Dandruff is a chronic scalp disorder that is marked by itching and excessive flaking of the skin. It usually starts between the ages of 10 and 20 and affects up to 40 percent of people over the age of 30.


If you have white flakes that appear in your hair or on your shoulders, particularly after you brush your hair or scratch your scalp, then you may have dandruff.


Factors that can cause the excessive skin scaling associated with dandruff include climate, diet, hormones, as well as skin disorders such as seborrheic dermatitis, psoriasis, and contact dermatitis. Seborrheic dermatitis appears as reddish-looking skin with mild, greasy, yellow scales and plaques with indistinct margins. Psoriasis is associated with silvery, scaly, well-defined plaques. The red, itchy, scaling scalp of contact dermatitis typically results from a sensitivity to certain hair care products or hair dyes.


Start by washing your hair with a gentle nonmedicated shampoo several times a week, massaging your scalp, and rinsing thoroughly. Sometimes this kind of regular attention controls the dandruff. If it doesn't work, ask your pharmacist to recommend a medicated anti-dandruff shampoo.

There are several different kinds of nonprescription medicated shampoos on the market and some have two versions of anti-dandruff treatments - one for oily flakes, and one for dry flakes. The most efffective medicated shampoos contain certain active ingredients such as:

  • selenium sulfide (e.g., Selsun®)
  • salicylic acid (e.g., X-Seb®)
  • ketoconazole (e.g,, Nizoral®)
  • pyrithione zinc (e.g., Dan Guard®, Head & Shoulders®, Sebulon®)
  • tar-based shampoos (e.g., Neutrogena T-Gel®, Spectro Tar®)

If non-prescription preparations are not successful after two weeks when used according to recommendations, or if the condition worsens, consider seeing a doctor, who may prescribe a corticosteroid lotion for the scalp. (Note: Never use corticosteroids for a long time period without advice from a doctor. They can thin out the skin and cause other side effects.)

Who gets dandruff?

Anybody can get dandruff, but certain things can make you more susceptible such as:

  • family: if you have relatives with dandruff, you are more likely to develop it.
  • gender: more men have dandruff, suggesting that male hormones may have a part to play.
  • certain illnesses: individuals with compromised immune systems (e.g., HIV AIDS), those suffering from neurologic diseases such as Parkinson's disease, and those recovering from stressful conditions such as heart attack or stroke are more likely to develop seborrheic dermatitis and dandruff.
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