Dandruff

Treatment

  • Dandruff is dry, flaky skin typically affecting the scalp. Seborrheic dermatitis is also dry, flaking skin but also has associated redness and commonly itching in affected areas. While the scalp is commonly affected, the eyebrows, sides of the nose, beard area, and central chest can also be affected. Inflammation and yeast overgrowth contribute to this condition.

  • Dry, flaky skin affecting hair-bearing areas along with varying degrees of underlying skin redness and itching with occasional peeling, crusting, or scabbing of the skin
  • Topical medicated shampoos/washes (ketoconazole, ciclopirox, salicylic acid) and topical leave-on medications (clobetasol, fluocinonide, fluticasone)
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    FAQ

    A board-certified Dermatologist is a medical doctor (MD or DO) that has completed 4 years of medical school as well as 1 year of internship and a minimum of 3 years of dermatology residency. They are the experts in over 3,000 conditions affecting hair, skin, and nails. They can see patients of all ages and are able to address medical, surgical, and cosmetic concerns.
    Most people see a Dermatologist once yearly for an overall skin check. If there is a personal or family history of skin cancers, abnormal moles, or other conditions such as acne, eczema, or psoriasis, the frequency of visits can be increased.
    Dermatologists recommend performing a once-monthly self-skin examination to check for new or changing spots. You should examine all aspects of your skin, using mirrors or a partner as needed. Do not forget to try to examine your scalp, look between fingers and toes, check the bottoms of your feet, and examine the groin area. Please have any new or changing lesions examined by a Dermatologist to determine if any treatments are needed.
    UV damage is the biggest skin aging culprit. Daily sun protection measures (even in the winter) is the best preventative step. Avoiding smoking, excessive alcohol consumption, other drugs, staying hydrated, and eating a well-balanced diet can all have positive anti-aging effects as well.
    Topical vitamin A products (retinols, retinoids) are the overall most effective topicals for addressing skin aging concerns such as loss of elasticity, fine lines, skin texture changes, and dyspigmentation. There are various over-the-counter products and prescription products that contain these active ingredients. People with very sensitive skin can sometimes have a more difficult time tolerating these topicals as they can be irritating to the skin.
    Dandruff is a condition that causes dry, flaky skin on the scalp, eyebrows, and/or beard area. When there are other findings present in addition to dryness and flaking, such as redness on the scalp, itching, and irritation, it is likely that you are dealing with a type of scalp eczema called seborrheic dermatitis. Dandruff is most likely a very mild version of seborrheic dermatitis. Seborrheic dermatitis is caused by inflammation on the scalp as well as yeast overgrowth.
    Mild dandruff can frequently be treated with once daily washing with a gentle shampoo, being sure not to aggressively exfoliate the scalp, which can worsen symptoms. Patients with seborrheic dermatitis are typically encouraged to shampoo daily as well.
    Seek out shampoos that contain zinc pyrithione or selenium sulfide as the active ingredients. These are readily available by multiple brands (Head & Shoulders, Selsun Blue, etc). Other active ingredients that can be helpful for dandruff or seborrheic dermatitis include: salicylic acid (Neutrogena T-Sal) and ketoconazole (Nizoral).
    When daily shampooing does not help control the issue, it would be helpful to seek dermatologic care. Also, if you are experiencing any symptoms such as itching, irritation, redness, crusting or scabbing, or hair loss associated with these symptoms, it is highly recommended that you see a dermatologist so you can be evaluated and treated appropriately.
    There is no cure for these conditions, but regular use of specific shampoos and occasionally other topical medications should help to keep the symptoms and appearance under control. These issues commonly flare during the dry, cold winter months and treatments can be adjusted in frequency to minimize flares when they do happen.