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…

This page provides general information and does not replace a doctor’s consultation. If symptoms are severe, persistent or worsening, seek medical advice promptly.

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.
Consult with a doctor about Dandruff

Consult with a doctor about Dandruff

Discuss your symptoms and possible next steps with a doctor online.

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

Andrei Popov
Andrei Popov
General medicineMedical License: 464628925

Reviewed on Jul 8, 2026

Online doctors for Dandruff

Discuss your symptoms and possible next steps for Dandruff with a doctor online.

Doctor
5.0(1)

Tomasz Grzelewski

DermatologyAllergology21 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques. For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance. Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults. In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions. Patients commonly seek his care for: 

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns

Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.

Book a video appointment
€86
Doctor
5.0(4)

Lizaveta Trafimchuk Takhvaniuk

DermatologyFamily medicine10 years of experience

Dr. Lizaveta Trafimchuk Takhvaniuk graduated in Medicine and subsequently specialized in Dermatology and Venereology. She has more than 10 years of clinical experience and is licensed to practice in Spain, where she focuses on the comprehensive diagnosis and treatment of dermatological conditions.

Throughout her education and professional career, Dr. Trafimchuk has gained extensive experience in managing diseases of the skin, hair, and nails, as well as in the diagnosis, treatment, and prevention of sexually transmitted infections (STIs). Her clinical approach is based on evidence-based medicine, combined with personalized care tailored to each patient’s needs.

In her daily practice, she treats a wide range of dermatological conditions, including chronic inflammatory dermatoses such as acne, rosacea, atopic dermatitis, psoriasis, and eczema. She also has experience in treating pigmentation disorders, including melasma, post-inflammatory hyperpigmentation, and dyschromia.

She has developed a particular interest in trichology, treating various types of alopecia, chronic hair loss, and scalp disorders. In addition, she has experience in managing infectious dermatoses of fungal, viral, and bacterial origin, as well as in evaluating benign and suspicious skin lesions, with referral to specialized care when necessary.

With a strong interest in a comprehensive approach to skin health, she also treats scars, post-procedural skin changes, and conditions related to hormonal factors and aging, including those associated with pregnancy, menopause, and age-related skin changes.

Thanks to her experience and continuous professional development, Dr. Trafimchuk provides high-quality medical care that is professional, confidential, and aligned with modern dermatology standards.

Book a video appointment
€72
Doctor
0.0(0)

Daria Litash

Dermatology2 years of experience

Dr. Daria Litash is an experienced physician specializing in general medicine, weight management, healthy weight loss, and overall wellness. Her approach combines thorough medical assessment with personalized recommendations to help patients improve their health and maintain an active, balanced lifestyle.

During every online consultation, she places particular emphasis on taking a detailed medical history and identifying the underlying causes of symptoms. When clinically appropriate, she recommends blood tests or additional diagnostic investigations to provide a more accurate assessment and create an individualized treatment plan.

Her main areas of expertise include:

  • Healthy weight management and weight loss
  • Overweight treatment and long-term weight maintenance
  • Hair loss assessment and management
  • Skin health evaluation
  • General medical consultations for adults
  • Preventive medicine and healthy lifestyle guidance

Dr. Litash also holds a qualification in Aesthetic Medicine, allowing her to approach skin and hair concerns from both a medical and preventive perspective, always following evidence-based principles and current clinical recommendations.

Her professional background includes several years of experience working in community pharmacy in Spain, providing her with extensive knowledge of medications, treatment options, and therapeutic alternatives available on the Spanish market, as well as experience in selecting international pharmaceutical products when clinically appropriate.

Her online consultations are designed to provide clear, personalized, and patient-centered medical care, helping individuals better understand their health, make informed treatment decisions, and achieve sustainable long-term wellbeing.

Book a video appointment
€96

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