How to Get Rid of Dandruff, According to a Dermatologist

If you've struggled to get rid of dandruff, finding the best anti-dandruff shampoo for your scalp's needs may make all the difference.

Hair Health Hotline: How Can I Combat Dandruff?
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Hair Health Hotline is your direct access to dermatologists, trichologists, hairstylists, and other beauty pros. Each story in this series tackles a common hair or scalp concern and offers science-backed solutions to care for your strands.

Dandruff is like a clingy, lovelorn ex, in that it can be generally unpredictable and linger around despite your best efforts to cut ties. And that can be a frustrating scenario since dandruff often results in visible flakes and an uncomfortable itch.

Needless to say, if you've been experiencing this particular scalp concern, the question of how to get rid of dandruff fast is probably top of mind. To help guide you to a flake-free existence, Caroline Robinson, M.D., F.A.A.D., founding dermatologist at Tone Dermatology, is breaking down the causes of dandruff and a four-pronged approach to combatting the issue.

Q: I've been experiencing flaking and there are so many dandruff products out there. I'm stumped about how to get rid of dandruff — where do I start?

A: For many people, switching to an over-the-counter anti-dandruff shampoo is enough to eliminate flaking. For others, a dermatologist may need to prescribe a treatment plan, says Dr. Robinson.

That may sound overly simple, as dandruff can be a tricky condition to wrap your head around. It's "one of the most poorly understood scalp conditions and one of the trickiest thing to treat," as Dr. Robinson puts it.

For one thing, "dandruff exists on a spectrum," says Dr. Robinson. "In dermatology, we recognize dandruff and another more severe form of dandruff called seborrheic dermatitis. And this form of dandruff has more scaling. It can have more redness, more itching, and more severe symptoms."

What causes dandruff and seborrheic dermatitis?

Three factors contribute to dandruff and seborrheic dermatitis, according to Dr. Robinson:

  1. An overproduction of your scalp's natural sebum (aka oil) production.
  2. A fungus called Malassezia that naturally lives on your scalp. It breaks down fatty acids from the aforementioned oils, and in people who are susceptible to dandruff, the broken down fatty acid product causes inflammation. Your skin responds by producing more skin cells. Enter: flaking.
  3. Genetics. If your parents dealt with dandruff, you're more likely to get it.

Flakes can also result from having a dry scalp, says Dr. Robinson. "Dry scalp doesn't have a specific medical diagnosis," she says. "I tell patients the analogy is that dandruff and seborrheic dermatitis are more like oily flaking, and then dry scalp is more like dry flaking. That's not a hard and fast rule, but it just kind of helps you distinguish the two a little bit and understand the complexities of dandruff and seborrheic dermatitis."

Question: How Can I Combat Candruff?

How can you get rid of dandruff?

It can be tough to figure out whether you have seborrheic dermatitis or flaking from scalp dryness. "A trained dermatologist can tell the difference between dry flakes related to dryness of the skin of the scalp versus flaking related to seborrheic dermatitis, but it's really difficult for the average person to distinguish the two," says Dr. Robinson

Luckily, your plan of attack should be the same, regardless of which issue is causing your flaking. "My recommendation is that if your symptoms are mild, it's totally fine to try an anti-dandruff shampoo," says Dr. Robinson. "And then you can even alternate with a hydrating shampoo, and find one that helps more with your symptoms. However, if your symptoms are more severe, I would recommend just going to a dermatologist to get that diagnosis." Below, you'll find more specifics on how to get rid of dandruff.

Switch to an anti-dandruff shampoo.

You've probably noticed that a whole slew of shampoos on the market are labeled as anti-dandruff formulas. These are the best place to start, says Dr. Robinson. "A lot of the anti-dandruff shampoos help either directly decrease the amount of yeast on the scalp, or they help break up the skin cells in flakes so the flakes are removed more easily, or they will help control oil on the scalp," she says.

These shampoos contain ingredients that are listed on the Food and Drug Administration's monograph for dandruff treatment, such as salicylic acid, pyrithione zinc, and selenium sulfide, notes Dr. Robinson.

It takes some trial and error to find which ingredient is most effective for your individual needs. "I think there's a huge misconception that how you treat your dandruff depends on your hair type," says Dr. Robinson. "And I do think there's a little bit of history to that because, historically, maybe the formulas surrounding the active ingredient in anti-dandruff shampoos, certain [formulas]were a little bit harsher for certain hair types. But nowadays a lot of the formulas are really designed for all hair types."

With that in mind, it's helpful to give each ingredient a chance. "Some people with dandruff have more flaking than others," says Dr. Robinson. "Some have more itching, some have more redness, some have more oil. And finding the ingredients that work a bit better for you based on your symptoms rather than your hair type is going to be helpful." For example, while salicylic acid stands out for its ability to regulate oil production, pyrithione zinc has powerful anti-inflammatory effects, so it's very helpful if you have a lot of redness and itching, she notes. It helps to leave an anti-dandruff shampoo on for five minutes — or slightly less if you're sensitive — before rinsing, to give the ingredients time to work, as Shape previously reported.

Skip the DIY remedies.

If you're considering trying a DIY remedy before purchasing a dandruff-fighting shampoo, reconsider, says Dr. Robinson. "Unfortunately, despite what the internet says, a lot of the natural remedies for dandruff and for the scalp in general just do not have any evidence to support that they're helpful," she says.

One popular option, in particular, can completely backfire. "Something I see a lot is the use of a topical coconut oil on the scalp, and I think it's important to dispel that myth right now because topical coconut oil actually has a high concentration of a lauric acid, which is a fatty acid that helps the yeast survive on the scalp," says Dr. Robinson. "So [coconut oil] actually makes dandruff and seborrheic dermatitis much worse. And it makes [seborrheic dermatitis and dandruff] difficult to treat, even if you're using the appropriate treatment."

Revisit how often you wash your hair.

Washing your hair helps prevent oil build-up, so it's key to wash your hair frequently enough. "A common theme that I see that contributes to seborrheic dermatitis is washing frequency," says Dr. Robinson. "And I think in patients with more tightly coiled hair, there is a tendency to wash less frequently for a number of reasons. I often have patients increase their washing frequency to at least weekly after I start the treatment so that I can see if other factors need to be modified," e.g. the strength of the treatment. (Here's a detailed look at how often you should wash your hair.)

If you're starting out with an anti-dandruff shampoo, use the shampoo every time you wash your hair, suggests Dr. Robinson. As for how to get rid of dandruff permanently, that's going to require continuous treatment. "Dandruff will come back because it's a chronic condition," says Dr. Robinson. "So once you reach symptom control, the best course of action is to decrease [use] very slowly. You can go to every other wash. Then you can maybe go to once a month and just find the minimum frequency that will help you stay clear for longer, rather than stopping cold turkey."

Don't hesitate to consult with a dermatologist.

As mentioned, if you're dealing with severe dandruff symptoms, it's best to head to a dermatologist from the jump rather than trying to solve your dandruff on your own. The same goes if you have mild symptoms but find that anti-dandruff shampoos aren't giving you results. "Typically, if you are using an anti-dandruff shampoo over-the-counter for symptoms that have just started, you should see relief within two to three washes," says Dr. Robinson. "And if you're not seeing some sort of improvement in your symptoms then I would strongly recommend seeing a board-certified dermatologist for treatment."

They may suggest a stronger treatment than what you can buy over-the-counter. "We often prescribe something anti-inflammatory like a topical steroid or some topical anti-inflammatory, and then couple that with a prescription shampoo, which can be a bit more effective," says Dr. Robinson.

There's also a chance they'll diagnose you with an entirely different condition. "Just because your scalp is itchy or flaky doesn't necessarily mean you have dry scalp or dandruff," says Dr. Robinson. "There are so many other things that can cause dryness and flaking on a scalp, like psoriasis and allergic contact dermatitis. So I do think, especially if you've been struggling for some time, that it's so important to figure out exactly what the cause of the flakes is."

Dandruff is a complicated issue, but there are tried-and-true treatment options you can rely on. Depending on your symptoms, your first order of business should be to either try anti-dandruff shampoos or to head to a doctor who can help you come up with a treatment plan.

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