Question

I've suffered from dandruff for years. Finally, I'm beginning to suspect it may have more to do with diet than merely using the right shampoo. I went from T-Gel-type shampoos to Nizoral or the lighter Nizorelle, which was the first to make a real difference, but I still needed to wash my hair almost daily. Just recently I tried an old household remedy: vinegar. I now only need to wash my hair every second or third day. I also suffer from mild psoriasis on my back. My GP reckons it is more a case of dry skin and recommends I avoid hot showers. Aqueous cream helps. I try to avoid diary and wheat as best as possible. Are there any other approaches that may help to bring better long-term results?

The nutritionalist
Dr John Briffa

Dandruff is very often related to scalp infection with yeast (fungal) organisms, which is why anti-dandruff shampoos, such as Nizoral, contain anti-fungal agents. When dandruff is persistent, it is usually a sign of yeast-overgrowth elsewhere in the body, particularly the gastrointestinal tract. Your belief that the root of your problem is in your digestive tract and diet is certainly correct. I recommend you avoid foods which encourage yeast growth such as sugar, alcohol, refined carbohydrates (like white rice and pasta), along with bread, dried fruit, stock cubes, alcohol, vinegar, soy sauce, peanuts and mushrooms. For at least a couple of months base your diet around meat, fish, fresh vegetables, beans, lentils and some whole grains such as brown rice and oats. I also recommend a supplement containing healthy-gut bacteria (known as 'probiotics') for 2-3 months. This will help to 'crowd out' yeast organisms.

· Dr John Briffa is a holistic doctor specialising in nutritional medicine. His website is www.drbriffa.com

The dermatologist
Emma Edmonds

Dandruff is actually caused by an oily scalp (not the over-dry scalp many assume), which can encourage the yeast Malassezia to grow. The trick is to treat it regularly. Try different shampoos - most dandruff hair products contain antiseptic properties (eg zinc, selenium, sulphur), until one 'cocktail' works for you. Vinegar has antiseptic qualities though its pungency means it's probably not a great long-term strategy. If your scalp becomes itchy or inflamed you could have seborrheic dermatitis, or even psoriasis. If so, see a dermatologist, as there are more specialist treatments available. In extreme cases, dermatologists can also make up even stronger 'shampoos' containing coal tar and steroids. This isn't a particularly easy option though - the shampoo, which is the consistency of Vaseline, is left on the head overnight. However, you may feel the positive results are worth the discomfort.

· Emma Edmonds is a dermatologist working on behalf of the British Skin Foundation (http://www.britishskinfoundation.org.uk/)

The acupuncturist
Angela Hicks

In Chinese medicine, the most common cause of dandruff is 'liver blood deficiency'. Blood, amongst other things, moistens the body, so 'blood deficiency' doesn't mean you are anaemic but that your blood isn't moistening your scalp sufficiently (the blood deficiency also causes psoriasis). A group of six points on the back, known as the Magnificent Six, are known to 'nourish' the blood while the 'Sea of Blood' point, close to the knee, also works very well. Another cause could be what acupuncturists call 'heat' - an itchy redness on your scalp and other areas. There's an acupuncture point by your elbow that's good at clearing heat. A final possibility is that your dandruff is due to too much 'damp' - a stagnation of fluid in your system causing greasy hair. Again there are specific points to alleviate this. Prescribed herbal remedies of angelica (dang gui) combined with peony (bai shao) both nourish the blood, and may also help.

· Angela Hicks is a British Acupuncture Council member and a principal of the College of Integrated Medicine

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