Flaky scalp and gray hair
Red flag #7: Yellowish flakes on the hair and scaly, itchy patches on the scalp
What it means: What most of us grew up calling dandruff is now understood to be a complicated interaction of health issues that deserve to be taken seriously. Seborrheic dermatitis is a chronic inflammatory condition of the scalp that causes skin to develop scaly patches, often in the areas where the scalp is oiliest. When the flaky skin loosens, it leaves the telltale "dandruff" flakes.
Seborrheic dermatitis coexists in a "chicken-and-egg" relationship with a fungal infection caused by an overgrowth of a yeast that's normally present on our scalps and skin. The yeast organism, Pityrosporum ovale, takes advantage of skin already irritated by dermatitis and inflames it still more. Some experts now believe that the yeast overgrowth may occur first, setting off the inflammatory reaction of the dermatitis, but that hasn't been proven.
More clues: One way to differentiate seborrheic dermatitis from plain dry skin: When skin is dry, you'll typically also see dry, scaly skin between the eyebrows and by the sides of the nose, says California dermatologist Raphael Darvish. Also, seborrheic dermatitis tends to be seasonal, flaring up during the winter and disappearing in the summertime. It may be triggered by stress as well.
What to do: See a dermatologist to make sure it's seborrheic dermatitis. If so, "there are great prescription shampoos and creams that can correct this," says Darvish. The most effective treatment for yeast overgrowth is ketoconazole, a newer drug that works by damaging the fungal cell wall, killing the fungus. It comes in the form of pills, creams, or shampoo under the brand name Nizoral. However, as an oral medication it has many side effects, so if you and your doctor decide on an oral treatment, an alternative antifungal, fluconazole, is preferable.
To calm flare-ups as quickly as possible, Darvish recommends using a prescription steroid cream. However, long-term use of these creams can thin the skin, particularly on the face, Darvish warns, so doctors recommend using them in short-term doses known as "pulse therapy."
To prevent recurrence, it's necessary to get the skin back in balance, and many experts recommend garlic for this purpose. You can either eat lots of fresh garlic, which might annoy those in close proximity to you, or take a garlic supplement.
Red flag #8: Gray hair
What it means: Many people perceive gray hair as a red flag, worrying that it's an indication of stress or trauma. And history abounds with stories like that of Marie Antoinette, whose hair was said to have gone snow white the night before she faced the guillotine.
Experts tend to dismiss such fears and stories, explaining that how our hair goes gray or white is primarily influenced by our genetics. However, in recent years research scientists have reopened the debate. While they can't yet prove or explain it, many researchers now believe that stress may trigger a chain reaction that interferes with how well the hair follicle transmits melanin, the pigment that colors hair. Researchers are looking at the role of free radicals, which are hormones we produce when under stress, and studies seem to show that they can block the signal that tells the hair follicle to absorb the melanin pigment.
Other experts argue that a trauma or stressful event causes the hair to stop growing temporarily and go into a resting phase. Then when the hair follicles "wake up" and begin turning over again, a lot of new hair grows in all at once, making it appear that a great deal of gray has come in all at the same time.
More clues: The schedule and pattern by which you go gray will most likely follow your parents' experience. However, if you suspect stress is graying you prematurely, keep careful track of stressful events. People who experienced a traumatic event that they believe caused them to go gray have reported that their hair eventually returned to its former color.
What to do: If you believe that stress or trauma is causing your hair to go gray, boost your coping strategies by working on your reactions to stressful situations. Yoga and meditation, for example, are effective stress-management tools.
If you see results, you'll know you're on the right track. In the meantime, you might want to talk to your parents about how their hair color changed over time, and learn what you can expect. After all, if Great-Aunt Eliza first developed her dramatic white skunk streak in her mid-30s, that might be something you want prepare yourself for.