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Dandruff
Is a common scalp condition that causes flaking of the skin
Is a mild form of Seborrheic Dermatitis
Is not contagious and does not mean poor hygiene
Scale on the scalp and dandruff (flakes in the hair). Image from Seborrheic dermatitis: Causes and treatment — DermNet
Symptoms of Dandruff
White or yellow flakes of skin in your hair
Itchy scalp
Dry or oily-looking scalp
Mild redness or irritation of the scalp
White or yellow flakes of skin in your hair
What Causes Dandruff
There is not one single cause of dandruff, but several factors contribute:
1. A yeast called Malassezia
Malassezia is a natural organism that lives on everyone's scalp.
In people with dandruff, this yeast grows more actively and breaks down the natural oils (sebum) on the scalp.
This process creates irritating substances that can trigger flaking and itching.
2. Oil (sebum) production
Oily scalps are more prone to dandruff.
The yeast feeds on oil, increasing irritation.
When the yeast breaks down these oils, it releases fatty acids that can irritate your skin.
3. Skin Sensitivity
Some people are more sensitive to these irritating substances than others.
Not everyone gets dandruff, even though everyone has Malassezia yeast on their scalp.
4. Other Contributing Factors
Stress
Cold, dry weather
Hormonal changes
Genetics
Infrequent shampooing
Certain hair products
Some medical conditions
How to Treat Dandruff
Shampoo regularly, using Anti-Dandruff Shampoo at least 2-3 times per week to remove excess oil and skin cell buildup.
Massage the shampoo into your scalp and leave it on for 5-10 minutes before rinsing.
Continue using the shampoo even after your symptoms improve to prevent flaking from returning.
If one type of shampoo stops working over time, try switching to another shampoo with a different active ingredient.
Common active ingredients are:
Pyrithione zinc: Reduces the yeast on your scalp
Selenium sulfide: Slows skin cell turnover and reduces yeast
Ketoconazole: A strong antifungal ingredient
Coal tar: Slows how quickly scalp skin cells die and flake off
Salicylic acid: Helps remove scale and flakes
Manage stress through exercise, adequate sleep, and relaxation techniques.
Eat a balanced diet rich in zinc, B vitamins, and healthy fats.
Avoid harsh hair products that can irritate your scalp.
Spend some time outdoors, as sunlight may help (Use sun protection).
Don't scratch your scalp, as this can worsen irritation and lead to infection.
Most cases of dandruff can be successfully managed with over-the-counter anti-dandruff shampoos.
When to See Your Healthcare Provider
See your healthcare provider if:
Over-the-counter shampoos don't help after several weeks
Your scalp becomes very red, swollen, or painful
The flaking spreads to your face, chest, or other areas
You develop thick, crusty patches on your scalp
Your symptoms significantly affect your daily life
Your healthcare provider may prescribe stronger medicated shampoos, topical steroid solutions, or other treatments if needed.
Reviewed by SC, MD 4/2026