What is dandruff?

Dandruff is very common. It is usually not dangerous nor can it be passed on to others. However, it can be troublesome and embarrassing to live with.

The main symptom of dandruff is the presence of grey or white flakes in the scalp or hair. It can also cause itching or dryness.

If dandruff is caused by a condition known as seborrhoeic dermatitis, you may also have scaly or itchy skin. This can affect parts of the body other than the scalp, like the face and ears.

Cradle cap is a form of seborrhoeic dermatitis that can affect babies, causing dandruff and scaly, yellow, greasy patches on the scalp.

What causes dandruff?

Your skin cells are constantly being renewed: your body produces new skin cells to replace old ones. Dandruff typically occurs when your skin cells start to renew too quickly, causing flakes of dead skin to form on the scalp and appear in the hair.

Common causes of a flaky scalp include:

• seborrheic dermatitis - a condition caused by an overgrowth of yeast which can cause itchiness and flaking on the scalp and elsewhere on the body
• psoriasis - a skin condition that causes red, flaky, crusty patches on the skin that can also be covered in silvery scales
• eczema - a skin condition that causes red, dry, flaky, itchy skin
• tinea capitis (scalp ringworm) - a fungal infection
• allergic contact dermatitis - an allergic reaction to hair products like mousse or hair dye
• a weakened immune system (which can be caused by treatment like chemotherapy, certain medications, or conditions like HIV)

Not washing your hair does not cause dandruff, but flakes may be more visible if you don’t wash your hair often.

Home remedies for dandruff

Dandruff can often be treated at home without the help of a doctor. Simple self-care techniques you might want to try include:

• avoiding irritating hair products like gels, dyes or hairsprays
• massaging your scalp gently when you wash your hair (rather than scratching)
• buying an anti-dandruff shampoo

Some health websites may recommend natural remedies such as apple cider vinegar for dandruff, but there is not enough evidence to prove their effectiveness.

Additionally, certain natural remedies for dandruff can be harmful. Consult your doctor if you are interested in using a natural remedy for dandruff but are unsure of its safety.

Non-prescription shampoos for dandruff

Anti-dandruff shampoos will typically contain at least one of the following ingredients which can help improve the symptoms of dandruff:

• zinc pyrithione
• salicylic acid
• selenium sulphide
• ketoconazole
• coal tar

Ask your pharmacist for advice if you’re not sure which ingredient might be best for you. You might have to try a few anti-dandruff shampoos before you find one that makes a difference.

To get the most out of your shampoo, leave it in your hair for about five minutes before rinsing. You may also need to use each shampoo for at least a month before judging its effectiveness as it can take time to see results.

Once you have found a suitable shampoo, you may need to use it regularly to prevent the condition from coming back.

The National Institute for Health and Care Excellence (NICE) has information about some brands of anti-dandruff shampoo available without a prescription in the UK.

Coconut oil for dandruff

Coconut oil and olive oil are recommended in the treatment of dandruff by NICE as they can help soften crusting or scaling of the skin.

For treatment to be effective however, these oils still need to be followed by an anti-dandruff shampoo.

NICE and the National Health Service (NHS) also recommend using a natural oil like olive oil or coconut oil to help treat cradle cap in babies. This can be applied overnight and removed the following day by gently washing the baby’s scalp with a baby shampoo.

Conclusion

Dandruff can be a persistent and distressing condition, but there are treatments available that might help to relieve your symptoms.

Dandruff can take time to respond to treatment, but if you are still experiencing symptoms after trying an anti-dandruff shampoo for at least a month, it might be time to speak to your doctor.