What's up with dandruff? I'm curious if this a part of a larger diagnostic pattern? I remember Margi mentioning front hairline dandruff as being a potential indicator of gallbladder related things. Perhaps bile insufficiency? I've been thinking that through and was thinking maybe it has to do with insufficient fat/oil digestion leading to dryness and flaking of the scalp? I currently have a client i'm working with and we've resolved most of his primary complaints but the dandruff is becoming a bit more of a primary complaint now. Another aspect of his situation was chronic tinnitus, for which I got him on a combination of Drynaria, Gastrodia, Eclipta, and Cornus extract granules, equal parts, 1/4 tsp BID. And his tincture formula has some Kudzu, Hypericum, Glechoma, and Lycium berry (among other remedies for other issues). But he's experiencing 0 relief thus far. He's been consistent on it for the last 2ish months. I've never treated someone with tinnitus before, so was wondering if this sometimes takes some time to see results? I was thinking especially if associated with a Kidney deficiency of some sort that might take longer (6 months?). I also recommended he try to get a neurological exam and get EENT to look around in there. Thoughts? Thanks David!

David said: No disrespect intended to Margi but dandruff has nothing to do with the gallbladder. Dandruff or seborrheic dermatitis has several known causes (and probably a few unknown ones as well). It is often genetic and affects men more than women. People with a genetic component have a quicker turnover of skin cells (7-10 days, instead of 30 days) and produce more dead skin cells. Beyond topical preparations nothing oral is likely to alter this. It can also be caused by a yeast/fungal overgrowth (Malassezia globosa) which is why the antifungal Selsun Blue is often helpful. The yeast feeds on excess sebum, converting the triglycerides into a waste product - oleic acid which is pro-inflammatory and causes flaking and redness of the scalp. Everyone has this yeast on their scalp, oilier scalps feed the yeast more and it is possible an allergy to the yeast might be involved. There is no evidence that ingestion or metabolism of fats plays a role, here, but increasing omega 3s and decreasing omega 6 fatty acids in the diet might offer some benefit. A third cause is atopic in nature with seborrheic dermatitis being considered the mildest form of psoriasis. This usually affects not only the scalp but also the eyebrows and the folds of the nose. Here immune amphoteric and immunoregulatory herbs may offer some significant help. Consider Gotu Kola, Sarsaparilla, Astragalus, Burdock seed, Milk Thistle seed (tincture, not standardized extract) as a good starting point. Topically a Gotu Kola, Oregon Grape root ointment can be beneficial.