Your Essential Guide to Dandruff Treatment
Doctor’s Note
As dermatologists, we know that dealing with dandruff can be an uncomfortable and embarrassing experience. We don't want you to feel self-conscious about the constant flaking of your scalp, especially when wearing dark-colored clothing. For patients, it's often hard to know what will help - we hope our online content will help!
Scalp Treatment: What is Dandruff?
Dandruff is a common scalp condition that causes white flakes and itching. It happens because the skin on your scalp sheds too quickly. This leads to mild to moderate itching and noticeable white or yellow flakes with small “holes” where hair grows.
Dandruff isn’t something that can be cured, but it can be managed. It’s a long-term skin condition that can come and go. Even though dandruff isn’t harmful and can’t spread to others, it can make people feel self-conscious.
What Causes Dandruff?
The exact cause of dandruff isn't fully understood. However, it's believed that the immune system might react to a type of yeast called Malassezia on the scalp. That’s why antifungal medicated shampoos are often used to treat dandruff.
Dandruff Lifestyle Changes
Dandruff can be unpredictable. Stress and cold weather can make it worse, while sunlight often helps improve it. Reducing stress, getting a bit of sunlight, and adjusting your hair care routine can help manage dandruff. There may also be a link between dandruff and diet, so eating foods rich in zinc and B vitamins might help.
Here are some tips to manage dandruff:
Reduce Stress: Lower your stress levels to help prevent flare-ups.
Sun Exposure: Get some sunlight on your scalp, but don’t overdo it.
Hair Care Routine:
If your scalp is oily, shampoo daily.
If your scalp is dry, shampoo less often.
Limit Styling Products: Avoid using too many products that can cause buildup.
Balanced Diet: Eat foods rich in zinc and B vitamins.
Over-the-Counter Dandruff Treatment
Over-the-counter (OTC) medicated shampoos can help manage dandruff. It’s a good idea to switch between different types of shampoos to target dandruff in various ways. Here are some options:
Nizoral
1% Ketoconazole: Fights fungus and inflammation. The prescription version is 2% ketoconazole.
Selsun Blue
1% Selenium Sulfide: Fights fungus and slows down skin shedding.
Head & Shoulders
1% Zinc Pyrithione: Fights fungus, bacteria, and inflammation
Neutrogena T/Gel
0.5% Coal Tar: Reduces scaling and itching, but can be messy. Coal tar shampoo is also very popular for seb derm and psoriasis.
Tea Tree Special Shampoo
Tea Tree Oil: Contains tea tree oil, which fights fungus and reduces inflammation.
Biolage Dandruff Shampoo
Zinc Pyrithione: Fights fungus and inflammation.
Neutrogena Dandruff Shampoo
3% Salicylic Acid: Good for thick flakes.
Redken Dandruff Shampoo
1% Zinc Pyrithione: Fights fungus and inflammation.
If you dislike shampoos, try dandruff spray, like PHARM TO TABLE Scalp Relief Tea Tree Leave-In Conditioner from Amazon (affiliate link).
Prescription Dandruff Treatment
If OTC dandruff shampoos aren’t working, it’s time to see a dermatologist. Persistent dandruff may actually be seborrheic dermatitis or scalp psoriasis. Dermatologists can prescribe stronger treatments, such as:
2% Ketoconazole Shampoo
2% Ketoconazole Shampoo: Antifungal, used for flare-ups 2-3 times weekly. The over-the-counter version is Nizoral (1%).
2% Ciclopirox Shampoo
Prescription-only antifungal. Used for flare-ups 2-3 times weekly.
Clobetasol Lotion
Prescription-only anti-inflammatory, used for itching. Strong steroid. Works well, though prolonged use can lead to skin thinning. Use only as directed.
Dandruff vs Dry Scalp
It’s important to know the difference between dandruff and a dry scalp. A dry scalp is usually caused by a lack of moisture and can lead to small, white flakes. On the other hand, dandruff flakes are larger, often white to yellow, and might have “hair holes.”
Cause: Lack of moisture
Itch: Mild
Flakes: Small, white
Context Clues: Cold weather, dry air, harsh shampoos, eczema
Treatment: Scalp moisturizers, gentle shampoo, avoid harsh chemicals.
Cause: Yeast
Itch: Mild to moderate
Flakes: Large, white to yellow, with “hair holes”
Context Clues: Look for flakes with “hair holes,” which dry scalp flakes don’t have.
Treatment: Antifungal shampoo.
Dandruff FAQs
Can dandruff be prevented?
Dandruff can’t always be prevented, but good scalp hygiene helps. Regular shampooing, avoiding harsh products, and managing stress can all help.
Is there a link between diet and dandruff?
Some studies suggest that a diet high in sugar and fat may make dandruff worse. More research is needed.
Can stress cause dandruff?
Yes, stress can weaken the immune system, making it harder for the body to fight off the yeast that causes dandruff.
Is dandruff contagious?
No, dandruff is not contagious.
Can dandruff cause hair loss?
Dandruff itself doesn’t cause hair loss, but scratching your scalp too much can damage hair follicles.
How often should I wash my hair if I have dandruff?
Washing 2-3 times a week with anti-dandruff shampoo usually helps, but if you have an oily scalp, you may need to wash more often.
Does dandruff have a cure?
Dandruff can’t be cured, but it can be managed with proper treatment.
What is the best shampoo for dandruff?
Popular choices include Selsun Blue, Neutrogena T Gel, and Nizoral A-D.
How does Selsun Blue Shampoo work for dandruff?
Selsun Blue contains selenium sulfide, which reduces the production of oils that can cause dandruff.
Can I use Neutrogena T Gel for dandruff?
Yes, Neutrogena T Gel contains coal tar, which slows down skin cell growth on the scalp.
What is Nizoral A-D Anti-Dandruff Shampoo?
Nizoral A-D contains ketoconazole, which is an antifungal that helps treat dandruff.
Is Head and Shoulders bad for your hair?
No, Head and Shoulders is designed to be gentle while treating dandruff.
Does Head and Shoulders Clinical Strength work for severe dandruff?
Yes, it’s made to provide extra relief for severe dandruff.
Does Head and Shoulders cause hair loss?
There’s no evidence that Head and Shoulders causes hair loss.
Are there sulfate-free dandruff shampoos?
Yes, sulfate-free dandruff shampoos are available for those with sensitive skin.