Dandruff
Dandruff is scale from the scalp shedding faster than normal. It is not caused by poor hygiene or by dryness, as is commonly assumed: in most cases there is…
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Medicines commonly prescribed for Dandruff
For informational purposes only. Always consult a doctor before using any medicine.
Dosage form: CREAM, 10 mg/gActive substance: terbinafineManufacturer: Towa Pharmaceutical S.A.Prescription requiredDosage form: CREAM, 10 mg/gActive substance: terbinafineManufacturer: Novartis Farmaceutica S.A.Prescription requiredDosage form: CREAM, 20 mg/gActive substance: ketoconazoleManufacturer: Laboratorio Stada S.L.Prescription required
Dandruff
Dandruff is scale from the scalp shedding faster than normal. It is not caused by poor hygiene or by dryness, as is commonly assumed: in most cases there is a yeast of the Malassezia genus behind it, which lives normally on the skin and provokes an inflammatory reaction in some people. It is not contagious, does not cause hair loss and is well controlled, though it tends to return.
How it presents
- white or yellowish flakes in the hair and on the shoulders;
- itching of the scalp, sometimes marked;
- the scalp may be red and somewhat greasy;
- it worsens in winter and with stress, and improves in summer;
- if there is also marked redness, greasy scale and involvement of the eyebrows, the sides of the nose, behind the ears or the chest, this is seborrhoeic dermatitis — the same process but more inflammatory.
What influences it
- excess sebum, which feeds the yeast;
- individual reactivity: some people react to the yeast and others do not;
- stress and lack of sleep;
- cold weather and central heating;
- washing too infrequently, allowing sebum and scale to build up;
- hair products that leave residue: sprays, waxes, gels;
- Parkinson's disease, stroke and reduced immunity, which are associated with more severe forms;
- hats and helmets that trap warmth and moisture.
What is not dandruff
Telling these apart matters, because the treatment differs:
- scalp psoriasis: thick, well-defined plaques with silvery scale extending past the hairline; there are usually lesions on the elbows or knees;
- scalp ringworm: patches of broken hair with scaling, mainly in children; contagious and needing oral treatment;
- contact eczema from a dye or shampoo: appears after a new product;
- lichen planopilaris: scaling around the follicles with scarring hair loss; needs prompt attention;
- simply dry skin: fine scale without redness or greasiness, improving with moisturiser.
When to see a doctor
- anti-dandruff shampoos have not worked in four weeks;
- the scalp is very red, painful or weeping;
- areas of hair loss have appeared;
- the scale is thick and adherent;
- the scaling extends to face, chest or back;
- itching is disturbing your sleep;
- it is a child, in whom ringworm needs to be excluded;
- it has come on suddenly and severely.
Treatment
The key lies in how the shampoo is used rather than which one you choose.
- medicated shampoos: ketoconazole, ciclopirox, zinc pyrithione, selenium sulphide, coal tar, or salicylic acid for thick scale;
- leave it on for five minutes before rinsing: this is where almost everyone goes wrong. An anti-dandruff shampoo applied and rinsed off immediately does nothing;
- apply to the scalp, not the hair, massaging with the fingertips;
- 2–3 times a week for four weeks, then once a week for maintenance;
- alternate two shampoos with different active ingredients if one stops working;
- steroid lotions or foams in short courses if inflammation is marked;
- oral antifungals for extensive, resistant disease;
- treat any involvement of the face and chest at the same time.
What helps day to day
- wash your hair as often as you need to: with dandruff, washing more often helps rather than harms;
- rinse thoroughly and leave no product residue;
- cut back on sprays, waxes and mousses;
- do not scratch: scratching inflames and increases the scaling;
- use your own clean comb and brush;
- breathable hats, and do not wear them all day;
- get enough sleep and manage stress: the effect on dandruff is real;
- do not put oils or greasy masks on the scalp: they feed the yeast.
Common questions
Is it contagious? No.
Does it cause hair loss? Dandruff itself does not. Heavy scratching and sustained inflammation can increase temporary shedding, which recovers with treatment.
Is it because I wash my hair too much? No. With dandruff, washing more frequently improves things.
Can it be cured completely? It is controlled. It tends to return, which is why a medicated shampoo is kept on once a week.
Do home remedies work? Tea tree oil has some modest evidence. Vegetable oils generally make dandruff worse.
Online consultation
In an online consultation the doctor reviews photographs of the scalp, helps distinguish dandruff from psoriasis, ringworm and contact dermatitis, checks how you are using the shampoo — usually where the problem lies — and sets out a treatment and maintenance plan.
This material is for information only and does not replace a medical consultation.
Medically reviewed by
Reviewed on Jul 8, 2026
Online doctors for Dandruff
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