Patient Information

What causes dandruff?

Dandruff isn’t a serious condition, and it’s not contagious, but it can be embarrassing if you have it. Most of the time dandruff can be treated with over-the-counter anti-dandruff products, but it may take time to get better.

What is dandruff?

Dandruff is a chronic scalp condition. The key symptoms are itching and flaking of the scalp. Dandruff flakes are usually white or light yellow. They tend to fall off a person’s head when the hair is touched, rubbed, or brushed. Dandruff can be mildly annoying (light dandruff flakes) to super annoying when the itching is severe and/or there are a lot of flakes. Some people can also have red irritated areas on other areas of the body, such as the inside of their ears, eyebrows, or other areas of the face.

What causes dandruff?

Dandruff (or itchy, flaky skin) is caused by seborrheic dermatitis (sometimes called “seborrhea”). It’s not exactly clear why some people have dandruff or why the symptoms sometimes get better and other times get worse.

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How do I know if I have dandruff?

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

How common is dandruff?

Dandruff is very common. It can start in early adolescence and continue throughout adulthood. Some babies even develop dandruff after birth, called ‘cradle cap’. Some medical conditions are also likely to cause dandruff, and people with other skin conditions (ex. psoriasis or eczema) may notice that their dandruff gets worse during a flare-up. People with scalp psoriasis or eczema may notice worsening of dandruff during a flare-up.

How can I get rid of my dandruff?

Unfortunately there’s no magic treatment to cure dandruff, but it can be effectively controlled. Mild-moderate dandruff usually improves with dandruff shampoo. If your dandruff doesn’t get better in a few weeks after trying over-the-counter dandruff products, you should see your primary care provider (PCP). There are stronger dandruff shampoos and other dandruff products such as creams and lotions, but they require a prescription.

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What shampoos can I use to help get rid of my dandruff?

There are four categories of over-the-counter anti-dandruff shampoos. The active ingredient makes them different, but they all work about the same.

  • Selenium sulfide shampoo (ex. Selsun Blue® and Exelderm®)
  • Tar-based shampoo (ex. T-Gel, DHS tar®, Pentrax®)
  • Zinc pyrithione shampoo (ex. Head & Shoulders®, Zincon® and DHS zinc®)
  • Ketoconazole shampoos (ex. Nizoral 1%)

Most dandruff shampoos don’t smell bad, and some new products may have fruity scents similar to non-medicated shampoos and conditioners.

Try using one of these shampoos daily until your dandruff is controlled. After that, you can cut back to two or three times a week. Be sure to massage it in well. Afterwards, rinse it out completely.

If you’ve tried over-the-counter dandruff shampoos for several weeks to a month or so but you don’t notice any improvement, make an appointment with your PCP.

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“I find it so embarrassing when dandruff flakes show up on my clothes. What should I do?”

Although flaking should get better with treatment, you may want to wear light colored clothing until you notice a difference. The white and yellow flakes of skin tend to be noticed more on dark clothing. Keeping your hair up in a ponytail or bun may help as well. Your hair will move less, which may help stop flakes from falling from your head.

How effective is dandruff treatment?

Dandruff treatment can be very effective, but it may take a while to find the best treatment for you. The good news is there are many different types of treatment so if one doesn’t work, another will likely help!

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