Quite simply, patients don’t use their antifungal dandruff shampoos regularly, which allows recurrence to occur. In addition, patients tend to use the antifungal dandruff conditioner on their scalp, but the conditioner can remove the antifungal ingredients the shampoo leaves behind. Instead, according to Jim Schwartz, a research fellow at Procter and Gamble, it is best to apply the dandruff conditioner to the hair ends only.
The fact that dandruff shampoos don’t work due to inconsistent use is a new concept. According to writer Kristin Sainani in the June 2009 issue of Allure magazine, a recent survey of 722 dermatologists revealed that 64% believed that patients experienced dandruff recurrence because response to the antifungal shampoos diminished over time. However, Sainani reports that a 2009 Procter and Gamble study (headed by Schwartz) found that no dandruff recurrence occurs when a 1-2% pyrithione-zinc-based product (like Head & Shoulders ) is used regularly for 24 or 48 weeks. In the study, two groups of 337 patients total using either a 1-2% pyrithione-zinc based product (like Head & Shoulders ) or a placebo for 24 or 48 weeks showed that those using the anti-fungal shampoo experienced no dandruff symptoms or recurrence relative to patients in the placebo group. This indicates that the popular belief that dandruff shampoos diminish their effectiveness over time is false, and instead, patients who tend to get dandruff should consistently use their antifungal dandruff shampoos, even after the dandruff seems to have been treated.
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