How Is Dandruff Treated?

Dandruff is dry skin on the scalp that has flaked off. The flakes, which are white or yellow, can make your scalp itchy. Dandruff is usually a symptom of seborrheic dermatitis, a skin condition that causes irritation and redness. While you can’t fully prevent dandruff, there are several ways to manage it. A variety of treatment options aim to clear up the flakes, cut down on itchiness, and keep the scalp healthy overall through antifungal and anti-inflammatory ingredients.

Medications

Because dandruff can mimic other conditions, such as dry skin, it might be best to check in with a healthcare provider before starting any dandruff treatment. Oftentimes, the first step in treating dandruff is using over-the-counter (OTC) options from your local drugstore. Some cases of dandruff might benefit from prescription-strength versions or products.

Over-The-Counter

OTC products are considered a solid first choice for most cases of dandruff. They can help alleviate symptoms like flaking, itching, dryness, and irritation. The products can come in the form of a shampoo, conditioner, lotion, or foam.

Microorganisms on the scalp, such as fungus or bacteria, may be contributing to your itchy, flaky scalp. OTC dandruff products have ingredients to get rid of microorganisms and calm any inflammation. Look for a product with one or more of the following antifungal, antibacterial, or anti-inflammatory ingredients:

• Zinc pyrithione, a common antimicrobial used in dandruff products that cuts down on fungus linked to dandruff
• Selenium sulfide, an agent that treats infections, relieves itching, and removes dandruff
  
• Coal tar, an ingredient that works against fungus and inflammation and reduces flakes and sebum (oil on the scalp)
• Salicylic acid, which helps remove dead cells and excess oil from the skin
• Tea tree oil, which might have antifungal properties

Because products have different ingredients, they will have different instructions. For instance, some products can be used daily. Others can be used at least two to three times per week for several weeks until your scalp is clear. And while some products should be left in your hair for five minutes, some should be rinsed out right away. Read the instructions carefully to make sure you use the product correctly.

If you are not experiencing any improvement, use a product with different ingredients and see if that works.

Once your dandruff improves, experts recommend using a medicated shampoo once every week to help prevent dandruff from recurring.

Prescription

If OTC dandruff products aren't working, a healthcare provider may recommend a prescription-strength dandruff medication. For more severe cases of dandruff, this often includes antifungal shampoos or leave-on formula products with different ingredients and strengths.

For example, you might get a prescription for the antifungal shampoo ketoconazole 2%. Ketoconazole 1% shampoo is available OTC under the brand name Nizoral and is applied every three to four days for eight weeks. The more potent prescription version is usually applied only once.

If the scalp inflammation is severe, you might be prescribed a topical corticosteroid like fluocinolone (sold under brand names like Synalar and Capex) to apply to your scalp. When used for the short term, the medicine can help calm itching and inflammation.

If you don't see results with antifungals and topical corticosteroids, the next choice might be an immunosuppressive like Protopic (tacrolimus) or Elidel (pimecrolimus). These medications decrease the amount of activity of your body's immune system, leading to less scaling, redness, and itchiness.

Lifestyle

Several factors are believed to play a role in dandruff production, some of which like fungus, stress, and nutrition might be able to be addressed through lifestyle changes.

Some dietary tweaks may help improve the overall health of your scalp by reducing inflammation, which could potentially help with treating dandruff. Eating foods that decrease inflammation, such as those that fall under the Mediterranean diet, may help with dandruff. Meanwhile, limiting foods that promote inflammation, such as processed foods, might also be able to help with dandruff.

Eliminating foods made with yeast or fungi, such as breads, cheeses, and beer, may help with dandruff, as well. Instead, you can populate your body with more helpful bacteria and yeast by taking probiotics.

You should always check with a healthcare provider to make sure eliminating anything from or making changes to your diet is safe for you.

Living With and Managing Dandruff

Dandruff is very common. It can come and go over time. Usually, you don't need medical attention for dandruff. Managing the flakes and itching might take trial and error with different OTC shampoo formulas. If you're finding the dandruff does not go away with OTC products, a healthcare provider can help determine what is causing the dandruff and potentially prescribe a stronger treatment.

When taking measures to control dandruff, hair texture might impact how often you should use dandruff shampoo. People can typically use a dandruff shampoo twice a week if they are white or Asian and once a week if they are Black.

Hair color might also need to be taken into consideration if you are using a dandruff shampoo with coal tar. The ingredient can discolor blonde, gray, or white hair.

Shampoo with coal tar can also make your scalp more sensitive to the sun. So if you are using this treatment approach, make sure to protect your scalp from sunlight.

If the presence of dandruff on your darker clothes makes you self-conscious, you can opt for lighter-colored clothing if you're able to.

A Quick Review

Dandruff is a common scalp condition. If you have it, you will have white or yellow flakes of skin coming off your scalp. The flakes can also make your scalp itchy. Fortunately, dandruff is treatable. There are a variety of over-the-counter products like dandruff shampoos to stop the flakes. The shampoos contain different ingredients, so you'll have to see which one works best for you. If over-the-counter remedies don't work, there are prescriptions that can help treat your dandruff. Dietary changes and continued use of dandruff shampoo might help with the ongoing management of dandruff.