The cells of the scalp are constantly dividing. You can't normally see this cellular division with the naked eye; however, when the moisture content of the scalp falls benath 10% the process becomes accelerated resulting in dandruff. 

I had no idea there were so many potential causes of dandruff! The good news is that poor hygiene is not one of them. Dandruff can be caused by one or more of the following:

Dehydration
Skin is hydrated from the inside out. If you needed added incentive to drink more water, there you have it.

Diet
Zinc, B vitamins and certain fatty acids are needed to balance the skin.

Dry skin increases the chance of getting dandruff. This totally makes sense because I've also seen people with dry facial skin display flaking.

Yeast sensitivity
Apparently those with yeast sensitivity find a reduction in the amount of dandruff during summer months. The reasons for this are not clear: either UVA rays from the sun counteract with the yeast or a colder climate leads to drier skin there by making dandruff more likely in winter or even a mixture of the two.

Malassezia is a fungus though to cause dandruff. This fungus is present in on both healthy skin and skin free of dandruff but those with dandruff have 1.5 to 2 times the normal level.

Skin conditions, e.g. eczema, Seborrheic dermatitis and psoriasis cause dandruff.

Parkinson's disease causes dandruff but the reasons for this are not understood.

A reaction to a product
One of your hair products may have caused skin inflammation leading to itchiness and increased scaling.

Washing your hair too often can irritate the scalp and cause dandruff too.

Not combing your hair enough!
I too was surprised by this factor. The risk that your dandruff is caused by this is only slight. It occurs because combing (and brushing) help to clear shedding of skin. I wouldn't give too much weight to this cause.

Stress! - also appears to cause dandruff so chill out ;)

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Ref. NHS, Medical News Today, 

If you, like me, have ever taken vitamin supplements to help with healthy hair growth you will probably have already heard about the “B-vitamins.” These are a group of essential nutrients which are well renowned for health in general, but hair in particular. Each of the 8 vitamins have a number after the B.

Some of the vitamins are better known by their other name, like folic acid (B9), whereas others are better known by the number, e.g. vitamin B12.

They are:

• Vitamin B1 aka thiamine
• B2 aka riboflavin
• B3 aka niacin
• B5 aka pantothenic acid
• B6 aka pyridoxine
• B7 aka biotin
• B9 aka folic acid
• B12 aka cyanocobalamin (but everyone calls it B12)
  

(If anyone knows what became of B4, B8, B10 or B11 then leave a comment below!)

These vitamins play a crucial role in the production and maintenance of proteins in the body. Since your hair is a made from a protein (keratin) these vitamins are vital for healthy hair.

I already wrote a blog about the best foods for natural hair growth and strength but to summarize you get many of the B vitamins in eggs, milk, rice and whole grains as well as poultry meat and offal such as kidney, liver or tripe.

The main hair benefits of B vitamins include:

1. Improved retention
2. Reduced hair loss 
3. Reduced hair thinning 
4. Prevention of loss of hair color
   

One reason for their role in hair growth is that folic acid and vitamin B12 are important for healthy red blood cells which carry oxygen around the body and help everything grow efficiently.

Dandruff and dry scalp have been linked to B vitamin deficiency and certain people with vitamin B7 deficiency get severe dermatitis (skin inflammation) and hair loss.

So if you have these issues, take a closer look at your diet, and if unsure seek help from a dietician or specialist nutritional expert.

Eggs & milk for breakfast anyone? Yes sirree. Bring on those whole oats too!

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Even when you know your hair quite well sales people that appear to know their stuff will feed on your fears. 

I went to a rebranding event by ORS (formerly Organic Root Stimulator). At the event they had a woman with a gadget that looks at your scalp so that she can analyze your hair and draw conclusions about its state. 

She said:

• You have fine hair but lots of it (I wouldn't call my hair strands fine save for the back)
• You are suffering severe hair loss (really?)
• In 10 years time you will have a bald spot in the middle of your head if you don't start exfoliating now (oh no!)
• You oil your scalp because it feels dry but the oils are just preventing new hair fibres from growing (I thought, "umm, no, actually, I only ever add oils to my scalp during scalp massage. If I don't do a scalp massage I don't apply oil at all and that does not result in scalp dryness. Importantly, I use high quality, light vegetable oils that are easily absorbed by the scalp so, what are you talking about?")
  

Trust me, I felt awful! 

She tried to find out how I take care of my hair. "Are you a naturalista?" she asked?

I was like, "Umm, I have natural hair, so I guess so?" sheepishly.

"No, having natural hair doesn't make you a naturalista. A naturalista is someone who makes all their own products and tries to source all organic and natural stuff."

I don't agree with that definition but I didn't argue. I told her I like to use stuff that won't damage my hair in the long run but I don't look for terms like "organic" and "natural" because they mean nothing; sales people just throw those terms around to close sales.

Anyhow, long story short, in that moment I would have bought anything she was selling. I was so freaked out by what she had said but...she didn't have any stock.

When we left that event I started looking up trichologists in my area but by the next morning I had calmed down and realized it was nothing more than sales spiel. 

I have never exfoliated my scalp in my life, ever, so I don't think it's essential. I massage my scalp regularly and wash my hair and scalp weekly - I don't get dandruff and my scalp is not dry.

In this video I exfoliate my scalp for the first time using my own methods plus I have some random chatter with Harry, my husband. It's early Sunday morning and we're just chilling. Enjoy.

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You might also like: 

• Neno Natural's DIY Hair Recipes

I get quite a few emails from people with a scalp problem seeking my input on products etc. Whilst I am not a doctor I have discovered that if you have scalp psoriasis the following carrier oils and essential oils can help to temper the problem.

Keep the lists in mind when you're buying commercial products or whipping up your own recipes using my DIY Hair Product Academy.

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You might also like:

• Neno Natural's DIY Hair Recipes
• Managing Scalp Psoriasis And Your Natural Black Hair

Ref: aromantic.co.uk, Carrier Oils by Len Price

According to The Science of Black Hair, "The scalp is the birth place of hair!"

If you want to create an optimal environment for hair growth you want your scalp to be:

1. Clean - wash it. 

Every 7 to 10 days wash your hair and scalp. This is one of the reasons I don't enjoy washing my hair with twists in it: I can't get to the scalp as freely.

2. Unclogged by petrolatums - don't use them

Vaseline, Blue Magic, Sulfur 8 etc don't moisturise, they clog.

3. Hydrated - drink lots of water

Scalp hydration works its way inside out. Drinking water is vital for scalp health, spritzing water is important for hair's moisture.

4. Dandruff free - drink lots of water

The cells of the scalp are constantly dividing. You can't normally see this cellular division with the naked eye; however, when the moisture content of the scalp falls below 10% the process becomes accelerated resulting in dandruff! If you needed added incentive to drink more water, there you have it.

5. Not dry - oil it with Neno Natural's Hair Growth Stimulator or another high quality vegetable oil

Whilst the scalp does produce its own oil, sebum, sometimes it's not enough to keep the scalp and hair moisturised. Jojoba oil has a structure very similar to sebum so it's one of my oils of choice for stimulating the scalp. Jojoba forms 50% of Neno Natural's Hair Growth Stimulator.

6. Well stimulated - massage it often

Being a thin layer of flesh, the scalp gets less blood circulating to it than other parts of the body. You can help blood flow to the scalp with regular, gentle massages using a vegetable oil. 

If there is one thing that has been consistent in my natural hair routine from the get go it's been massaging my scalp and recognising its health as important to my hair growth.

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Please note that I am not a doctor (my husband is) but all the below information is from credible sources (listed at the end of this blog). 

What is seborrhoeic dermatitis?
A rash or inflammation of skin that usually comes up in areas rich in sebaceous glands e.g. the face, scalp and centre of the chest.

How common is it?
Pretty common: 3-5% of people globally are affected by it.

Is it more prone in certain age groups?
Yes: young adults, the elderly and infants

What causes it?
This isn't fully understood. What is know is that a yeast called Malassezia (present in skin) plays a part in its development. Other possible causes include:

• Neurological or immunodeficiency diseases, e.g. Parkinson's disease or HIV
• Tiredness
• Stress 
  
• Cold weather

What does NOT cause it?

• What you eat, i.e. diet
  
• Genetics
  

What are the symptoms of scalp seborrhoeic dermatitis?

• Soreness
  
• Itchiness
  
• Flaky skin
  

What does seborrhoeic dermatitis look like on the scalp?
Bumpy, red (if you're light skinned) with greasy-looking white or yellowish scales. The rash may weep.

How is it diagnosed?
Your doctor should be able to tell, however, it can be difficult for doctors to distinguish seborrhoeic dermatitis from psoriasis.

Can it be cured?
No, it can only be managed. This means you might have to take a treatment continuously or on and off for many months or years.

How is scalp seborrhoeic dermatitis treated?
Your doctor might prescribe:

• Medicated (anti-fungal / anti-yeast) shampoos with one or more of the following active agents: zinc pyrithione, coal tar, selenium sulphide or ketoconazole 
• To help reduce itchiness/soreness: a cream with a strong steroid might be prescribed to be used occasionally and sparingly
• For severe inflammation: pimecrolimus cream or tacrolimus ointment     
• A salicylic acid-based ointment can be rubbed in at night and washed off in the morning
• A scale softener, e.g. you might need to soak the scalp in warm olive oil
• For a stubborn rash: oral anti-fungal / anti-yeast medication. 

To avoid repetition, please read the second half of the blog on psoriasis for a few more dos and donts unique to those with natural hair.

You might also like:
Managing scalp psoriasis and your natural black hair
13 Top Tips for Keeping Natural Black Hair Moisturised - No More Dry Hair!
Solutions for a burnt scalp e.g. due to hot water or direct application of essential oils

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References:
The British Association of Dermatologists
NHS Clinical Knowledge Summary

I have a mild preference for British over US medical sources because the UK system is not-for-profit so the sources won't have a money-making motive in them.

I've had a couple of people contact me after burning their scalp because their water was too hot or because their skin made contact with undiluted essential oils e.g. peppermint oil.

Types of burn:

1. First degree burns are surface level, they only affect outer skin
   
2. Second degree burns have blisters because the outer layer of skin and the first inner layer (the dermis) is affected
   
3. Third degree burns are very severe and need immediate medical attention. If you have third degree burns you're probably not going to be checking for remedies on the internet.

If you have first degree burns, these are some quick solutions:

• Run the burnt area over cool water ~ you could stand under the shower if you can tolerate the cold or just bend your head over a tub and hold the showered head over your head for a while (5 to 15 minutes depending on how you feel).
  
• Rub aloe vera gel over the burnt area, it's got a soothing effect.
  
• If you have a small aloe vera plant you can actually break off a piece and dab it over the burnt area of the scalp, it has a very cooling effect too.
  
• Rub antiseptic cream over the burnt scalp area.

• If you are going to your doctor don't rub anything onto the wound, stop at cold water because it will be easier for your doctor to assess your scalp if there are no products on it.

If you have second degree burn or worse, see a doctor. If your scalp is still sore after 3 or 4 days also see a doctor. Normally, after the initial shock your scalp should cool down and start healing quite rapidly after about 24-48 hours.

What not to do!

• Don't apply freezing cold (ice-like) water or ice to the area. The ice especially can damage skin tissues.
  
• Do not rub butter, vaseline or any other petroleum/petrolatum based oil on the wound.
  
• Don't keep touching or rubbing your scalp, let it heal.
  
• Obviously don't use harsh chemicals e.g. relaxer on your hair and avoid washing and conditioning until you're healed. From my experience you should make a full recovery within one or two weeks at the most.

If your hair has been yanked out due to burns, don't freak out, in many cases it will grow back.

References:
How can I treat minor burns? (wiseGEEK)
How do I deal with minor burns? (NHS)

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What is scalp psoriasis?
Although a healthy scalp appears smooth to the eye, flakes of keratinized cells are continually forming on the scalp's surface. We can't see this flaking process until it is thrown out of balance resulting in dandruff. 

With psoriasis this flaking process is multiplied many times over. Skin cells are produced and die within 5 to 6 days instead of the normal 28-day cycle. These dead skin cells build up on your skin in dry, thick, scaly patches.

What causes scalp psoriasis?

The exact cause is not known but we do know that the body's immune system plays a role. The immune system protects the body against infection. If you have psoriasis, special white blood cells (called T-cells) start to attack healthy skin cells by mistake. This causes the body to produce more skin cells and T-cells to replace those lost.

Common triggers
Psoriasis worsens or can start as a result of one of more of the following triggers:

• A skin injury (cut / scrape / insect bite / sunburn)
  
• Alcohol
  
• Smoking
  
• Stress
  
• Certain medicines, e.g. lithium, some antimalarial medicines and anti-inflammatory medicines including ibuprofen
• Other immune disorders e.g. HIV

What can you do to control scalp psoriasis?

1. See a doctor or a trichologist

They can prescribe the appropriate lotions and creams that help to soften the skin cells so that they wash off easily. The active ingredients in the lotion will typically be salicylic acid, lactic acid or phenol; this is applied to the scalp to soften the psoriasis plaques which can then be shampooed out more easily.

The doctor can also recommend medicines or a round of treatment. If you're in the US you can locate a doctor via psoriasis.org, if you're in the UK, just see your NHS GP to start off with.

Here is very useful information on treatments that work from the British Medical Journal Group:

2. Ideally do not use celebrity and TV or internet doctors' advice. 

Your circumstances are unique to you and what works for one person may not necessarily work for you. Following internet advice could lead to lots of trial and error that only makes things worse. It's not worth the risk.

That said, check out this girl with scalp psoriasis on Embarrassing Bodies (a UK TV show where people showcase medical problems that have been ruling their lives). I chose to show you this because the show is run by proper doctors and they're not trying to push products. These two episodes show the great results you can achieve after treatment.

3. Don't aggravate the psoriasis:

• Stop relaxing your hair. Healthy hair has a pH of 4.0 to 5.5 (acidic) whilst relaxers are very alkaline with pH values ranging from 12 to 14. This difference in pH will create disharmony.
• Don't use hair dyes. They're also alkaline
  
• Don't use any products that use petroleum / petrolatum / mineral oils. These oils are heavy and are much more likely to block your skin. The scalp needs to breathe. Importantly, note that although I speak against mineral oils, I have seen a TV doctor recommend it and I have seen at least one natural haired girl state that Sulfur 8 which contains mineral oil works for her. Shea butters that haven't been mixed with these cheap oils are a good option.
• Consider using organic unrefined jojoba as your preferred oil. Jojoba is the only oil whose structure is similar to that of sebum, the oil produced by the scalp's own sebaceous glands. Jojoba is also a weak acid and as such will complement your scalp's own acidity
• Drink lots of water, at least, eight 250ml glasses a day. The moisture content of scalp is controlled from the inside. According to The Science of Black Hair (page 28), if the moisture content of the scalp falls below 10% and the scalp's natural flaking process is disrupted, dandruff and other scaly scalp irritation issues result
  
• Don't use blow dryers and hot combs, they will only dry your hair further
• Don't use commercial shampoos including the anti-dandruff variety

Unique issues you may face with natural hair
1. If you're being "forced" to go natural because of the scalp psoriasis you'll also have to learn how to manage your new hair. In addition to nenonatural.com there are many other online tutorials by USA hair bloggers, UK hair bloggers and beyond.
2. Combing flakes out will be harder because of the curls so you'll need more patience than someone with, say, type 1 hair, especially if your hair is long.

You might also like:
13 Top Tips for Keeping Natural Black Hair Moisturised - No More Dry Hair!
Managing natural hair and scalp seborrhoeic dermatitis

References:
Psoriasis Treatments: Now and in the Future (webmd)
Psoriasis.org
Scalp Psoriasis - Channel 4, Embarrasing Bodies

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