Dr. Louise Achey
Q: What is the best way to get rid of my annoying dandruff?
One of the most common skin conditions globally, nearly one-half of adults will experience the frustration and embarrassment of dandruff.
Dandruff happens when the skin cells on the skin of your scalp build up into thickened layers, then peel off as grayish-white flakes on your shoulders and upper back. Changes in your skin’s oil production, physical or emotional stress, cold weather, and hormone changes can each trigger dandruff.
How °alassezia. If the top layer of your skin becomes damaged, that balance can get disrupted. If Malassezia is allowed to multiply beyond a healthy level, those additional organisms create byproducts that are irritating to your skin. This damages it further, triggering skin cells to multiply and stick together in thickened clumps, called scales. These scales eventually peel off as grayish-white flakes that show up in your hair and on your shoulders.
What is the best way to fight dandruff?
There are several products available. Antifungal shampoos are your best choice. They suppress the growth of Malassezia fungus. Shampoos containing a keratolytic loosen the skin cells clumped together, called scales, and work more slowly. Coal tar shampoos interfere with the growth of excess skin cells, reducing scale formation, and are the least effective.
Three antifungal shampoos are available without a prescription. The oldest product is pyrithione zinc, the active ingredient in Head and Shoulders® shampoo. Selenium sulfide is considered more effective than pyrithione zinc, and is available as 2.5% shampoo which is prescription only (Selsun®), and as 1% non-prescription shampoo, Selsun Blue®.
If pyrithione zinc and selenium sulfide don’t help, try ketoconazole (Nizoral®) shampoo. Initially available only by prescription, in 1997, the Food and Drug Administration (FDA) allowed Nizoral® to be sold without a prescription.
Other medicated shampoos marketed for dandruff work differently. Instead of attacking the Malassezia fungus, salicylic acid and sulfur are keratolytics: they dissolve the keratin that holds your skin cells together. Shampooing with these agents helps remove scales.
Coal tar shampoos are not nearly as effective as antifungal or keratolytic shampoos. Coal tar work to suppress excess skin cell growth, discouraging the creation of scales. Although coal tar shampoos smell pungent, if you rinse thoroughly, the smell fades as your hair dries.
When using a medicated shampoo, start by shampooing every day for the first week, then 2-3 times weekly for the next 2-3 weeks. Once your dandruff is under control, you can alternate with non-medicated shampoos. Dandruff can be persistent; you may need a medicated shampoo once weekly to maintain control.
Medicated shampoos can dry out your hair and scalp. Applying a hair conditioner after rinsing out a medicated shampoo won't interfere with its effectiveness, but may help reduce minor scalp irritation and ease itching.
Here 5 Ways to Help Defeat Dandruff:
1. Be gentle.
To minimize scalp irritation that can encourage dandruff, try shampooing with non-medicated shampoo. To help loosen scales, soften them with mineral oil, coconut, or olive oil for at least 30 minutes before shampooing. If you have long hair, wetting it before applying the oil keeps it from soaking into your hair instead of your scalp. You can also use oil at night, gently scrub it into your skin with a toothbrush, and follow with shampoo in the morning.
2. Don't rush.
Keep medicated shampoo on your hair for at least 5 minutes. When you start your shower, lather up with your medicated shampoo, then complete your shower before rinsing thoroughly.
3. Beware of staining.
Coal tar can stain light hair, skin, and clothing. Selenium sulfide can stain your scalp, light-colored hair, and clothing yellowish brown.
4. Chill out.
Physical or emotional stress can aggravate dandruff. Try getting more rest, or add a calming practice to your day, like meditation or yoga.
5. Consult your doctor.
Dandruff is a mild form of a more severe skin condition called seborrheic dermatitis. Consult your doctor if you notice yellow, oily, scaly patches on your face, ears, or armpits, develop red, inflamed areas on your scalp or skin., or if you don't see any improvement in 4 weeks.
Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and the author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog, TheMedicationInsider.com.©2022 Louise Achey
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