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What Works to Treat Dandruff?

For a flaky scalp that is indeed due to dandruff, we describe some of the best, research-supported ingredients and products to consider below. Keep in mind that dandruff products do NOT have to be expensive; don’t waste your money believing that expensive haircare means better results—it’s just not true.

  • Zinc Pyrithione (ZPT) shampoos and conditioners: ZPT is the oldest and the most often used anti-dandruff ingredient. It’s found in many antifungal shampoos and conditioners, including Head & Shoulders, Dove Dandruff Care, DHS Zinc Shampoo, and Zincon Medicated Dandruff products. If you have stubborn dandruff, check the label to make sure you’re using higher concentrations (2%). While these rinse-out products do help, leave-on products with ZPT often provide better results.
  • Zinc Pyrithione leave-on products: As mentioned above, shampoos with ZPT can be very effective, but leave-on products with ZPT can provide even better results. Like many ingredients, ZPT works best if left on the surface of skin so it remains there long enough to have a greater effect.

The only leave-on options with ZPT we’re aware of are Head and Shoulders Clinical Solutions Leave-On Dandruff Treatment and DermaZinc Cream. You’re instructed to massage the product into your scalp once or twice daily. You apply it at night and leave it in; in the morning, after shampooing your hair, you reapply it and leave it in all day.

Note: You can leave a shampoo or conditioner with ZPT on your scalp for a while before rinsing, but that still doesn’t give you the same results as a leave-on product.

  • Ketoconazole (KET): KET is another ingredient that can control proliferation of the fungus known to cause dandruff. Using a product with KET is a great option, especially if ZPT hasn’t worked for you. Nizoral is an example of a shampoo that contains KET. Products with 2% KET have been shown to be better for stubborn dandruff than other anti-dandruff ingredients.
  • Ketoconazole (KET) leave-on products: The same reason to use a leave-on product containing ZPT also applies to KET. Consult your physician for leave-on options medicated with KET, as such products are not available over-the-counter.
  • Combination of Ketoconazole and Zinc Pyrithione: If you don’t get the results you want from either a ZPT or KET product, it might be worth trying a product that contains both of these anti-fungal ingredients. This is something to discuss with your physician.
  • Coal tar: A by-product of coal after it’s processed has been shown to be very effective for dandruff and other forms of seborrheic dermatitis. The most well-known coal-tar shampoo is Neutrogena T-Gel (but there are others). Coal tar fights dandruff by slowing the rate at which the skin cells on your scalp die and flake off. It’s not the most elegant ingredient—it looks and smells bad—but it works. You’re likely to find information on the internet asserting that coal tar is a carcinogen, but the research is at best mixed, and many studies have shown it to be safe and effective.
  • Selenium sulfide: This works similarly to coal tar in that it slows the rate of skin cell death and thus the accumulation of dead skin cells. A bonus: Selenium sulfide doesn’t have the odor or aesthetic issues of coal tar. You can find selenium sulfide in Selsun Blue shampoo and Head & Shoulders Clinical Strength Dandruff and Seborrheic Dermatitis Shampoo, among others.
  • Salicylic acid: Also known as BHA, salicylic acid is an exfoliating superstar that helps slough off excess skin cells anywhere they accumulate on skin, including on the scalp. It can be very effective for dandruff and presents less risk of irritation than other options for treating this concern. BHA also has anti-inflammatory and antimicrobial properties, making it an option for addressing itchy, flaky scalp and reducing the Malassezia fungus. Popular shampoos with salicylic acid are Denorex and Neutrogena T/Sal Therapeutic Shampoo.
  • Tea Tree Oil (Melaleuca): When it comes to any skin condition, the desire for a natural solution is, well, a natural inclination. Tea tree oil is one of the only natural options for dandruff that has any research behind it, although that isn’t saying much because the research is very limited; also, the research is often performed by the company doing the study, and so it might be biased. However, tea tree oil does have anti-fungal properties that might be helpful for mild forms of dandruff. Several shampoos and conditioners contain tea tree oil, including Paul Mitchell Tea Tree Special Shampoo and Kiehl’s Tea Tree Oil Shampoo. Going the “natural” route will cost you more, but the results won’t necessarily be any better.

Inherently, the anti-fungal properties of all these anti-dandruff products present a risk of irritation, which often can be mitigated by changing how often you use them.

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