Dandruff

Young women's version of this guide
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holding-head-sqWhat is dandruff?

Dandruff is the name of a chronic scalp condition and it is also the name of the fine, white flakes that are visible on the scalp. Dandruff may be white or light yellow.

What are the symptoms of dandruff?

The symptoms of dandruff are itching and lots of flakes from a person’s scalp. Dandruff tends to fall off a person’s head when the hair is touched, rubbed, or brushed. It isn’t a serious condition and it’s not contagious. There are many effective and available treatments without a prescription and for severe cases, prescription medicines may be ordered by a health care provider.

What causes Dandruff?

Dandruff (or itchy, flaky skin) is caused by:

  • Dry skin: This can happen during the winter when the air is dry and it may disappear during the summer. The flakes are generally small and very dry. You may also notice similar dryness on other parts of your body, such as your legs and arms.
  • Irritated, oily skin: Sometimes called seborrheic dermatitis. It affects not only your scalp, but also may affect areas in your body with many oil glands. For example: the eyebrows, sides of the nose, back of the ears, breastbone, armpits, or even your groin area. In men, seborrheic dermatitis can affect the skin under the beard, mustache, or sideburns. The areas on the scalp tend to be red (inflamed) and greasy with flaky, white or yellow scales.
  • Sensitivity to a scalp fungus: A fungus called malassezia naturally lives on healthy scalps without causing problems. However in certain people, this fungus can irritate the scalp causing redness and and an oily patch of white flaky scales that resemble seborrheic dermatitis.
  • Not shampooing enough: Your scalp skin cells naturally die and shed. Sometimes they can get trapped in oily clumps. If you don’t shampoo often enough, these clumps may build up, causing dandruff.
  • Reaction to certain hair products (contact dermatitis): Certain ingredients in hair care products or hair dyes can cause irritation of the skin, which results in a red, itchy, and scaling scalp. This is especially common to those with sensitive skin.

How do I know if I have dandruff?

There’s no specific test used to diagnose dandruff, but flaking skin and itchiness are the main symptoms. Your health care provider or dermatologist can tell if you have dandruff by looking at your scalp and skin.

How common is dandruff?

Dandruff is very common. It can start anytime but it is especially common during the pre-teen and teen years and may continue throughout adulthood. In fact, babies develop dandruff after birth, a condition called “cradle cap.” Also, some medical conditions are likely to cause dandruff. For example, people with scalp psoriasis or eczema (other skin conditions) may notice worsening of dandruff during a flare-up.

How can I get rid of my dandruff?

Mild to moderate dandruff is usually treated with over-the-counter dandruff shampoo. Some people may require treatment with a prescription product.

There are five types of active ingredients that are found in over-the-counter dandruff shampoos. In general, dandruff shampoos are classified according to the medication they contain.

Key ingredients that fight dandruff:

  • Selenium sulfide 1% shampoo (such as Selsun Blue®)
  • Sulfur shampoo (such as Scalpicin®, X-Seb®)
  • Tar-based shampoo (such as T-Gel®, DHS tar®, Pentrax®)
  • Zinc pyrithione shampoo (such as Head & Shoulders®, Zincon®, DHS zinc®)
  • Ketoconazole shampoos (such as Nizoral 1%®)

Some shampoos (such as Head & Shoulders®) contain an antifungal agent called zinc pyrithione. Anti-fungal shampoos kill any scalp fungus that may be causing dandruff.

Ketoconazole containing shampoo (such as Nizoral 1%®) is also antifungal and is best used for treating seborrheic dermatitis of the face. Tar-based shampoos (such as Neutrogena T/Gel®) slow down the rate by which skin cells on your scalp die and flake off. Selenium sulfide shampoos (such as Selsun Blue®) have both antifungal activity and they also slow the rate of shedding skin. Each dandruff product is different, so make sure to follow the instructions on the product before washing your hair.

How often should I shampoo to get rid of my dandruff?

You should shampoo daily and use the dandruff shampoo 2-3 times a week until your dandruff is controlled. Follow the instructions on the product and be sure to rinse it out completely.

If you’ve tried a dandruff shampoo for several weeks but don’t see any improvement, then make an appointment with your health care provider or dermatologist.

How effective is dandruff treatment?

Dandruff treatment can be very effective. After the treatment, no one will know you had dandruff unless they looked at the shampoos in your shower.

If you’re concerned about dandruff, here’s a tip on how to bring it up with your health care provider: “My scalp is really itchy and flaky. Is there anything I can do?”