Severe Dandruff causes itchy scalp
Severe Dandruff can be controlled with proper treatment

Common doubts about dandruff answered

Being a common disease, and, an exaggerated physiological process, there are many frequently asked questions about dandruff that need be answered.

Most frequently asked questions about dandruff cover the causes of dandruff, the most effective treatments available and effectiveness of medicated antidandruff shampoos.

What is Dandruff?

Dandruff scales are visible flakes of skin that are continuously shed from the scalp. This is a normal physiological process that is exaggerated in some individuals.

What is the Cause of Dandruff?

People with dandruff have large numbers of a tiny fungus, the yeast Pityrosporum ovale, on the scalp. These stimulate the superficial cells of the skin to flake faster, which becomes visible on the scalp.

What are the Signs and Symptoms of Dandruff?

Symptoms of Dandruff: Itchy scalp is the classical symptom of dandruff. Most people have dead epidermal cells fall onto their shoulders and dresses. Rarely scratching of the scalp can cause secondary inflammation and infection.

Signs of Dandruff: Dryness and scaling are the signs of dandruff. The scales may be either dry or greasy. In severe cases, the scales may be visible on the face, behind the ears, on the eye lashes (blepharitis) and front and back of chest. Tinea versicolor may coexist with severe dandruff.

What are the aggravating  or triggering factors for Dandruff?

Dandruff may be exacerbated following stress, alcohol ingestion, certain medications like steroids, oral contraceptive pills, hot spicy foods, and can get converted to the severe inflammatory type of seborrheic dermatitis n immune deficient states like HIV, diabetes or in diseases like Parkinsonism. Dandruff is also aggravated in cold climates.

Is There a Cure for Dandruff?

As it is an exaggerated physiological process, dandruff can only be controlled, not cured. Any treatment claiming to be a dandruff cure  is probably a scam.

How to Get Rid of Dandruff?

The treatment of dandruff  includes regular cleansing of the scalp with an antidandruff shampoo containing antifungal medications like ketoconazole (e.g. nizoral shampoo), climbazole, zinc pyrithione , pyrictone olamine etc. Selenium sulphide, tar and salicylic acid shampoos also help to get rid of dandruff.

Are there any Systemic Medications Used in Dandruff?

Vitamin B complex and Vitamin A have been reported useful as adjunctive in the treatment of dandruff. Systemic antifungal medications like ketoconazole is used in treatment resistant moderate to severe cases of dandruff.

Which is the Most Effective Anti-dandruff Shampoo?

In mild dandruff, regular washing with a normal, ‘daily use, with moisturizer’ shampoo is enough. In moderate to severe dandruff, medicated anti-dandruff shampoos with antifungal agents as mentioned above are helpful. To start with, medicated shampoos should be used every alternate day.  Once the dandruff is controlled, then a maintenance application of weekly once will help keep the disease under control.

Are There Any Effective Natural Herbal Home Remedies for Dandruff?

There are many home remedies available for dandruff, ranging from warm coconut oil to lemon in cider vinegar. Oily applications are best avoided in wet or greasy dandruff, as these may actually aggravate the situation. Some of the home remedies for dandruff are effective, but the evidence is only anecdotal; meaning, no clinical trials have been conducted to prove the claims.

Are Herbal Shampoos Better and Safer Than Medicated Shampoos in the Treatment of Dandruff?

The anti-yeast properties of herbal shampoos are not proven. Whether herbal or medicated, all shampoos are made up of the cleansing agent (detergents), with other substances like foaming agents, thickeners, softeners or conditioners, coloring agents, preservatives, fragrances, opacifiers etc.  Only the active ingredients differ.

Hence being herbal does not guarantee more effectiveness or safety than the medicated shampoos. In fact it could be even the opposite, as herbal shampoos contain unproven or untested ingredients; actually, medicated and proven shampoos may be more effective and safer.


The information given in this article is for educational purpose only so that patients are aware of the options available for diagnosis and treatment of common skin, hair and nail diseases. No diagnosis should be made or treatment undertaken without first consulting your dermatologist. If you do so, the author will not be responsible for any consequences. The images provided are for illustration purpose only and should not be reproduced without the consent of the author.

About the Author of Skin Care Tips from Dermatologist: Dr Hanish Babu, MD
Dr Hanish Babu, MD, Dermatologist, Sharjah and Ajman, UAE
Dr Hanish Babu, MD

Dr Hanish Babu, MD is a dermatologist with more than 3 decades of experience in treating skin and sexually transmitted diseases in UAE and India. He has been practicing in UAE since last 22 years. He is a respected speaker during the Continuing Medical education Programmes for doctors, medical students and paramedical staff and is also a Stress Management Trainer. He organises group therapy sessions for patients with psoriasis, eczema and vitiligo.

He is available for consultation at Cosmolaser Medical Centre in Samnan, Sharjah (06 5678 200) from 9 am – 1 pm and at City Medical Centre, Al Bustan, Ajman (06-7 441 882) from 4.30 pm – 9.30 pm.

Visit his personal website for more details and for educational articles on Skin, hair, nail and sexually transmitted diseases. Click here to Book an Appointment with dermatologist Dr Hanish Babu, MD

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