Patient Basics: Dandruff

Dandruff is flaking of the scalp, with white or yellowish flakes of dead skin that show up in the hair and on dark clothes. It often itches. It is a mild form of a common skin condition called seborrheic dermatitis and has nothing to do with being unclean. Dandruff can’t be cured for good, but the right shampoo, used the right way, keeps it under control for most people.

Key points

• Dandruff is linked to a yeast called Malassezia that lives on everyone’s scalp and feeds on skin oil.
• Over-the-counter dandruff shampoos work for most people. Look for ketoconazole, zinc pyrithione, selenium sulfide, salicylic acid or coal tar.
• Leave the shampoo on your scalp for about 5 minutes before rinsing.
• Dandruff often comes back, so most people keep using a dandruff shampoo once or twice a week.
• See a doctor if your scalp is very red, sore or oozing, or if dandruff doesn’t improve after a few weeks of treatment.

What causes dandruff

Your scalp sheds skin cells all the time, usually too small to see. With dandruff, the scalp sheds faster and the cells clump into visible flakes. The main trigger is the Malassezia yeast. It breaks down scalp oil into substances that irritate the skin in some people, which speeds up shedding. Things that make dandruff more likely or worse include:

• Oily skin and the teen and adult years, when oil glands are most active
• Cold, dry weather, so dandruff is often worse in winter
• Stress and lack of sleep
• Washing hair less often, which lets oil and flakes build up
• Some health conditions, such as Parkinson’s disease and HIV

Dandruff is not contagious.

Dandruff or dry scalp?

A dry scalp gives small, white, powdery flakes, often with dry skin elsewhere on the body. It gets better with a gentle moisturizing shampoo and fewer hot showers. Dandruff flakes tend to be larger, a little oily or yellowish, and the scalp may be itchy or pink. Other conditions can look like dandruff:

• Seborrheic dermatitis beyond the scalp, with red, scaly patches on the eyebrows, sides of the nose, behind the ears or on the chest
• Scalp psoriasis, with thick, silvery scales on clear patches that often go past the hairline
• Contact dermatitis, an itchy reaction to hair dye or another hair product
• Scalp ringworm (tinea capitis), a fungal infection mostly in children, with scaly patches and broken hair. It needs antifungal pills from a doctor.

How to get rid of dandruff

Choose a dandruff shampoo

Dermatologists suggest picking by active ingredient, not brand. Each works a little differently:

• Ketoconazole fights the yeast. The 1% strength is sold over the counter, and 2% needs a prescription.
• Zinc pyrithione fights yeast and bacteria.
• Selenium sulfide slows shedding and fights yeast. It can discolor blond, gray or color-treated hair, so rinse well.
• Salicylic acid loosens scale so it washes away. It can dry the scalp.
• Coal tar slows skin cell turnover. It has a strong smell, can stain light hair and makes the scalp more sensitive to sun.

If one shampoo stops working, switch to another with a different ingredient, or take turns with two.

Use it the right way

• Massage the shampoo into the skin of your scalp, where the flakes form.
• Leave it on for about 5 minutes, then rinse well. This gives the ingredient time to work.
• Use it 2 or 3 times a week until flakes clear, then once or twice a week to keep them away. Use your regular shampoo on other days if you like.
• Use conditioner on the lengths of your hair if the shampoo feels drying.
• If you have tightly coiled or textured hair that you wash less often, using a dandruff shampoo once a week and a scalp moisturizer may be enough. Ask a dermatologist which products fit your hair.

Prescription treatment

For stubborn dandruff, a doctor may prescribe ketoconazole 2% or ciclopirox shampoo, a steroid solution or foam to calm redness and itching for a short time, or a nonsteroid foam called roflumilast.

Home remedies

Tea tree oil shampoo eased dandruff in a small study, but tea tree oil can cause an itchy allergic rash. Oils such as coconut or olive oil soften flakes, but they don’t treat the yeast and may feed it. Apple cider vinegar hasn’t been shown to help and can irritate the skin. Regular washing, managing stress and getting enough sleep may help keep flare-ups down.

Dandruff in babies

Thick, greasy, yellow scales on a baby’s scalp are called cradle cap. It is the same condition and usually clears by the first birthday. Gently wash with baby shampoo and loosen the scales with a soft brush. Ask your pediatrician before using any dandruff shampoo on a baby.

When to see a doctor

• Flakes and itching don’t improve after 4 to 6 weeks of regular dandruff shampoo
• Your scalp is very red, swollen, sore or oozing
• Thick scale or rash spreads to your face, ears or chest
• You notice patches of hair loss
• Your child has scaly patches with broken hairs

Common questions about dandruff

Is dandruff dead skin?

Yes. Dandruff flakes are clumps of dead skin cells shed from the scalp. Everyone sheds scalp skin, but with dandruff the scalp sheds faster, so the cells clump into flakes big enough to see. Irritation from the Malassezia yeast is the main reason for the faster shedding.

How long does dandruff last?

Dandruff tends to be a long-term problem that comes and goes. A good dandruff shampoo usually clears flakes within 2 to 4 weeks. Flakes often come back if you stop entirely, so most people keep using it once or twice a week. Many find it eases with age.

Does dandruff cause hair loss?

Dandruff itself doesn’t usually cause lasting hair loss. Hard scratching can break hairs, and severe inflammation may increase shedding for a while. Hair usually grows back once the scalp calms down. Patchy hair loss with scaling should be checked, because ringworm and other conditions need different treatment.

Questions to ask your doctor

• Is this dandruff, psoriasis or something else?
• Which shampoo ingredient would suit my hair and scalp?
• How often should I wash with it?
• Do I need a prescription treatment?

Learn more

• Dandruff (NHS)
• Seborrheic dermatitis (MedlinePlus, U.S. National Library of Medicine)

This guide is general information and doesn’t replace advice from your own doctor. Last updated October 2026.