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Wednesday, January 22, 2025
Dandruff is one of the most common scalp conditions, affecting around half the worldwide population (1). While it isn’t harmful, it can be itchy, frustrating, and even embarrassing.
The good news is that with the proper knowledge and products, dandruff is entirely manageable. In this guide, we’ll explore the causes of dandruff, what might trigger flare-ups, and how you can effectively tackle the problem of a flaky, itchy scalp.
Dandruff is a condition where the scalp sheds excessive amounts of skin cells, resulting in visible white flakes, often more obvious in dark hair. It’s usually accompanied by dryness and itching (2).
Shedding of the skin is normal; your skin constantly produces new cells and sheds the old ones to stay healthy. However, people with dandruff usually shed skin more quickly, causing larger patches of skin to flake off. While not harmful, it is somewhat embarrassing, and many people want to know how to get rid of dandruff. To do that, we need to understand what causes dandruff in the first place.
Most people assume that dandruff is caused by dry skin, but this isn’t entirely accurate. While a dry scalp can flake and itch, the root cause of dandruff is usually a type of yeast-like fungus called Malassezia that exists naturally on our scalps.
Malassezia is a healthy part of the skin’s microbiome (3)—not only for humans but for many animals (4)—but too much of it can cause an itchy, flaky scalp. Malassezia thrives in oily environments. The excess sebum combines with dead skin cells, creating a perfect food source for the microbe that can cause it to grow in excess. Therefore, it’s often an oily scalp, rather than a dry scalp, that is responsible for dandruff.
Some people have permanent dandruff, but many of us will experience flare-ups caused by changes to our environments or psychological states (5). Here are some potential triggers that could contribute to having a flaky scalp:
Importantly, dandruff is not caused by poor hygiene—washing your hair more won’t stop the fungus from growing excessively. However, some dead skin flakes will be washed out with every shampoo, so your dandruff might look more noticeable if you don’t wash your hair regularly.
The best way to tackle dandruff is by addressing the root cause: controlling yeast overgrowth. And the most effective way to do this is by using an anti-dandruff shampoo.
Some of the best anti-dandruff shampoos are products like Nizoral, an anti-fungal shampoo that contains an ingredient called ketoconazole. Ketoconazole reduces the amount of Malassezia on the scalp, bringing balance and eliminating flakes.
Using Nizoral is the same as using a regular shampoo—apply it to wet hair and massage it gently into your scalp—so you can easily integrate it into your routine. However, you should leave the shampoo on your scalp for 5 minutes before rinsing thoroughly to allow the ketoconazole to work.
You should aim to use the shampoo twice weekly and start seeing improvements after a couple of weeks. We recommend you continue shampooing for a few more weeks to ensure the yeast is under control. If you regularly suffer from an itchy scalp, you might want to keep using Nizoral anti-dandruff shampoo as an ongoing, once-a-week treatment, as it can stop dandruff from returning (8).
Otherwise, you could switch to a milder anti-dandruff shampoo like Head & Shoulders, which is gentler on the skin. Regular shampoo is also fine, but steer clear of products designed for dry hair. These are overly moisturising and will recreate the moist environment that Malassezia loves.
Anti-fungal shampoos containing ketoconazole are excellent dandruff treatments, but they are powerful cleansers and can leave your hair and skin feeling dry (9). To counteract this, you can:
Remember, you only need to use ketoconazole shampoo for a few weeks to see improvements, after which you can switch to a gentler anti-dandruff or regular shampoo. If dry hair is your only negative of using the treatment, it might be worth persisting—it’s a few weeks of dryness for a flake-free scalp. However, stop using the product if your scalp is very itchy or irritated or your dandruff worsens.
Anti-fungal shampoos like Nizoral are generally considered the best anti-dandruff shampoo, especially for severe cases. These products directly reduce the Malassezia microbes responsible for causing an itchy, dry scalp. But they aren’t your only option.
Shampoos with the following ingredients can also help you manage your symptoms (2):
Each ingredient targets dandruff in different ways, so choosing the best shampoo for dandruff depends on your specific symptoms, scalp type, and skin sensitivity. We recommend trying Nizoral first and exploring other options if you don’t get along with the product.
Seborrheic dermatitis is a skin condition on the same spectrum as dandruff (13). Like dandruff, it’s caused by excess Malassezia yeast, typically follows a cycle of flare-ups and periods of clearing, and can be triggered by weather or stress (14). But while dandruff affects the scalp, seborrheic dermatitis can cause red, flaky, itchy patches on the eyebrows, forehead, and behind the ears.
Over-the-counter antifungal shampoos like those containing ketoconazole are still the go-to treatment as per NICE guidelines (15). However, the shampoo should be used as a facewash, focusing on the irritated areas. If it dries your skin, follow it with an oil-free, water-based moisturiser.
You can buy Nizoral at Oxford Online Pharmacy and take the first step toward a flake-free scalp. If you’ve already tried antidandruff shampoos and haven’t seen any improvement, speak to your doctor.
Q: Why is my scalp so itchy?
A: An itchy scalp is often caused by irritation from dandruff. Other causes might include dry skin, allergic reactions to hair products, or conditions like psoriasis or eczema.
Q: How can I cure dandruff permanently?
A: There’s no permanent cure for dandruff, but it can be managed effectively with proper habits. Use of anti-dandruff shampoos, maintaining a dry scalp, and avoiding oil-based products can help.
Q: Does dandruff cause hair loss?
A: Dandruff itself doesn’t directly cause hair loss, but excessive scratching can damage your hair follicles and weaken the hair shaft, leading to breakage and hair thinning.
Q: Is dandruff a sign of poor hygiene?
A: Not at all! Dandruff is a common condition and has more to do with natural factors like oil production and yeast balance than with cleanliness.