Medical Side Effects

James Troutman

Originally emailed 2001/01/31
Last revised 2003/08/23

Since you like medical "stuff" (as opposed to Medical's stuff, I suppose), you might enjoy this little medical mystery of mine, especially since you know some of it already.

Back in August I came down with a virulent case of dandruff. OK, it wasn't "virulent" exactly (in fact, the dermatologist eventually told me that it was a fairly mild case), but it was incredibly itchy, and it wouldn't respond to my usual dandruff regimen: a one or two time shampooing of the head with Head and Shoulders. Nor did it respond to Selsun Blue, Nyzoral [sic], or several other over-the-counter dandruff treatments that I tried.

Eventually (as I alluded to above) my doctor referred me to a dermatologist. She put me on a regimen of a daily five to ten minute washing with industrial strength selenium sulphide (or is it sulphate? Whatever, it's the active ingredient in Selsun Blue, only prescription strength). This helped a little, but didn't completely clear up the problem. So I continued to itch (well, she also gave me a steroid cream to help control the itching).

On my next visit she supplemented the selenium sulph-ide/ate with something called Derma-Smoothe, an  oily substance that one massages into one's scalp at night;  one then sleeps with a shower cap to prevent the oil from soiling the pillows.

This was a miracle drug! Within two days, the problem had completely cleared up. BTW, Derma-Smoothe's active ingredient is plain old peanut oil (I think Jimmy Carter gets a commission); that's right, just peanut oil and a tiny, tiny bit (something like .01%) of some steroid medication.

I did ask the dermatologist what could have brought on this virulent dandruff attack. She told me that my mild case of seborrheic dermatitis may have been brought on by any number of things. Had I been ill? No. Did I have any allergies? No. Was I HIV-positive? No. (I still find it a bit disconcerting to be asked a question like that so casually.)

So I continued using both the selenium stuff and the peanut oil for about two months. I discovered that if I went even one day without using one or the other, the problem came back. Washing with the selenium wasn't too bad; I discovered that if I applied the stuff to my head before stepping into the shower, that the five minute rule was easy to meet. However, it became a real drag to sleep with salad dressing and a bag on my head each night.

Anyway (and you are probably anticipating what's coming) my final visit to the dermatologist was last Wednesday, when she exulted in the success of her treatment ("You can't argue with success" were her exact words), and suggested that I continue with the selenium shampoo and try to reduce the peanut oil applications to once a week. (Well, once a week is better than every night, I suppose.)

You know what happened last Thursday; the oral surgeon found the infection in my mouth caused by the bony impacted wisdom tooth and prescribed penicillin to clear it up. Then an amazing thing happened. I haven't put the salad dressing on my head since last Thursday night and the seborrheic dermatitis has not come back! I'm still using the selenium stuff (why tempt fate?), but I'm pretty confident that I'll be able to get off that shortly.

So there you have it. A low grade infection at my impacted wisdom tooth (I've had discomfort there since about last spring but I don't really know for sure when the infection may have started) seems to have been the catalyst for one of the worst cases of dandruff in history (well, in my medical history, anyway).

Oh, and as a postscript, since this called Side Effects plural, I was initially dismayed when the oral surgeon prescribed the penicillin, since I know that in the past it has always given me diarrhea. Well, I'm pleased to report that I've been taking the penicillin for over five days, and I haven't suffered from diarrhea.

Until today, that is. In spades! I will spare you those gory details. Thank goodness I only have one more day's worth of pills to take.

--JT

Update: The correct spelling is Nizoral with an I not a Y, and it is selenium sulphide. Interestingly, C.S.I. once did an episode in which a man had apparently died of selenium poisoning, and evidence pointed to a woman with dandruff. The team even found a prescription for a dandruff medication in the woman's belongings. Alas, when a closeup of the prescription was shown to the audience, it turned out to be for Nizoral, which does not contain selenium.