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Read articleDandruff and Itchy Scalp: Causes and Proper Treatment
Dandruff is the shedding of white or yellowish flakes from the scalp, often with itching. It is not a sign of poor hygiene; its most common cause is a frequent condition called seborrhoeic dermatitis, linked to a yeast that normally lives on the skin. Most cases improve with a suitable medicated shampoo used the right way, but dandruff can return, so many people need regular preventive use.
What causes dandruff and an itchy scalp?
Not all scalp flakes are the same, and knowing the cause determines the right treatment:
Stress, lack of sleep and the weather, whether heat and sweating or air-conditioning dryness, make dandruff worse for many people.
- Seborrhoeic dermatitis: greasy yellow or white flakes with redness and itching, which can spread to the eyebrows, sides of the nose, behind the ears and the beard.
- Dry scalp: small, dry white flakes without obvious redness, worse with hot water and harsh shampoo.
- Psoriasis: thick silvery scales on well-defined red patches that may extend past the hairline onto the forehead.
- Contact allergy: itching and redness after a hair dye or a new hair product.
- Scalp fungal infection: more common in children, causing flaking with patches where hair breaks or falls out.
- Head lice: intense itching, especially behind the ears and at the back of the head, with nits stuck to the hair.
What types of medicated shampoo are there?
Medicated shampoo is the mainstay of treatment for dandruff caused by seborrhoeic dermatitis, and it varies by active ingredient:
If there is no improvement after 4 weeks with one type, try one with a different active ingredient, or alternate between two.
- Ketoconazole: an antifungal that reduces the yeast involved, and one of the most effective options.
- Selenium sulfide: reduces yeast and rapid cell turnover; it may slightly change the colour of dyed hair.
- Zinc pyrithione: suitable for mild cases and preventive use.
- Salicylic acid: helps lift thick scales.
- Coal tar: helps dandruff and psoriasis, but has a strong smell and may stain light hair.
How do you use medicated shampoo correctly?
Many people say medicated shampoo did not work for them, and the reason is often how it was used. Massage it into the scalp itself, not the lengths of the hair, leave it on for 3 to 5 minutes so it can work, then rinse well.
Use it two to three times a week at first until things improve, then once a week or every two weeks to prevent it coming back. You can use a gentle regular shampoo on other days, and conditioner on the ends if your hair feels dry.
Daily habits that help your scalp
Alongside shampoo, these habits help ease dandruff and itching:
- Wash your hair with lukewarm, not hot, water.
- Wash your hair after heavy sweating in the heat or exercise, and dry it well before covering it with a hijab or ghutra.
- Do not scratch your scalp with your nails; scratches increase inflammation.
- Limit heavy oils on the scalp if you have seborrhoeic dermatitis, as they can feed the yeast and increase flaking.
- Patch-test any new dye or henna on a small area of skin 48 hours beforehand, and avoid black henna, which may contain substances that cause severe allergy.
When is it not ordinary dandruff?
If the scales are thick and silvery in defined patches, or there are bald patches, painful swellings or pus, or clear hair loss along with the flakes, the cause may be psoriasis, a fungal infection or something else, each needing a different diagnosis and treatment.
In children especially, flaking with patches of broken hair may be a scalp fungal infection, which needs oral treatment prescribed by a doctor; shampoo alone is not enough.
Frequently asked questions
Is dandruff contagious?
Dandruff from seborrhoeic dermatitis or dryness is not contagious. Scalp fungal infections and lice are contagious, so any suspicion of them needs an examination.
Does dandruff cause hair loss?
Ordinary dandruff does not cause baldness, but heavy scratching and inflammation can increase shedding temporarily. If hair loss is noticeable, see a doctor to find the cause.
Can cradle cap in babies be treated?
Greasy scalp scales in babies are common, harmless and usually clear on their own. Gentle washing and softening the scales are usually enough; do not use adult medicated shampoo on a baby without asking a doctor.
Can I use medicated shampoo during pregnancy?
Some medicated shampoos are generally considered suitable because little is absorbed through the skin, but check with your doctor or pharmacist before use, especially with coal tar.
When to see a doctor
See a dermatologist if dandruff has not improved after 4 to 6 weeks of using medicated shampoo correctly, if itching is severe enough to disturb sleep, if there is spreading redness or thick scaling on the forehead and ears, if it comes with hair loss, bald patches or pus, or if a child has flaking with broken hairs. You can book a consultation at Medical Care Clinics in Al-Shati Al-Gharbi, Dammam, close to Al-Khobar and Dhahran, where our dermatology team will examine your scalp and find the cause and the right treatment.
This article is general health education and does not replace a medical examination. Every case needs its own assessment by a doctor.
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