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Treatments and drugs
By Mayo Clinic staffDandruff can almost always be controlled, but dandruff treatment may take a little patience and persistence. In general, mild dandruff can often be helped by daily cleansing with a gentle shampoo to reduce oiliness and skin cell buildup.
When regular shampoos fail, over-the-counter (OTC) dandruff shampoos may succeed. But dandruff shampoos aren't all alike, and you may need to experiment until you find one that works best for you. Dandruff shampoos are classified according to the medication they contain:
- Zinc pyrithione shampoos (such as Selsun Salon, Head & Shoulders). These contain the antibacterial and antifungal agent zinc pyrithione, which can reduce the fungus on your scalp that can cause dandruff and seborrheic dermatitis.
- Tar-based shampoos (such as Neutrogena T/Gel). Coal tar, a byproduct of the coal manufacturing process, helps conditions such as dandruff, seborrheic dermatitis and psoriasis by slowing how quickly skin cells on your scalp die and flake off.
- Shampoos containing salicylic acid (such as Ionil T). These "scalp scrubs" help eliminate scale, but they may leave your scalp dry, leading to more flaking. Using a conditioner after shampooing can help relieve dryness.
- Selenium sulfide shampoos (such as Selsun Blue). These shampoos slow your skin cells from dying and may also reduce malassezia. Because they can discolor blond, gray or chemically colored hair, be sure to use them only as directed and to rinse well after shampooing.
- Ketoconazole shampoos (such as Nizoral). Ketoconazole is a broad-spectrum antifungal agent that may work when other shampoos fail. It's available over-the-counter as well as by prescription.
Try using one of these shampoos daily until your dandruff is controlled, then cut back to two or three times a week. If one type of shampoo works for a time and then seems to lose its effectiveness, try alternating between two types of dandruff shampoos. Be sure to leave the shampoo on for at least five minutes — this gives the ingredients time to work.
If you've shampooed faithfully for several weeks and there's still a dusting of dandruff on your shoulders, talk to your doctor or dermatologist. You may need a prescription-strength shampoo or more aggressive treatment with a steroid lotion.
- Weston WL, et al. Overview of dermatitis. http://www.uptodate.com. Accessed Oct. 15, 2008.
- Seborrheic dermatitis: What it is and how to treat it. American Academy of Family Physicians. http://familydoctor.org/online/famdocen/home/common/skin/disorders/ 157.html. Accessed Oct. 16, 2008.
- Gupta AK, et al. Skin diseases associated with Malassezia species. Journal of the American Academy of Dermatology. 2004;51:785.
- Satchell AC, et al. Treatment of dandruff with 5% tea tree oil shampoo. Journal of the American Academy of Dermatology. 2002;47:852.
- DeAngelis YM, et al. Three etiologic facets of dandruff and seborrheic dermatitis: malassezia fungi, sebaceous lipids, and individual sensitivity. Journal of Investigative Dermatology Symposium Proceedings. 2005;10:295.
