Dandruff is a common form of skin eczema that occurs in parts of the body with high oil (sebum) production. It commonly affects the scalp causing itching and flaking of the skin on your scalp. Although dandruff isn’t contagious or a serious condition, it can be embarrassing and sometimes difficult to treat.
Dandruff symptoms are easy to spot: white, oily looking flakes of dead skin that dot your hair and shoulders, and an itchy, scaling scalp.
Dandruff is caused by dry skin, mostly what you get during winter when the air is cold and rooms are overheated. Flakes from dry skin are generally smaller and less oily than those from other causes of dandruff, and you’ll likely have symptoms and signs of dry skin on other parts of the body, such as your legs and arms.
Most cases of dandruff may need nothing more than daily shampooing with a gentle shampoo to reduce excess oils and skin cell buildup. Tougher cases of dandruff often respond to medicated shampoos. When regular shampoos fail, over-the-counter (OTC) dandruff shampoos may succeed. Not all dandruff shampoos are alike, and you may need to try different ones until you find one that best works for you. If you develop itching, stinging, redness or burning from any of these products, discontinue use. If you develop an allergic reaction, such as a rash, hives or difficulty breathing, seek immediate medical attention.
Dandruff shampoos are classified according to the medication they contain:
- Zinc pyrithione shampoos (such as Selsun Salon, Head & Shoulders). These contain the antibacterial and antifungal agent zinc pyrithione, which can reduce the fungus on your scalp that can cause dandruff and seborrheic dermatitis.
- Tar-based shampoos (such as Neutrogena T/Gel). Coal tar, a byproduct of the coal manufacturing process, helps conditions such as dandruff, seborrheic dermatitis and psoriasis by slowing how quickly skin cells on your scalp die and flake off.
- Shampoos containing salicylic acid (such as Ionil T). These “scalp scrubs” help eliminate scale, but they may leave your scalp dry, leading to more flaking. Using a conditioner after shampooing can help relieve dryness.
- Selenium sulfide shampoos (such as Selsun Blue). These shampoos slow your skin cells from dying and may also reduce malassezia. Because they can discolor blond, gray or chemically colored hair, be sure to use them only as directed, and rinse well after shampooing.
- Ketoconazole shampoos (such as Nizoral). Ketoconazole is a broad-spectrum antifungal agent that may work when other shampoos fail. It’s available over-the-counter as well as by prescription.
One alternative therapy that seems to reduce dandruff is daily shampooing with tea tree oil. Tea tree oil, which comes from the leaves of the Australian tea tree (Melaleuca alternifolia), has been used for centuries as an antiseptic, antibiotic and antifungal agent. It’s now included in a number of shampoos found in natural foods stores. The oil may cause allergic reactions in some people.
Treatment for dandruff in most cases doesn’t require doctor’s care. But if there is still no improvement with over-the-counter (OTC) dandruff shampoos, or if your scalp becomes red or swollen, see your doctor or dermatologist. You may have seborrheic dermatitis or another condition that resembles dandruff.