Advanced Skin Care

Dandruff Signs and Symptoms

The scalp is itchy and flakey.
One or more of the following areas may have patches of red, scaly skin: the scalp, hairline, forehead, eyebrows, eyelids, creases of the nose and ears, ear canals, beard areas, breastbone, midback, groin, or armpit.
In darker skin, affected areas may look lighter in color.
Mild dandruff – only some flaking with or without redness in a few small areas
Moderate dandruff – several areas affected with bothersome redness and itch
Severe dandruff – large areas of redness, severe itch, and unresponsive to self-care measures
Self-Care Guidelines
Most cases of dandruff are easy to control with non-prescription home measures. These include:
Frequent (daily) shampooing or a longer lather time.
Stopping use of any hairstyling products.
If a regular daily shampoo fails, consider an over-the-counter dandruff shampoo. There are several types (containing ketoconazole, selenium sulfide, 2% pyrithione zinc, salicylic acid, or tar), and one may work better than another. Sometimes one will work well for a time and then become less helpful; then it may help to switch to a different type.

To remove thick scale, apply warm mineral oil or olive oil and wash out several hours later with dishwashing liquid or a tar shampoo.

Anthrax Signs and Symptoms

Cutaneous Anthrax
Characteristic rash*
*The characteristic rash of anthrax looks like pink, itchy bumps that occur at the site where B. anthracis comes into contact with scratched or otherwise open skin. The pink bumps progress to blisters, which further progress to open sores with a black base (called an eschar). The early rash (the pink, itchy bumps) looks like many other rashes, so a history of exposure to the bacterium will be important to making the diagnosis. The eschar is more characteristic of anthrax infection, but if diagnosis and treatment are delayed until the eschar appears, the prognosis is poor.

Treatments Your Physician May Prescribe
Your doctor can diagnose anthrax by testing your blood, respiratory secretions, or wounds. The diagnosis may be difficult to make without history of exposure, so be sure to tell your doctor if you think you may have come into contact with B. anthracis or if you meet any of the above risk factors.

Anthrax is treated with common antibiotics. If you have been exposed but are not yet sick, you will get the anthrax vaccine. (This vaccine is available only to people in the military, people who work with B. anthracis, and people who have been exposed to B. anthracis.) If you are infected, you will take a long course of antibiotics.

Hair Loss (Alopecia Areata)

Signs and Symptoms
Hair loss most commonly occurs on the scalp, but it can also target the eyebrows, eyelashes, beard, and other body sites. Symptoms may include the following:
Round, patchy areas of non-scarring hair loss, ranging from mild to severe
Mild: 1–5 scattered areas of hair loss on the scalp and beard
Moderate: More than 5 scattered areas of hair loss on the scalp and beard
Severe: loss of all of the hair on the scalp and body
Scalp burning (without redness), accompanying lesions
Pitting and ridging of the fingernails
Hairs that do grow back often lack color, or may be either temporarily or permanently white. This hypopigmentation is not seen in other forms of alopecia.
Self-Care Guidelines
Psychological support may be beneficial.

Wigs may be worn to camouflage hair loss.
When to Seek Medical Care
Those experiencing areas of patchy hair loss are advised to seek evaluation from a primary care provider or dermatologist.
Treatments Your Physician May Prescribe
Both topical and systemic medications may be prescribed, as well as injections. Treatments include:
Localized steroid injections (to help speed regrowth)
Clobetasol propionate gel or solution, a potent topical steroid
Anthralin cream, a topical irritant
Light therapy
Topical steroids plus minoxidil (Rogaine®)
Systemic steroids, such as prednisone, though they have no long-term benefit and are not recommended for use beyond the short-term