How Can You Get Rid of Dandruff?

Learn what causes dandruff and how you can control your flakes.

Sanaz Majd, MD,
February 17, 2011

Growing up, I remember a super mean nickname that some of the nasty kids in my class had for a classmate of mine with horrible dandruff--“Snowflakes,” they called her.  She was always fidgeting with her clothing, attempting to clear away the dandruff flakes falling on her shoulders.  I remember seeing her sad face when one of the school bullies decided to get his kicks by making fun of her one particular day.  At the time I gave him a little piece of my mind, and then turned to her and said, “You don’t worry.  In a few years you won’t even remember these people’s names.”  Last time I heard, she went to law school, and is now defending others.  And I doubt she’s Facebook friends with her former tormenters.

Kids can be so cruel.  But it’s important to realize that dandruff is actually not so uncommon.  Although it can truly be a blow to the self-esteem, it’s a benign condition. Most people suffer from dandruff to some extent – but just some more than others.

What is Dandruff?

Seborrheic Dermatitis is the annoyingly long medical term used to refer to dandruff.  Dandruff is a condition in which the cells of the skin and scalp overproduce, causing sloughing, flaking, and more oil gland production.  The skin also houses a mild amount of fungus – yes, unfortunately, this is quite normal and a part of all of our normal healthybodies.  However, occasionally, this fungus can overgrow.  This can occur not only on the scalp, but also anywhere there is a greater amount of oil glands – like on the eyebrows, around the crease of the nose, around the ears, and on the upper chest or upper back. 

In some, dandruff can be itchy if severe.  And the flaking can be cosmetically distressing, especially when wearing dark or black clothing, where the sloughing of the skin seems to be more apparent.

Who Gets Dandruff?

Unfortunately, dandruff is often genetic.  How fast your skin sloughs off and how oily your glands are typically have nothing to do with what you are doing and everything to do with your parents’ genetic makeup. 

One good example of seborrheic dermatitis is the common “cradle cap” condition that babies often experience, which typically resolves within 8 to 12 months of age on its own.

Dandruff can worsen in times of stress, or when our immune systems are down.  It can also be more prevalent as a result of certain health conditions involving the nervous system, like Parkinson’s Disease. 

How Can You Treat Dandruff?

It can be highly frustrating, but unfortunately there is simply no cure for dandruff.  Like diabetes, asthma, and other medical conditions, it’s something that many patients may battle their entire lives.  Though there’s no cure, there are several ways in which people can learn to keep their flakes in check:

Shampoos: Various over-the-counter shampoos that you leave on the scalp for a minimum of 5 to 10 minutes have been shown to improve dandruff.  These shampoos typically include one of these three active ingredients:  selenium sulfide, tar, or zinc pyrithione.  These shampoos really need to be used for at least four to eight weeks before you can expect to see a significant difference.  Initially, you should use the shampoo daily until symptoms improve, and then use it every other day.  If there is no difference after four to eight weeks, you should then switch to a shampoo with a different active ingredient.

Steroid Creams: If your dandruff is itchy, using an anti-inflammatory product to decrease the inflammation can help calm down the process.  There are various potencies and concentrations of the prescription steroid creams, and your doctor will select the one that is most suited for you based on your symptoms and your exam.  The least potent is an over-the-counter cream called hydrocortisone 1% cream.  These creams often work best when the dandruff is on the body, but there are preparations that can be used on the scalp as well.  Again, initially they may need to be used daily, but then gradually decreased with time.  Long-term chronic use of steroid creams--unlike the previously mentioned shampoos--are not recommend because of possible thinning of the skin as a side effect.

Antifungal Treatments: An over-the-counter shampoo with the anti-fungal ingredient called ketoconazole can be applied as a shampoo, and even as a lotion to parts of the body that are affected.  Again, you really need to allow at least four to eight weeks of treatment before seeing any improvement.  There is also a stronger prescription version of the same product.

Combos: If you have severe symptoms, it may be worthwhile to treat your dandruff with a combination of the previously mentioned treatments. 

Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues.

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Dandruff image courtesy of Shutterstock