Dandruff is one of those conditions that serves as more of an annoyance than a physical ailment. You’ll definitely know if you have it (as evidenced by flakes on your clothing and pillowcase), but everything else surrounding the common scalp condition is a little less clear. “While we don’t know exactly why dandruff occurs, in many people it is thought to be due to a mixture of genetics, allergies and sensitivities, and an imbalance of skin microbes,” says trichologist (a doctor specializing in hair and scalp health) Dominic Burg, MD. According to Burg, experts believe that the common condition is driven by an overgrowth of microorganisms—like bacteria, yeasts, and fungi—that live on the surface of the scalp. When these microbes consume the natural oils on your skin, they can produce byproducts that the body reacts to, leading to shedding and inflammation. At least, that’s the hypothesis.
“We do know it has nothing to do with hygiene,” says dermatologist Ava Shamban, MD. In other words, dandruff has nothing to do with how often you shower or shampoo. Our skin follows its own shedding cycle, gradually sloughing away excess cells. Dandruff is what happens when you experience increased turnover of cells and this exfoliation happens unevenly, causing both excessive shedding and buildup. While the itching and irritation that follow are often associated with dryness, it can also occur on any hair or skin type.
Meet the Expert
- Dr. Ava Shamban is a board-certified dermatologist specializing in various skin treatments including those related to acne, acne scarring, pigmentation, rosacea, photo aging, and intrinsic as well as epigenetic aging.
- Dr. Dominic Burg is the chief scientist, hair biologist, microbiologist, and trichologist for évolis Professional. He has an expertise in hair and scalp biology, more specifically in hair cycle signaling.
“It’s a misnomer that dandruff only happens with dry skin or a dry scalp; a flaking, oily scalp is also very common with this condition,” says Shamban. While you’re most likely to experience dandruff on your scalp, it can also happen (more rarely) on the eyebrows or beard. Whatever the case, most who have it just want instant and permanent relief from the experience—but it’s not so simple as prescribing a single treatment. Instead, the best course of action is regular care to prevent its return. The good news: It requires only a few steps that are easy to incorporate into your existing routine. Below, Shamban and Burg share their best tips for treating dandruff quickly.
Verify Your Scalp Condition
If you think you have dandruff, you’re probably correct. But before you begin treating it, make sure it’s not one of two other possibilities. Burg notes that a dry scalp that has mild dryness, flakiness, and minor shedding shouldn’t be confused with “true” dandruff. “Your scalp condition will change over time, and many of us will notice a change with the seasons or with other factors in our environment,” he says. Often, you’ll notice this type of mild reaction occur during seasonal changes or when you’re exposed to excess heat styling—and you can soothe it simply by dialing back the heat or switching to more hydrating formulas. Dandruff, on the other hand, has a much stronger effect. “The scenario of true dandruff can usually be recognized by skin cells falling off in medium to large clumps that are usually a little oily,” explains Burg.
On the other side of the spectrum, you might have more extreme symptoms that point to an inflammatory skin condition known as seborrheic dermatitis. Burg describes this as “characterized by flaking, skin irritation, redness, and sometimes sores—whereas dandruff is usually painless.” Both Burg and Shamban agree that if you’re experiencing redness, sores, pain, or excessive itching, you need to book a dermatologist appointment. Unlike most cases of dandruff, seborrheic dermatitis cannot be treated using over-the-counter remedies and requires dermatologist care and prescriptions.
What is Seborrheic Dermatitis?
Seborrheic dermatitis is a skin condition that causes patches of dry flakes or greasy scales along with redness. It is most commonly found on the scalp, but can also appear on other oily areas of the body like the nose and ears.
Look for Antifungal Ingredients
Once you’ve verified that you actually have dandruff, head to your nearest drugstore and start reading those ingredients labels. “Common ingredients like pyrithione zinc, ketoconazole and selenium disulfide are antifungal and have shown some good results in reducing dandruff,” says Burg. They’re an affordable addition to your in-shower arsenal; Shamban’s drugstore favorite is the popular Selsun Blue ($7), which contains cooling menthol and a dose of selenium sulfide. (Leave it on for two minutes to get the full effect.)
Coal tar and its derivatives have also been typically used to treat dandruff, but Burg cautions against using these ingredients, which he says can be too harsh. “They’re not great for the scalp and hair follicles,” he says. Instead, stick to his approved list of antifungals and use them regularly. Dr. Burg says that the length of treatment will vary based on the individual, but if you don’t see any change after several weeks of use, it’s time to book that derm appointment. It’s important to remember that even if you do see improvement, you could experience more flare-ups down the line. “Some people may require continual treatment,” he says.
Turn to Essential Oils
Aside from smelling good, your favorite essential oils and botanical extracts can go a long way in soothing dandruff symptoms. “Rosemary oil, lavender oil, green tea extract, and mangosteen all have great antimicrobial, anti-inflammatory and antiseptic properties,” says Burg. He particularly likes the évolis Professional Promote, Prevent and Reverse ranges, which utilize essential oils to target scalp buildup and encourage overall hair health. Another one of his favorite OTC ingredients is salicylic acid, which is originally derived from willow bark. The anti-inflammatory is typically used in your favorite acne treatments, but also helps regulate scalp buildup and shedding.
"The great thing about these ingredients is that they can be used long term, are gentle and can keep dandruff at bay," says Burg—noting that since they have a more mild effect, they also may take slightly longer to work than ingredients like selenium disulfide.
Shamban also suggests swapping your usual shampoos for formulas that rely on an essential oil base. Her pick is Philip B Anti-Flake Relief Shampoo ($42), which features a base that’s free of irritating coal tar and packs a powerful mixture of tea tree oil, sage, and aloe vera. The calming, soothing effect helps take down inflammation and minimize itching and discomfort. "It works equally well on flaking scalps that are dry or oily," she says.
Make Time for Deep Treatments
We’d suggest regular deep treatments whether or not you have dandruff—for the simple reason that they’re relaxing and always leave your hair looking and feeling better. But for those that have extra flaking and shedding, scalp oil treatments are a must. Burg recommends treatments with added moisturizers like baobab oil to maintain hydration. Shamban likes the Phillip B Rejuvenating Oil ($35) applied as a hot oil treatment at home. "It’s extremely helpful for those that have irritation," she says of the conditioning formula.
While you’re at it, make some time to brush your hair, too. "It’s old-school, but it works to get rid of the scale" says Shamban. Brushing helps stimulate the scalp and brings more circulation to the area while also gently exfoliating cell buildup.
Consider a Prescription
In some cases, dandruff may be extreme and persistent enough to warrant a derm prescription (without classifying as seborrheic dermatitis). If nothing OTC seems to work for you, you’ll want to visit a doctor’s office anyway. Burg says that most prescriptions for dandruff are stronger versions of over-the-counter medicated shampoos. “With medicated solutions, results can be seen relatively quickly—within a week or two,” he says. Once the symptoms improve, ask your doctor how to proceed. Some patients with more long-lasting dandruff use a medicated treatment once weekly to keep sebum levels down, alternating it with regular use of a dandruff-friendly shampoo. Any of the essential oil-packed formulas above are a good option for the latter; Burg says the main thing you want to avoid are sulfates, which can be too harsh and stripping for those with sensitive scalps.
Your dermatologist or trichologist may also choose to prescribe steroids, which are typically used short-term. “If necessary, there are steroid shampoos or steroid liquid solutions,” says Shamban. These should work within a week. “Even if there is still some excess after one or two washes, at least the discomfort will subside,” she says. Once the worst of the symptoms have been treated, proceed with the rest of their expert advice: once-weekly medicated washes, anti-inflammatory shampoos, and plenty of nourishing at-home treatments. Your scalp should revert to its pre-flake state in no time.