‘Dandruff’ – excessive scaling of the scalp

Dandruff is the shedding of dead skin cells from the scalp. It is a common chronic scalp condition marked by itching and flaking of the skin on your scalp.

Seborrheic dermatitis is quite a common skin condition that affects the scalp causing an itchy scalp and scaly or flaky skin and stubborn dandruff.

Dandruff and seborrheic dermatitis each cause scaling on the scalp that is often associated with itching. There are, however, distinctions between the two disorders. Dandruff is non-inflammatory, increased scaling on the scalp that represents the more active end of the spectrum of physiologic desquamation.

Seborrheic dermatitis is an inflammatory, erythematous, and scaling eruption that occurs primarily in “ seborrheic “areas i.e. those with high number and activity of sebaceous glands, such as the scalp, face, and trunk.


The common symptoms of dandruff include itching and white, oily flakes. There are several conditions including psoriasis, dry skin, seborrhoeic dermatitis, or contact dermatitis, which present similar symptoms. Before beginning treatment for dandruff, it is important to consult the dermatologists to make sure you’re treating the right condition.


  • Seborrheic scalp
  • Increased oil activity
  • Unclean habits- Not shampooing often enough
  • Stress and Emotional problem
  • Hard shampoos
  • Exposure to severe cold
  • Sensitivity to hair care products
  • Pityrosporum oval organism (yeast)


  • Dandruff can almost always be controlled, but dandruff treatment may take a little patience and persistence.
  • Daily cleansing with a gentle shampoo to reduce oiliness and skin cell buildup can often help mild dandruff.
  • Dandruff shampoos are classified according to the medication they contain –
  • *Zinc pyrithione shampoos, contain an antibacterial and antifungal agent ( zincpyrithione) which has been to fight the fungus that causes dandruff.
  • * Tar-based shampoo, contain coal tar, which slows cell turnover and reduces the formation of dandruff’s scaly flakes.
  • * Shampoo containing salicylic acid
  • * Selenium sulfide shampoos- Can prevent cell turnover and may help control the Malassezia fungus. These types of shampoos may discolor blond or gray hair and can cause significant discoloration in chemically treated hair, so follow the directions carefully and rinse well.
  • * Ketoconazole shampoo contains a broad antifungal agent.
  • * Topical corticosteroid for severe seborrheic dermatitis Creams- two additional types of medication that
    Help seborrhea and cortisone creams and antifungal creams together with medicated shampoos.

Cortisone Creams Reduce Inflammation – It can be taken over the counter in either 0.5% or 1% concentrations. They are safe to use on the face and will often help in just a couple of days when applied twice daily. These products also are available as scalp lotions that are applied once a day, preferably on damp hair after shampooing. You can use scalp cortisone creams together with medicated shampoos.

Antifungal Creams -are more effective apparently because they reduce the number of yeast organisms living on the skin. Over the counter creams include 1% clotrimazole cream and miconazole cream 2% antifungal creams also are applied once or twice a day.

*Oral treatment

Try using one of these shampoos daily or every other day until your dandruff is controlled, then cut back to two or three times a week, as needed.

If you’ve shampooed faithfully for several weeks and there’s still a dusting of dandruff on your shoulders, talk to the dermatologist. Stronger treatments should be taken only after the prescription.