Dandruff is a common scalp condition that causes white or yellow flakes of skin to shed from the scalp, often accompanied by itching. It’s typically a symptom of seborrheic dermatitis, which involves inflammation and irritation of the scalp. Although dandruff can’t be completely prevented, it can be managed through various treatments that reduce flakes, relieve itchiness, and promote a healthy scalp. These treatments often involve antifungal and anti-inflammatory ingredients.

Medications

Since dandruff can resemble other scalp issues like dry skin, it’s a good idea to speak with a healthcare provider before starting treatment. Most people begin with over-the-counter (OTC) options, but prescription-strength products may be necessary for more persistent cases.

Over-the-counter treatments

OTC products are a reliable first step for treating most dandruff cases. These products—available as shampoos, conditioners, lotions, or foams—can help ease symptoms like flaking, dryness, itching, and scalp irritation.

microorganisms
Fungal or bacterial organisms on the scalp may contribute to dandruff. Many OTC products contain active ingredients that reduce these organisms and soothe inflammation.

common active ingredients include:

  • zinc pyrithione: reduces fungus linked to dandruff

  • selenium sulfide: fights infections, soothes itching, and helps eliminate flakes

  • coal tar: reduces inflammation, flaking, and oil buildup

  • salicylic acid: helps exfoliate the scalp by removing dead skin and excess oil

  • tea tree oil: has natural antifungal properties

Because each product may contain different active ingredients, instructions will vary. Some shampoos can be used daily, while others are intended for use a few times per week. Some should be left on the scalp for several minutes, and others should be rinsed off immediately. Reading and following the instructions is essential.

If the product you’re using doesn’t work, try one with different ingredients. Once dandruff improves, it’s often recommended to continue using a medicated shampoo once a week to prevent recurrence.

Prescription treatments

If OTC solutions aren’t effective, a healthcare provider may recommend prescription-strength treatments. These may include stronger antifungal shampoos or leave-on products.

example treatments include:

  • ketoconazole 2% shampoo: a more potent antifungal treatment than the 1% version available over the counter

  • topical corticosteroids: such as fluocinolone, used to relieve inflammation and itching when applied to the scalp

  • immunosuppressive creams: like tacrolimus (Protopic) or pimecrolimus (Elidel), which reduce immune system activity and help calm redness, scaling, and irritation

Lifestyle changes

Several lifestyle factors can influence dandruff flare-ups. While not a cure, addressing these factors may support treatment efforts.

diet
Eating an anti-inflammatory diet—such as one based on the Mediterranean pattern—may support scalp health. Reducing processed foods and those high in sugar and fat can help minimize inflammation.

yeast-containing foods
Some people may benefit from limiting foods that contain yeast or fungi (like bread, beer, and cheese) and incorporating probiotics to encourage healthy gut and skin microbiomes.

stress
Chronic stress may worsen dandruff, so managing stress through relaxation techniques, exercise, or improved sleep may help reduce flare-ups.

Always consult your healthcare provider before making major dietary or lifestyle changes.

Living With and Managing Dandruff

Dandruff is a very common condition that often comes and goes. In most cases, medical attention isn’t necessary, and symptoms can be managed with OTC dandruff shampoos through trial and error.

hair texture and frequency of washing
How often you should use dandruff shampoo may depend on your hair type and texture. People with straight or wavy hair may use dandruff shampoo two times per week, while those with natural Black hair may only need to use it once weekly.

hair color and sun sensitivity
Coal tar shampoo can discolor blonde, gray, or white hair and increase sun sensitivity. When using coal tar, protect your scalp from sun exposure by wearing a hat or applying sunscreen.

appearance and clothing
If flakes on dark clothing make you feel self-conscious, switching to lighter colors can help reduce visible signs of dandruff.

A Quick Review

Dandruff causes white or yellow flakes and can make your scalp itchy and irritated. Thankfully, it’s treatable. A wide range of OTC products is available, each containing different ingredients to help reduce symptoms. If those don’t work, prescription shampoos or topical treatments may be necessary. Dietary changes and continued use of medicated shampoo may help with long-term management. With the right approach, you can reduce symptoms and maintain a healthier scalp.