Treatment for Dandruff

Dandruff is a very common skin condition characterized by dry, fine flaky skin on the scalp with areas of pink or red inflamed skin. It is seen in all ages from babies to the elderly, it affects almost half of the population at the pre-pubertal age. Dandruff affects not only scalp, but also the eyebrows, ears, sides of nose, beard and less commonly central part of the chest.

Seborrheic dermatitis is a severe form of dandruff which causes intense itching, burning and redness, along with flaking. Dandruff tends to be a chronic or recurrent disorder with periodic ups and downs, with proper treatment it can be controlled effectively. Dandruff treatment includes self-care at home, medical treatment and medications.

Self-Care at Home

Home care includes daily shampooing with proper over-the-counter cleansers such as ketoconazole or selenium sulfide. Along with the scalp, all affected areas should be washed with the therapeutic shampoo. People who shampoo less are usually prone to dandruff. Inflammation of the scalp skin can be treated with over-the-counter topical applications such as mild cortisone creams or 1% hydro-cortisone lotions.

These topical applications should be applied for two to four weeks for better results. For those desiring natural treatments, white vinegar can be used to clean the scalp which has natural cleansing properties. Since dandruff tends to be chronic, results may not be quick, long term skin and hair care is required to control dandruff.

Medical Treatment

In Seborrheic dermatitis, once the diagnosis is confirmed, the main treatment includes antibacterial cleansers, anti-fungal shampoos and anti-inflammatory creams and lotions. Combination treatments using several different medicated ingredients at the same time are the most effective dermatological treatments for severe dandruff.

If the dandruff does not come under control with standard prescription, see a dermatologist. As an added treatment, dermatologists may prescribe a skin care routine for mild, moderate and severe dandruff.

Routine for Mild dandruff

Step 1 – scalp wash daily or alternate day with ketoconazole or ciclopirox shampoo.
Step 2 – application of hair conditioner on hair [avoid using on scalp] as needed. If symptoms are more severe daily scalp wash is required.

For Moderate dandruff

Step 1 – scalp wash with ketoconazole or ciclopirox shampoo daily.
Step 2 – application of hair conditioner on hair as needed.
Step 3 – Application of fluocinonide or clobetasol solution on the scalp once or twice a day for itchy skin.

Severe dandruff

Step 1 – Wash your scalp with tar shampoo and rinse.
Step 2 – Wash with salicylic acid shampoo and rinse scalp.
Step 3 – Wash with ketoconazole or ciclopirox shampoo [leave it for 5 minutes on the scalp] and rinse scalp.
Step 4 – Apply conditioner as needed.
Step 5 – Apply clobetasol foam or solution to the scalp once or twice a day for itchy, inflamed areas.
Step 6 – special nourishing bedtime treatment with Dermasmoothe under a shower cap and rinse scalp in the morning.

Oral Medications

Rarely, in severe cases, short-term treatment with oral anti-fungal pills and/or oral steroids such as prednisone, may be required. Oral medications are not the mainstay of dandruff treatment and should not be used on routine basis.