Beauty

Dandruff is one of the most common scalp complaints there is. A few white flakes on a dark top can make anyone feel self conscious. The good news is that it is usually easy to manage at home.

This guide covers what causes dandruff and how it differs from other scalp conditions. It also explains how to use dandruff shampoo properly and when to get advice. It is general information drawn from Australian health sources.

What dandruff actually is

The Better Health Channel, run by the Victorian Government, describes dandruff as simple scaling of the scalp skin. It says about 50 per cent of people have it at some point. Normally the top layer of skin sheds one cell at a time, so you never notice it. When the scalp is inflamed, cells clump together and the clumps show up as flakes.

Healthdirect is clear that dandruff is not contagious. It is also not a sign of poor hygiene. That matters, because plenty of people feel embarrassed for no good reason. Flakes say more about how your skin reacts than about how clean you are.

Dandruff and seborrhoeic dermatitis

Seborrhoeic dermatitis is a more severe, inflamed form of dandruff. Healthdirect explains that it may be caused by an immune reaction to a tiny fungus called Malassezia. This yeast normally lives on healthy skin near areas that produce oil. Some people simply react to it more than others.

It tends to appear where there are lots of oil glands. That includes the scalp, the face and the torso. Signs include patches of oily, flaking or scaly skin that may be red, itchy or stinging. In babies the same condition on the scalp is called cradle cap.

The Better Health Channel lists several factors linked to more severe seborrhoeic dermatitis. These include stress, genetic factors and winter, when it is usually worse. Some health conditions are also linked, such as neurological disease and HIV. Looking after your stress levels is good for your skin as well as your mood, and eating well can reduce stress too.

Other causes of an itchy, flaky scalp

Not every flaky scalp is dandruff. Psoriasis affects about three per cent of people, according to the Better Health Channel. It often appears on the scalp, elbows and knees. On the scalp it forms small red patches with thick scale, and it can be mistaken for severe dandruff.

Psoriasis has a genetic link and may be triggered by stress. It needs a different approach from simple dandruff. If your flakes are thick, sit on clearly defined red patches or also appear elsewhere on your body, a GP can take a look. Healthdirect says diagnosis is usually made by talking through your history and examining the skin.

Choosing a dandruff shampoo

Shampoo is the first step for most people. The Better Health Channel lists the common active ingredients found in pharmacy products. Reading the label tells you which one you are buying. Products differ, so follow the directions on the pack.

• Zinc pyrithione, also called zinc omadine.
• Selenium sulphide.
• Piroctone olamine, a newer ingredient described as less toxic than zinc pyrithione.
• Antifungal agents.
• Tar, used mainly for more severe scalp conditions.

A pharmacist can help you choose a product that suits your age and health. Healthdirect suggests asking a pharmacist about antifungal options for this reason. Bring a list of any other products you use on your skin and hair. That way they can steer you away from anything that might clash.

How to wash for the best result

Some products are mild enough for daily use, while others are meant for weekly use. People with a scaly scalp are generally advised to shampoo daily. Washing too rarely lets scale build up and can make symptoms worse. Most dandruff shampoos are applied and rinsed out in the same wash.

Conditioner can stop frequent washing from drying out your hair. The Better Health Channel notes a useful detail here. A matching dandruff conditioner may boost the shampoo’s effect by 5 to 10 per cent. A conditioner from a different range may stop the shampoo working.

Patience pays off. Dandruff typically takes 5 to 10 washes to clear. Healthdirect notes that treatment may need to be used often at first, then only when symptoms return. Seborrhoeic dermatitis in adults is often long term and may flare up from time to time.

Feeling confident about your appearance

Flakes are a small thing, but they can affect how you feel. Many people care about the details of their appearance, which is one of the reasons people whiten their teeth. A big event can make these things feel more pressing. Before a wedding, add scalp care to the list alongside those wedding day questions you meant to ask.

Starting a regular routine a few weeks out gives the shampoo time to work. Light coloured clothing hides flakes better than dark colours while you wait. Like knowing how to combat sensitive teeth, it comes down to the right product used consistently. Small daily habits usually do more than one big effort.

When to see a doctor

Healthdirect suggests seeing a doctor if symptoms do not improve, suddenly get worse or interfere with daily life. The same applies if your scalp is causing you anxiety or embarrassment. For severe dandruff that does not respond to shampoos, the Better Health Channel says corticosteroid lotions can relieve symptoms. A doctor may refer more severe cases to a dermatologist.

For babies, see a doctor or maternal and child health nurse if cradle cap does not improve or spreads. The skin underneath can become infected and may need treatment. Healthdirect says cradle cap usually clears up within 6 to 12 months. The healthdirect dandruff page has more detail on care for infants.

Frequently asked questions

Is dandruff caused by not washing my hair?

No. Dandruff is not a sign of poor hygiene and is not contagious. That said, washing too rarely can let scale build up and make flakes worse.

How long does dandruff shampoo take to work?

The Better Health Channel says dandruff typically takes 5 to 10 washes to clear. Keep using the product as directed while you wait for results. If nothing has changed after that, a pharmacist or GP can suggest next steps.

Why is my dandruff worse in winter?

Seborrhoeic dermatitis is usually worse in winter. Stress and genetic factors are also linked to more severe flares, according to the Better Health Channel. Sticking with your routine through the cooler months can help keep flakes under control.

Can I use any conditioner with dandruff shampoo?

It is best to use the matching conditioner from the same range. A conditioner from a different range may stop the shampoo working properly. A conditioner also helps stop frequent washing from drying out your hair.

This article is general information only and is not medical advice. Please speak with your doctor or a qualified health professional about your own situation.