Choosing the Best Medicated Shampoo for Dandruff

When flakes of dandruff start falling on your shoulders or your scalp gets itchy, it can be frustrating and uncomfortable. Washing your hair is part of the equation for managing dandruff, but it’s important to find the right product.

Dandruff is a common condition, affecting about 50% of the population. It is a scaly, itchy scalp condition where layers of skin cells come together to create flakes you can see in your hair. Although dandruff is definitely annoying, it’s not contagious. Usually, it can be treated without seeing a health care professional.

Understanding Dandruff and Its Causes

Dandruff involves a yeast that lives on everyone’s skin, as well as sebum, a type of oil made by the body. Sebum on the scalp protects our hair, which is why dandruff can appear on the scalp.

When you start to look at dandruff shampoos, it’s important to know that dandruff usually occurs due to a combination of the three following factors:

• Presence of Malassezia yeasts on the scalp
• Sebaceous (oil gland) function and overproduction
• Your body’s immune response to the presence of yeast

As a result, most dandruff shampoos contain ingredients that aim to reduce yeast on the scalp or keep the sebaceous glands from producing too much oil. Contact dermatitis, as well as skin conditions like psoriasis and eczema, can also cause dandruff.

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Identifying the Right Shampoo Ingredients

Manufacturers use many different ingredients in dandruff shampoos. Certain ingredients may work well for some people, but not so well for others. A shampoo that has a mix of these ingredients should help rid the scalp of dandruff: ciclopirox, coal tar, salicylic acid, sulfur, selenium sulfide, zinc pyrithione, ketoconazole. Here’s a little more background about some of the most common dandruff-fighting shampoo ingredients:

• Ciclopirox: Ciclopirox is an ingredient used to treat seborrheic dermatitis, a chronic inflammatory skin condition that causes oily spots and scaly patches on the scalp. Seborrheic dermatitis also can cause recurrent dandruff.
• Coal tar: Coal tar can be effective at fighting dandruff. Some shampoos, such as those with coal tar, may darken or stain light-colored hair. The American Academy of Dermatology recommends using sun-protective clothing and wearing a wide-brimmed hat because some dandruff shampoos, such as those with coal tar, can make your scalp more sun-sensitive.
• Ketoconazole: Ketoconazole is an antifungal. Plan to use it up to three times a week or as often as the label recommends. You may need to do more to moisturize your hair when using ketoconazole as it can be drying.
• Selenium sulfide: Although this active ingredient is effective, it can cause a yellow-brown discoloration on white, gray or dyed blonde hair. Rinsing it out thoroughly can prevent this.
• Salicylic acid: Some dandruff shampoos use salicylic acid combined with another topical medication so the shampoo removes the flakes and the medication gets to the scalp. Salicylic acid shampoos reduce flaking and scaly patches, and can help moisturize a dry scalp.
• Tea tree oil: Tea tree oil is an essential oil that can reduce the symptoms of dandruff and help stop the buildup of oil associated with dandruff. Many shampoos contain tea tree oil. The oil comes from the leaves of the Australian tea tree, called Melaleuca alternifolia.
• Zinc pyrithione: Zinc pyrithione can be helpful for both dandruff and seborrheic dermatitis. Pyrithione zinc shampoos use an antifungal called zinc pyrithione that also fights bacteria. If you choose this product, plan to use it three to four times a week and then a regular shampoo on other days you would wash your hair.

According to HairClub Hair Health Expert and Trichologist Shab Reslan, “A dandruff shampoo is essential in clearing your scalp better than your daily shampoo, which typically offers a more gentle cleansing.” She recommends choosing a dandruff shampoo with cleansing agents that can break down sebum and product buildup, environmental debris, and flakes caused by Malassezia fungus. Your scalp should feel clean and clear of any dandruff after one or two uses.

How to Use Over-the-Counter Dandruff Treatments

Use an OTC dandruff treatment just as you would any other shampoo for cleansing your hair. Read the label to find out how often to use it. Some shampoos can be used daily if you wash your hair that often, while others are recommended for use only a couple of times a week. If you wash your hair daily but can use a dandruff shampoo only a couple times a week, use your regular shampoo on the remaining days. Aim to leave your dandruff shampoo on the scalp for five to 10 minutes before rinsing it out unless otherwise instructed. Be prepared for some trial and error to find the right dandruff shampoo for you. Anti-dandruff shampoos contain different ingredients, so you may respond to one ingredient better than another.

Considerations When Choosing a Dandruff Shampoo

In addition to ingredients, you may also want to consider the following variables when choosing a dandruff shampoo:

• Hair color: Coal tar shampoos can darken or stain the appearance of your hair. For this reason, doctors don’t usually recommend using it on light-colored hair.
• Frizzy and flyaway hair: If you have hair prone to flyaways, you may wish to try a ZPT-containing product.
• Oily hair: Dandruff shampoos with selenium sulfide can make oily hair feel even oilier, according to the National Library of Medicine. If you manage hair greasiness, you may want to try dandruff shampoos with other ingredients.
• Male vs. female response: Due to differences in their skin barrier, men are more likely than women to have dandruff.

Potential Side Effects and Precautions

Each ingredient geared toward dandruff treatment may have potential side effects. Avoid using a waxy hair conditioner or leave-in product. Keep your scalp protected from the sun.

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Alternative Medicine

Many shampoos contain tea tree oil. The oil comes from the leaves of the Australian tea tree, called Melaleuca alternifolia.

Lifestyle Adjustments

Manage stress. Stress can affect your body in many ways. It may even cause dandruff or make it worse. Take care of your hair and scalp. Find a hair care routine that works for you. If you have fine or naturally straight hair or an oily scalp, wash your hair often. If you have textured or naturally curly or coiled hair, wash your hair when needed. When you wash your hair, gently massage the scalp to loosen flakes. Get a little sun. A few minutes of sunlight each day may help with dandruff. But don't stay outside too long because too much sun can damage your skin. Use fewer styling products. Hair gels, sprays and other products can build up on your scalp.

When to Seek Professional Advice

You should see a health care professional, like a dermatologist, if you are using an over-the-counter treatment for dandruff and it's not getting better after about a month or if it's getting worse. If you have tried various dandruff shampoos for at least a month and your flakes persist, we recommend seeing a medical professional such as a dermatologist or a trichologist, a specialist who focuses on diseases or problems related to the hair and scalp. We also recommend visiting a doctor if there is redness, pain, crusting, or pus.

Additional Information

CeraVe Anti-Dandruff Hydrating Shampoo is clinically tested to help eliminate visible flakes without disrupting the scalp barrier. This dandruff shampoo with 1% pyrithione zinc is gentle on both your hair and scalp and helps reduce itching and irritation. When paired with the CeraVe Anti-Dandruff Hydrating Conditioner, it removes buildup without stripping away moisture, leaving your hair feeling healthy and soft.

Managing an Itchy Scalp

Having an itchy scalp can be unbearable. You might even have trouble sleeping or concentrating. Your scalp could also feel dry, flaky, scaly, or have red patches. Special shampoos for an itchy scalp can help relieve your symptoms, as they have ingredients that target different causes of itching, such as dandruff, psoriasis, or head lice. For some scalp problems, you may need to get a prescription from your doctor. Finding out what is causing your itchy, dry scalp symptoms will help you choose the right shampoo. Here are some of the best types of shampoos for an itchy scalp.

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Best Shampoos for Specific Scalp Conditions:

• Psoriasis: Over-the-counter (OTC) shampoos can help treat mild psoriasis symptoms. During a flare-up, OTC shampoos can help soften and wash away scale so that your prescription topical medication can get through to your scalp. Ask your dermatologist about trying one of the following types of shampoos. These are the best types of psoriasis shampoos on the market: Coal tar shampoo can help cut down on the overgrowth of skin cells and help your body shed dead cells. It's less used today, but you can still find shampoos that contain this ingredient. Shampoos containing hydrocortisone can help reduce swelling, redness, and itching. Shampoos with salicylic acid, urea, or lactic acid soften and gently peel away thick scales.
• Ringworm: For ringworm of the scalp, you usually need to take a prescription oral medication (pills) for 1 to 3 months. Using over-the-counter or prescription antifungal ketoconazole shampoos can help keep symptoms under control. Ketoconazole is an antifungal medicine that slows the growth of fungi, including ringworm.
• Head Lice: Over-the-counter lice medicine is called pediculicide. Pediculicide shampoos treat lice by paralyzing and killing them. But pediculicide shampoos don’t get rid of lice eggs, so you may need to repeat the application after a week or two. Follow the directions on the box carefully.
• Eczema: The key is to find a gentle shampoo that won't make eczema worse. Look for shampoos that are fragrance-free, because scented ingredients can be irritating. Also steer clear of shampoos that contain sodium lauryl sulfate, or SLS, which makes products foamy but may irritate your eczema. If those options are still too harsh or unhelpful, try a medicated shampoo for dandruff. Look for dandruff shampoos that contain coal tar or zinc pyrithione, which are ingredients that can relieve itching, redness, and swelling.
• Allergic Reaction: The treatment is to stop using the product you're allergic to. If you have trouble figuring out what ingredient is bothering you, a dermatologist may be able to help you narrow it down.

Tips to Avoid Allergic Reactions:

• Be sure to rinse out all the shampoo - regular or medicated - when you wash your hair. Shampoo left on the scalp can cause itching, dryness, and flaking.
• Avoid using hair dye with an ingredient called para-phenylenediamine (PPD), which often triggers allergic reactions.
• Use gentle products without added fragrances or dyes.
• Rinse your hands right after applying hair products.

Addressing Common Questions

• Which shampoo is best for an itchy scalp? There are different types of shampoos for an itchy scalp. The best shampoo depends on what's causing your symptoms, such as dandruff or psoriasis.
• What do dermatologists recommend for an itchy scalp? If you have an itchy scalp, dermatologists advise trying to figure out the cause. If you can’t figure out why your scalp itches, then you should see a family doctor or board-certified dermatologist. Once you know the cause of your itchy scalp, you can find ways to relieve your symptoms, such as using special shampoos.
• Why is my scalp so itchy but I have no dandruff? Your scalp can itch for reasons other than dandruff. If you have an itchy scalp without dandruff, you could have another condition like psoriasis, eczema, ringworm, head lice, or an allergic reaction to a hair product.
• How do you stop an itchy scalp? The first step in stopping an itchy scalp is finding out what is causing it. Then, you can look for the best shampoo for your condition. If you’re struggling to figure out the cause of your scalp itch, or your shampoo isn’t helping, then see your family doctor or a dermatologist.
• What is the best over-the-counter product for an itchy scalp? The best over-the-counter product for an itchy scalp depends on what condition is causing your symptoms. Special shampoos have ingredients for treating different conditions that cause itching.
• Can dry shampoos help ease an itchy scalp? If you have an itchy scalp, you probably should not use dry shampoo. Regular shampoos that do not target the condition causing your scalp itch can make your symptoms worse.
• How can I permanently get rid of dandruff? Dandruff - or seborrheic dermatitis - is a chronic and relapsing condition of the scalp. Using medicated shampoos 2 to 3 times a week should help give some relief and temporary resolution, but chances are that the use of the shampoo will have to continue with scalp flare-ups.
• How do I get rid of dandruff fast? If your dandruff is mild, try brushing your scalp and shampooing more often. If your dandruff is more severe, switch to using a medicated dandruff shampoo.
• Are there ingredients to avoid that cause dandruff? Ingredients like parabens, silicones, sodium chloride, sulfates, and synthetic fragrances are unlikely to cause dandruff, but they can make existing flakes worse because they can be harsh and drying to the scalp.
• What should I do if my dandruff is extreme? If you’ve tried OTC dandruff shampoos that contain selenium or ketoconazole (following best practices for application, such as leaving the product on for at least 5 minutes before rinsing), you may need a prescription-strength medication. In that case, speak with your doctor about a topical corticosteroid.

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