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Dandruff is a common problem, affecting 15 to 20 per cent of the population. Dandruff is formed when dead skin cells are shed from the scalp, as small white or yellow flakes. You may see them in your hair or they can fall off onto your shoulders, especially when brushing your hair. The cause of dandruff isn’t fully understood, but a variety of factors are thought to be involved, including a type of yeast on the scalp called Malassezia. Seborrhoeic dermatitis, of which dandruff is a type, can affect other areas, including the face, eyebrows, beard area, chest and arms.
Sometimes dandruff can cause mild burning or itching on your scalp. There is usually no redness of the scalp unless you have scratched the area due to an itch. Dandruff is not infectious and can’t spread from person to person; it is not a sign of bad hygiene.
Dandruff tends to come and go over time. It can usually be treated effectively but often returns after treatment stops.
- if your scalp is very itchy or has sores or crusts
- if your scalp has lumpy or irregular patches
- if other parts of your body are also affected, such as your eyebrows, forehead or ears
- if you have patchy hair loss
- if the person with dandruff is under 12 years old, pregnant or breastfeeding
- if you have tried a number of anti-dandruff shampoos and the dandruff hasn’t resolved
- if you have started to use new hair products when symptoms appeared
- avoid wearing dark clothes while your dandruff is particularly bad
- don’t use hair spray or other products that can irritate your scalp, such as hair dyes
- some treatments may work better than others; you may need to try several. Use a product for about 1-2 weeks then review the results – if there are no improvements with the treatment, consider changing to another product or combination therapy
- dandruff is likely to return so you may need to treat it again, or from time to time
- follow directions on the shampoo label; if it irritates or burns your scalp, rinse it away thoroughly and don’t use it again. Ask for advice from your pharmacist on choosing a different product
- do not use dandruff products if your skin is broken, and avoid contact with your eyes
- some treatment options may stain skin, hair or clothes
- always ask a healthcare professional before using any treatment options for children under 12, pregnant and breastfeeding women
- wash hand immediately after use
- products which cause increased sensitivity to sunlight can lead to sunburn. It is very important to wear sunscreen on the treated and exposed areas to prevent sunburns and further irritation to the areas
- use soap-free shampoos and conditioner to prevent further irritation to the affected areas. Do not use harsh products or chemicals as this may aggravate the areas and potentially cause the symptoms to worsen
e.g. Head & Shoulders, Polytar, Sebitar, Neutrogena T/Gel, Selsun preparations, Hair Science Anti-Dandruff Shampoo; ketoconazole 1% (Nizoral 1% Shampoo)
- ketoconazole 1% can be used regularly (up to twice a week)
e.g. ciclopirox (Stieprox), ketoconazole 2% (Nizoral 2% Shampoo, Sebizole Shampoo)
- shampoos containing zinc pyrithione, such as Head & Shoulders; selenium sulphide, such as the Selsun range; and coal tar, such as Polytar, Neutrogena T/Gel and Sebitar help relieve scaling and itching. They help stop the growth of some yeasts and fungus and help treat dandruff
- keratolytic agents (included in products such as Hair Science and Sebitar) help by removing scales of dead skin from the scalp
- do not use selenium sulphide-containing shampoos, such as the Selsun range, for 48 hours before or after colouring, bleaching or perming your hair. Selenium sulphide may discolour jewellery
- coal tar products, such as Polytar Plus and Sebitar, can make your scalp more susceptible to sunburn, so avoid strong sunlight. Coal tar products are best avoided during pregnancy and breastfeeding unless recommended by your doctor. These products may stain bed-linen, towels and clothing, so rinse thoroughly
- ketoconazole and ciclopirox are very effective antifungals which stop growth of yeast and other fungal infections, providing relief from dandruff. They are often successful when other treatments have failed
- ketoconazole 2% shampoos should be massaged into the scalp and left for three to five minutes before rinsing. Use twice a week for two to four weeks. Leave at least four weeks before repeating the course (the 1% strength [available by general sale] can be used regularly, up to twice a week)
- ciclopirox (Stieprox) should be used two or three times a week. Apply twice each time, rinsing between applications. Leave in hair for a total of three to five minutes over the two applications
- any other shampoo product can be used on the days when the ketoconazole or ciclopirox shampoo isn’t being used
- ketoconazole and ciclopirox shampoos may occasionally cause discolouration of white, grey or artificially coloured or damaged hair. They are best avoided during pregnancy and breastfeeding unless recommended by your doctor
Other dandruff products
e.g. tea tree oil shampoos
- there is some evidence that tea tree oil shampoos can improve dandruff
Availability of medicines
- GENERAL SALE available through pharmacies and possibly other retail outlets.
- PHARMACY ONLY available for sale through pharmacies only.
- PHARMACIST ONLY may only be sold by a pharmacist.
Last Reviewed: 06/05/2009
Dandruff is when your scalp sheds excessive amounts of larger-than-normal skin flakes. These flakes stick to the hair shafts, eventually falling on the collars and shoulders of clothes.
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