soap residue can actually aggravate skin problems. After your dandruff has cleared up, use the medicated shampoo no more than once or twice a week, because it is too harsh for daily use. When possible, let your hair dry naturally instead of blowing it dry. 

Brushing your hair with a natural-bristle brush can also prove beneficial. Brush your hair from your scalp outward with steady, firm strokes. This will carry oil from your scalp, where it can cause dandruff, along the hair strands, which need the oil to stay shiny and healthy. 

Call your Doctor if: 

• Scaling is greasy and yellow, and does not respond to over-the-counter dandruff shampoos and lotions; you may have seborrheic dermatitis and need more aggressive treatment to relieve the redness, itching and flaking.
• Your dandruff is localized in a few patches and is very itchy; you may have a fungal infection or psoriasis, which requires treatment with prescription medication.