Treatments for dandruff

PEOPLE'S PHARMACY

April 03, 2005|By Joe Graedon and Teresa Graedon | Joe Graedon and Teresa Graedon,King Features Syndicate

I've had terrible trouble with my scalp for more than a year. The dermatologist I saw diagnosed my condition as severe dandruff, or seborrheic dermatitis. My scalp itches and flakes, and I shed big hunks of white skin. It makes me miserable to look like I've been through a snow flurry. I have tried over-the-counter products, plus several expensive prescription treatments. Please help.

Seborrheic dermatitis and bad dandruff are caused by microscopic yeast (fungus) called malassezia. Antifungal dandruff shampoos (Nizoral, Head & Shoulders, Selsun Blue) work for some people, especially if they are rotated every couple of weeks. Alternative approaches involve soaking the scalp in Listerine or diluted apple-cider vinegar. Leave either on the scalp for five to 10 minutes and then rinse off.

I'm responding to the use of Vicks VapoRub or Mentholatum to keep the inside of the nose lubricated. I'm a flight attendant who flies long international flights (often 10 hours or more). Given the lack of humidity on the airplane, my nose was often uncomfortably dry, sometimes bleeding slightly. An ear, nose and throat specialist recommended a product designed to be used inside the nose, without the petrolatum base of Vicks or Mentholatum. I have found two: "Nose Better" and "Ayr Gel."

These are not saline-spray products (which seem to work well, but evaporate quickly), but gel that stays inside the nose and helps maintain appropriate moisture. They are both over-the-counter products, but often not regularly stocked. I've had good luck at many pharmacies just asking them to order the product for me. It makes a huge difference in my poor nose's ability to tolerate the dryness of the airplane.

Thank you for this practical suggestion. We found both products online. Directions say they may be used in the nostrils to relieve discomfort. Neither Vicks VapoRub nor Mentholatum should be used inside the nose.

I was just prescribed lovastatin and was disappointed to learn of the ban of grapefruit or its juice while taking this medication. Why? Is there any other cholesterol-lowering drug that doesn't exclude grapefruit?

Grapefruit can raise blood levels of lovastatin and many other medicines. This could increase the risk of side effects. Zocor and Lipitor are affected by grapefruit, but Pravachol and Crestor are not.

My husband's internist suggested glucosamine and chondroitin for mild arthritis. My husband's medical records state that he is allergic to shellfish. I guess his doctor did not know that ground shellfish is a component of many glucosamine-chondroitin supplements. After several days on the supplement, my husband was rushed to the hospital with symptoms of a severe allergic reaction. After three days of testing, they couldn't find a cause. Then I read the ingredients on the glucosamine label and discovered the shellfish.

He stopped taking the supplement and has not had another episode. Perhaps his story will help prevent a similar occurrence in others with shellfish allergy.

Glucosamine is often made from the shells of crab, shrimp and lobster. Most people who are allergic to shellfish are sensitive to a protein in the muscle rather than the shell. But rather than risk a potentially life-threatening reaction, people who are allergic to shellfish should avoid glucosamine or look for kosher vegetarian glucosamine called Regenasure.

I have had heart bypass surgery and am on Coumadin to thin my blood. I get it tested every month. I have heard people talk about fish oil as a substitute for Coumadin. Could I take it instead of or along with my anticoagulant?

Do not try this. Fish oil cannot substitute for Coumadin. The two together might lead to dangerous bleeding.

You recently answered a reader complaining of side effects from cholesterol-lowering statin drugs. I, too, had similar problems, including severe muscle pain, to the point where I could no longer take them. I was switched to Zetia, a cholesterol medicine that is not a statin. I have had no side effects of any kind after using this product for several years. It's less expensive and works just as well. Why haven't you passed this information on to your readers?

Although statin-type drugs such as lovastatin (Mevacor), simvastatin (Zocor) and atorvastatin (Lipitor) are powerful tools for lowering cholesterol, they are not the only way to do it. Zetia (ezetimibe) lowers blood fats by preventing cholesterol absorption from the small intestine.

We're glad this drug has worked well for you without side effects. Some people experience muscle and joint pain, fatigue, sinusitis or diarrhea while on Zetia.

Not long ago a waitress wrote to suggest angostura bitters for flatulence. No pharmacist I have asked has ever heard of angostura bitters. Where do I find them?

Angostura bitters are a bartender's staple, used for making mixed drinks like Manhattans and old-fashioneds. They're in the grocery store near the soft-drink aisle, next to the cocktail onions, margarita mix and grenadine syrup.

Angostura bitters have been around for more than 100 years and have also been used as a digestive aid. The label suggests 1 to 4 teaspoons after meals to treat flatulence. The waitress who wrote to us suggested a teaspoon in a glass of 7-Up or club soda.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features Syndicate, 888 Seventh Ave., New York, NY 10019, or e-mail them via their Web site: www. peoplespharmacy.org.

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