Dandruff (Seborrhea)

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Dandruff (Seborrhea) Slideshow Pictures

Quick GuideDandruff (Seborrhea) Pictures Slideshow: Causes, Treatments and Prevention

Dandruff (Seborrhea) Pictures Slideshow: Causes, Treatments and Prevention

What treatments are available for dandruff?

Treatment of seborrhea (dandruff) is directed at fighting the skin inflammation. This is done either directly, by using cortisone-based creams and lotions (which reduce inflammation), or by using topical anti-yeast lotions and shampoos. Treatment should be directed at the cause of the dandruff.

What doesn't help dandruff?

  • Moisturizing: Moisturizing lotions don't do much more than smooth out scales and make plaques look redder.
  • Switching brands of shampoo: Shampoo doesn't cause dandruff. However, medicated shampoos (see below) can help.
  • Changing hair-care routines: There is no "right" shampoo or conditioner. What is more important is the frequency with which these agents are used. As a rule, the more frequently one shampoos, the better the result. Seborrhea and dandruff are not caused by excessive shampooing "drying out the scalp." Hair dyes and conditioners do not cause or aggravate dandruff.
  • Switching antiperspirants: When underarms are red from seborrhea, almost anything will make them redder, including antiperspirants, even though they are only aggravating the seborrhea and not causing it.

What over-the-counter products can help dandruff?

  1. Shampoos: Here are some ingredients in medicated shampoos that you can look for to help control dandruff of the scalp. All are available over the counter.One can use any of these either all of the time or just once or twice a week, depending on how severe the symptoms are. If the problem quiets down or disappears, use unmedicated shampoos. If one kind of shampoo works for a while and "runs out of gas," switch to another. For resistant cases, alternate two different types.
  2. Creams: Two additional types of medication that help seborrhea are cortisone creams and antifungal creams.
    • Corticosteroid creams reduce inflammation. These can be purchased 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. One can use scalp corticosteroid creams together with medicated shampoos.
    • Antifungal creams are often 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.

As with shampoos, creams should be applied until the seborrhea subsides. When the seborrhea comes back (and it will, sooner or later), the creams should be used again.

Medically Reviewed by a Doctor on 4/21/2015

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