Dealing with Dandruff: Dandruff Symptoms, Causes, and Treatments

By Katelyn Woolridge, MD October 14, 2019 One Comment

dandruff causes and treatments

What is Dandruff?

Dandruff, also known as pityriasis simplex capillitii, is an extremely common condition resulting in diffuse, fine white or greasy scaling of the scalp and beard area. Considered to be the mildest form of seborrheic dermatitis, dandruff is not contagious and is not considered to be a serious health condition. However, dandruff can be a source of embarrassment as dandruff flakes within the hair or on clothing may be visible to others. The condition can also result an uncomfortable and consistent itchiness of the scalp.

What Causes Dandruff?

Despite what many people think, dandruff is not a result of poor hygiene. The exact cause of dandruff can actually be very hard to pinpoint. In fact, there are several potential influencing factors to dandruff including:

  • Malassezia, a yeast that normally lives on the skin and eats the natural oils of the scalp
  • Amount and composition of sebum produced by the sebaceous glands of the skin
  • Excessive use and accumulation of certain hair care products
  • Not cleansing the scalp frequently enough
  • Hormones and immune response

While dandruff can affect both genders, it is more common among men than women. Dandruff can develop at any age with most sufferers noticing symptoms around puberty. Individuals who suffer from diseases that affect the immune system (like HIV) or the nervous system (Parkinson’s Disease) are more susceptible to developing dandruff.

Dandruff Symptoms

The most common symptom of dandruff is the existence of dandruff flakes (diffuse, fine white scale) within the hair of the scalp and beard region. Often times, these flakes will fall or be scratched from the head and end up along the shoulders of the sufferer.

A secondary, but perhaps more irritating, symptom of dandruff is a persistent itchiness at the affected area. This intensity of this itchy sensation can range from being a minor inconvenience to a constantly uncomfortable side effect.

Dandruff Treatments

Typically, dandruff can be effectively controlled through a combination of over-the-counter medicated shampoos and lifestyle changes.

Dandruff Shampoo

The most effective way to treat or manage dandruff is to use medicated shampoo or scalp treatments. There are many different types of dandruff shampoos, each containing different active ingredients, which can in turn differ in how they control dandruff symptoms. Alternating two shampoos with different active ingredients may work better than one alone. Common anti- dandruff medications found in dandruff shampoos include:

  • Salicylic Acid (Neutrogena T/Sal, Baker’s P & S)
  • Coal Tar (Neutrogena T-Gel)
  • Pyrithione zinc (Head & Shoulders, Jason Dandruff Relief 2-in-1)
  • Ketoconazole (Nizoral A-D)
  • Selenium sulfide (Selsun Blue, Head & Shoulders Intensive)

Lifestyle Changes

Small changes to your daily routine can have big impacts on countering dandruff. Try making these lifestyle changes:

  • Shampoo Often: A daily shampooing using a dandruff shampoo is ideal, especially for individuals with oily scalps. When using medicated shampoos, allow the shampoo some time to work prior to rinsing.
  • Cut Back on Styling Products: The buildup from the use of many hair care products like mousse or gels make the scalp more prone to dandruff.
  • Manage Stress: Stress can trigger dandruff. Try doing yoga or strenuous exercise to distress.

When to see a Dermatologist

Many people experience and successfully manage dandruff using over-the-counter shampoos and lifestyle changes. As dandruff can be a chronic condition, the expectation is for control, not cure. However, if symptoms cannot be controlled with over-the-counter products and lifestyle changes, it may be wise to see a dermatologist for evaluation. Prescription medications may be necessary to control the dandruff, or an alternative diagnosis and treatment plan may be provided. Several conditions may share symptoms with dandruff and seborrheic dermatitis, such as psoriasis, eczema, or fungal infections of the scalp.


Katelyn Woolridge, MD

Katelyn Fusilier Woolridge, M.D. is a board certified dermatologist specializing in medical, pediatric, surgical, and cosmetic dermatology. She graduated summa cum laude from Louisiana State University in Baton Rouge in 2010 and obtained a doctorate of medicine from Louisiana State University in New Orleans in 2015. Dr. Woolridge is a member of various medical organizations, including the American Academy of Dermatology, Texas Dermatological Society, Texas Medical Association, and Houston Dermatological Society.


One Response to “Dealing with Dandruff: Dandruff Symptoms, Causes, and Treatments”

  1. Sarah says:

    indeed the dandruff is something I’ve faced from along time, I try a couple of things, though it goes for the time and would come back as after some time, thanks for sharing tips I would be applying some 🙂

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