As anybody whose wardrobe is bereft of black T-shirts knows, there’s nothing quite like a bout of dandruff to ruin your self-confidence. Those unsightly skin flakes that you brush off your shoulders are mostly harmless, but they are embarrassing and can be accompanied by a red and itchy scalp.
To put it simply: dealing with dandruff bloody sucks.
Around 50% of the global adult population deals with dandruff at some point in their lives — it can happen to literally any of us . However, in most cases, dandruff is easily treated.
Let's dive into why you may have dandruff and what you can do about it.
What causes dandruff?
Dandruff is dead skin that forms on your scalp as a result of relapsing dermatitis or eczema.
Skin cancer expert, Dr Ryan Harvey says dandruff occurs following an oversupply of Malassezia — the yeast that occurs in the gland-rich areas of your scalp: “It’s not completely understood why the body creates an excess of Malassezia.
“Although the yeasts can start to behave differently, metabolising our normal oils in a different manner which results in the inflammatory reaction of the skin and scalp.”
Having yeast in your hair sure sounds disgusting but it is perfectly normal. Everyone has it, whether you suffer from dandruff or not.
When Malassezia is overabundant, your body reacts to the yeast by replacing dead skin cells at an overly fast rate.
You might regularly exfoliate to remove dead skin, but when dandruff occurs, the process has accelerated to the point where you’re going to need some form of treatment.
Dandruff could be the result of a skin condition, including:
- Seborrheic Dermatitis: A nasty form of eczema that can inflame the chest, arms, and behind the ears and leave scaly, flaky, red patches scattered within hair-bearing areas of the scalp
- Psoriasis: A chronic skin condition that affects 2-4% of the population and can be hereditary 
“There is a genetic component to inflammatory skin conditions and people with dandruff may have other family members with the same problems,” adds Dr Harvey.
If you’re diagnosed with one of these skin conditions, a GP may prescribe topical antifungal creams for inflamed areas around the face and body. For the scalp, medicated shampoos can be used in conjunction with steroids to reduce the itching and coal tar cream to reduce the scaling areas.
If you’re looking at psoriasis, mild cases can be treated with topical steroids, salicylic acid, and coal tar. Severe cases may require phototherapy, which is exposure to ultraviolet radiation in combination with topical treatments.
Is there a cure for dandruff?
There’s no cure for dandruff, only treatments. And sadly, it doesn't go away on its own. But it's not all bad news.
A medicated shampoo may clear up the flakes for good — and we'll get to that shortly — while topical solutions can be required to take care of infrequent flare-ups from here on out.
Another great way to stay on top of dandruff is to keep track of changes in your life and environment. For example, these can all affect your skin and make your dandruff worse:
- Carb and sugar-heavy diets
- Increased stress
- New medications
- Moving house
- Using a new shampoo
- Not washing your hair often enough
- And even the changing of the seasons
If dandruff coincides with any of the above, see if that detail can be removed, substituted, or improved in some way. You can’t go avoiding the shift into winter, so if the colder weather results in a flare-up, consult a GP or dermatologist to help find a treatment.
Anti-dandruff shampoos: The most common dandruff treatment
If you’re experiencing dandruff for the first time, you should start by trying an anti-dandruff shampoo. “The usual treatment involves medicated shampoos which contain an active ingredient that works on the yeasts that live on the scalp,” says Dr Harvey.
You’ll find it at the chemist and supermarket easily enough, but it’s also worth noting that dandruff is the most commercially exploited skin disease.
This means you’re going to be faced with an abundance of products making all sorts of bold claims, but there’s one simple combination of ingredients to look out for to get rid of dandruff: ketoconazole, selenium sulphide, and zinc pyrithione.
Zinc pyrithione is particularly important for its fungistatic and bacteriostatic properties (that means it goes straight to the root of the problem and treats it, rather than just cleansing and removing the flakes).
You may have to try several different products before finding one that works for you, and you’ll also need to keep using the shampoo for at least a month to clear up dandruff.
Dr Harvey points out that some dandruff sufferers may need to use the shampoo twice a week indefinitely. It may sound excessive, but it’s a small price to pay to reduce the itching (not to mention the unsightly shoulder flakes).
If an anti-dandruff shampoo doesn’t fix the problem, dandruff may be the result of an underlying medical condition, and a GP or dermatologist should be consulted, as they may be able to identify the problem on sight. In rare cases, a skin biopsy could be used.
What else can you do to treat dandruff?
Besides using an anti-dandruff shampoo and making a few lifestyle tweaks, there are some home remedies you can try to get rid of those pesky white flakes.
Apple cider vinegar
Although there's no research to confirm that apple cider vinegar helps reduce dandruff, it is a commonly used home remedy, as it is said to regulate your skin's pH levels and minimise fungal and bacterial growth .
As for how to use it, there are plenty of recipes online, many using ingredients that we're sure you have in your kitchen (think baking soda, chamomile tea, or simply just water).
Tea tree oil
Tea tree oil can help manage dandruff in 2 ways and there is some research to support both. It reduces yeast overgrowth (a.k.a Malassezia) on the scalp thanks to its antifungal and antibacterial properties  and it also relieves itchiness and greasiness  — so it can be especially beneficial if you have an oily scalp.
You can use it in its essential oil form or look for a shampoo that lists tea tree oil as an active ingredient. Just keep in mind that this oil can be irritating, so if you have sensitive skin, this may not be the solution for you.
Most of us know that aloe vera can help treat burns, skin irritation, and minor wounds — and that's mainly because of its anti-inflammatory benefits. It's thanks to those same benefits, as well as its antifungal and antibacterial properties, that aloe vera also works for dandruff control and prevention .
You can use aloe vera gel on its own, or mix it with other ingredients to make a DIY hair mask (again, no shortage of recipes online).
Coconut oil can help hydrate the skin, maintain a healthy fungal microbiome on your scalp, and reduce inflammation . Applying 1 or 2 tablespoons directly on the scalp and letting sit for 30-60 minutes before you rinse it out is definitely worth a try, especially if you've got dry skin.
You can also make a quick scalp scrub by mixing the coconut oil with sugar, apple cider vinegar, honey, and an essential oil (bonus points if it has anti-inflammatory properties).
Does shaving your head fix dandruff?
Shaving your head will not fix dandruff.
In fact, this will only make your flaking scalp more obvious. Using hair products may conceal the flakes, but any leftover product can also be a cause of increased Malassezia, and hence isn’t much of a fix after all.
Even if you don't shave your head yourself, scalp inflammation and dandruff (as well as the constant itching) can end up causing your hair to break and shed, leading to hair loss — which, again, can make the flakes more noticeable.
If this is something you're struggling with, incorporating hair regrowth products into your routine can be a good idea. Pilot's Hair Growth Booster includes everything your scalp needs to stay healthy: Biotin Hair Gummies, Hair Growth Shampoo & Conditioner, and a derma roller.
Yes, dandruff is annoying — but you're not alone
Living with dandruff can be a real pain in the arse. It’s itchy, uncomfortable, and unsightly, and can cause a pretty serious knock to your confidence.
It’s also one of those conditions that, because it isn’t intrinsically threatening to your general health, gets ignored or avoided all too easily (and let’s be honest: most of us do have more pressing issues than dealing with a flaky scalp).
Luckily, nobody has to struggle with it alone: it’s a very common condition, and with a switch to the right shampoo and conditioner, most people who have dandruff can say goodbye to the flakes and the itchy skin, and hello to a healthier scalp (and the confidence that comes with it) for good.
Photo credit: Getty Images