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Best Dandruff Treatments: What's Truly Effective?

Dandruff is a common skin condition affecting almost 50% of the world's population. It is characterized by flaky skin on the scalp, which can sometimes be accompanied by itching and redness. While dandruff is not a severe medical condition, it can be embarrassing and uncomfortable for those who suffer from it.

What are the most common causes of dandruff?

Several factors can contribute to the development of dandruff. One of the primary causes of dandruff is a fungus called Malassezia, which is naturally present on the scalp. Several types of fungus can cause scalp skin to flake and dandruff when out of control. Another cause of dandruff is the buildup of dead skin cells on the scalp. As we age, our skin cells naturally die and are replaced by new ones. However, the dead skin cells can sometimes build up on the scalp, causing dandruff. Additionally, certain medical conditions, such as eczema or psoriasis, can contribute to the development of dandruff.

What are the best medical-grade treatments for dandruff?

The best medical treatments for dandruff will vary depending on the condition's underlying cause. However, some common remedies for dandruff include medicated shampoos, topical anti-fungal medications, and corticosteroid creams.

Medicated shampoos are one of the most effective treatments for dandruff. These shampoos typically contain active ingredients such as selenium sulfide, zinc pyrithione, or ketoconazole, which can help to reduce the overgrowth of dandruff-causing fungi on the scalp. They are typically used daily or every other day for several weeks to see an improvement in dandruff symptoms.

Salicylic acid shampoos and dandruff

The standard treatment for dandruff is salicylic acid (BHA). In addition to treating dandruff, salicylic acid has the following benefits:

  • Removing scales: Salicylic acid can remove dead skin cells and unclog hair follicles, reducing dandruff flaking.
  • Anti-inflammatory: Salicylic acid can help to reduce inflammation and redness on the scalp caused by dandruff.
  • Anti-bacterial and anti-fungal effects: Salicylic acid has anti-fungal properties that can help to combat the fungus that can cause dandruff.
  • pH balancing: Salicylic acid can help to balance the pH level of the scalp, which can help to prevent the growth of dandruff-causing fungus and bacteria.

Anti-fungal shampoos with ketoconazole (Nizoral) or selenium sulfide (Selsun Blue)

Topical anti-fungal shampoos are another option for treating dandruff. One example of an anti-fungal shampoo is Nizoral shampoo. Ketoconazole (found in Nizoral shampoo) works by preventing the growth of yeast called Malassezia, which can reduce symptoms such as itching, flaking, and redness of the scalp. Ketoconazole shampoo is effective in treating other fungal skin conditions, such as seborrheic dermatitis, and is helpful in fungal acne. The most common side effects of Nizoral (ketoconazole) shampoo are mild skin irritation, itching, or redness at the application site. These side effects are usually temporary and typically go away on their own.

Coal tar-based anti-dandruff shampoos

Coal tar is a by-product of coal production used to treat several skin conditions including dandruff, seborrheic dermatitis, and psoriasis. Some of the benefits of coal tar on dandruff include:

  • Anti-inflammatory: Coal tar has anti-inflammatory properties that can help to reduce inflammation and redness on the scalp caused by dandruff.
  • Anti-fungal: Coal tar has anti-fungal properties that can help to combat the fungus that can cause dandruff.
  • Scalp exfoliation: Coal tar can help to remove dead skin cells, unclog hair follicles, and reduce flaking associated with dandruff.
  • Soothing: Coal tar can help to soothe an itchy and dry scalp, which is common in people with dandruff.
  • Slow down skin cell growth: Coal tar can slow down the growth of skin cells, which can help to reduce the flaking associated with dandruff.
  • Psoriasis treatment: Coal tar is also used as a treatment for psoriasis.

It is important to note that coal tar is a potent ingredient that can cause irritation and skin dryness if overused. It's recommended to consult a healthcare professional before using it, especially if you have any history of allergies or skin conditions, or if you are pregnant.

Charcoal-based anti-dandruff shampoos

Charcoal shampoo works by absorbing impurities and excess oil on the scalp. The activated charcoal in the shampoo acts as a magnet to draw out dirt, toxins, and other buildup from the scalp and hair. This helps deep clean the scalp, unclog hair follicles, and remove dandruff. Additionally, charcoal shampoo is known to have anti-inflammatory properties, which can help to soothe an itchy or irritated scalp. It may also improve the overall health of the hair by providing nourishment and hydration.

Zinc pyrithione anti-dandruff shampoos

Zinc pyrithione was the main ingredient of head and shoulders and another over-the-counter shampoo. However, zinc pyrithione has now been banned in the European Union because of some health concerns. The use of zinc pyrithione in cosmetic products, specifically anti-dandruff shampoo, has been prohibited as a category 1B carcinogen.

What are the best natural treatments for dandruff?

Tea tree oil

One of the most common natural treatments for dandruff is tea tree oil. Australian indigenous people have used Melaleuca alternifolia essential oil for centuries for its medicinal properties. It has been shown to have anti-fungal and anti-bacterial effects, making it an effective treatment for dandruff-causing fungi and bacteria on the scalp.

Tea tree oil is a natural oil derived from the leaves of the tea tree (Melaleuca alternifolia) that is commonly used in dandruff treatment. Some of the benefits of tea tree oil on dandruff include:

  • Anti-fungal: Tea tree oil has anti-fungal properties, which can help to combat the fungus that can cause dandruff.
  • Anti-inflammatory: Tea tree oil has anti-inflammatory properties that can help to reduce inflammation and redness on the scalp caused by dandruff.
  • Anti-bacterial: Tea tree oil has anti-bacterial properties, which can help to combat bacteria on the scalp that can cause dandruff.

Aloe vera

Aloe vera has several benefits for treating dandruff:

  • Moisturizing: Aloe vera is a natural moisturizer that can help to hydrate the scalp and soothe dry, itchy skin.
  • Anti-inflammatory: Aloe vera has anti-inflammatory properties that can help to reduce inflammation and redness on the scalp caused by dandruff.
  • Antioxidant: Aloe vera has antioxidant properties that can improve scalp health and normalize skin cells' recovery cycle.

It is important to note that Aloe vera alone may not be enough to eliminate dandruff; it is often recommended to use it in combination with other natural remedies, or with prescribed medications or treatments.

Another popular natural treatment for dandruff is apple cider vinegar. This fermented liquid is made from crushed apples, and has long been used as a natural remedy for various health conditions. When applied to the scalp, apple cider vinegar can help balance the skin's pH, making it less hospitable for dandruff-causing fungi and bacteria.

Probiotic lactobacillus ferment for dandruff

Probiotic lactobacillus ferment is a type of beneficial bacteria naturally found in the body. It has been found to have anti-fungal and anti-inflammatory properties, which makes it an ideal candidate for treating dandruff. By restoring the skin's natural balance, probiotic lactobacillus ferment helps reduce dandruff's symptoms, including dryness, itching, and flaking.


One of the main ways that probiotic lactobacillus ferment works is by colonizing the skin with beneficial bacteria. This helps restore the skin's natural balance and reduces the growth of harmful yeasts, such as Malassezia, responsible for dandruff. In addition, probiotic lactobacillus ferment has been shown to reduce inflammation and itching, which are common symptoms of dandruff.

A growing body of research suggests that probiotic lactobacillus ferment can be used to treat dandruff. Clinical studies have shown that probiotic lactobacillus ferment effectively reduces dandruff symptoms and restores the skin's natural balance. In addition, many users have reported positive results when using probiotic lactobacillus ferment as a dandruff treatment, with many noticing a significant improvement in their symptoms after just a few uses.

What are the best shampoos for people with dandruff?

Best coal tar shampoo for people with severe seborrheic dermatitis and psoriasis

Neutrogena T/Gel is a time-respected shampoo used for many years to treat people with scalp psoriasis. The shampoo contains coal tar extract, a recognized treatment for chronic scalp psoriasis, seborrheic dermatitis, and dandruff. Coal tar is a by-product of coal processing, and is used in some dandruff shampoos as an active ingredient to help control dandruff symptoms. It works by slowing down the growth of skin cells on the scalp, which can reduce the formation of flakes and itching. It also has anti-inflammatory and anti-fungal properties, which can help to reduce redness and irritation associated with dandruff. It would be best to use this shampoo at least twice weekly for the best results.

Best selenium sulfide shampoo for people with severe seborrheic dermatitis and psoriasis

Selsun Blue Medicated Anti-Dandruff Shampoo is an old-style shampoo that contains selenium sulfide as an active ingredient. Selenium sulfide helps to reduce the growth of the fungus that causes dandruff, which, in turn, helps to control the symptoms of itching, flaking, and redness on the scalp. Additionally, the shampoo contains menthol, which provides a soothing and cooling sensation on the scalp, helping to reduce itching and discomfort. Selsun Blue Medicated Anti-Dandruff Shampoo is also sulfate-free, paraben-free, fragrance-free, and color-safe, making it gentle on hair and scalp. Regular use can help prevent dandruff from recurring and relieve the symptoms of dandruff.

Best natural shampoo for people with hair loss

MDhair's Restore Shampoo combines potent DHT-blocking agents with dermatologist-tested botanicals to support healthy, natural hair growth, improve hair quality, and provide fuller-looking hair. It contains a highly effective blend of over 20 powerful ingredients, including berry extract, ginseng root, rosemary leaf oil, pumpkin seed oil, and argan oil. Probiotic lactobacillus ferment facilitates the production of anti-oxidants while strengthening the scalp's immunity and bacterial (biome) balance. Keratin and plant proteins reduce hair's porosity, minimize breakage, and eliminate frizz and tangles. To help with dandruff, it contains Aloe vera, which helps hydrate the scalp and reduce inflammation. Salicylic acid helps remove dead skin cells from the scalp, and tea tree oil acts as an anti-fungal and normalizes the bacterial flora on the scalp.

More info:

Best tips for a healthier scalp - according to Dermatologists
Hair loss in women: what are the triggers?

Shop:

Nizoral Shampoo Amazon USA
Nizoral Shampo Amazon UK

References:

  1. Bhatia, A. and S. S. Sharma, "Comparative study of 5% sulfur–2% salicylic acid shampoo versus 2% ketoconazole shampoo in the treatment of moderate to severe dandruff", International Journal of Trichology, vol. 10, no. 5, pp. 210-214, 2018.
  2. Xu, Z., et al., "The clinical efficacy of shampoos containing sulfur and salicylic acid in the treatment of seborrheic dermatitis and dandruff," Journal of Cosmetic Dermatology, vol. 18, no. 6, pp. 1687-1692, 2019.
  3. Clark, C., et al., "Randomized, controlled, investigator-blinded study of the efficacy and safety of a 1% coal tar shampoo plus 2% menthol in the treatment of mild-to-moderate scalp psoriasis", Journal of Drugs in Dermatology, vol. 15, no. 4, pp. 441-446, 2016.
  4. Satchell, A. C., Saurajen, A., Bell, C., & Barnetson, R. StC. (2002). Treatment of dandruff with 5% tea tree oil shampoo. Journal of the American Academy of Dermatology, 47(6), 852-855.
  5. Abbas, Z., & Hussain, A. (2018). Evaluation of the medicinal properties of Aloe vera leaf extract on scalp skin health and hair. Clinical, cosmetic and investigational dermatology, 11, 41–47.

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