Excessive skin-shedding from the scalp is called dandruff.  Skin-cell shedding is a natural process that occurs all over the body as new cells push up from beneath to replace the old ones.

Dandruff poses no health risk but can be itchy, and shed flakes of skin may cause embarrassment. Although dandruff cannot be cured, it can be controlled.

The condition is very common. For example, about 50 million Americans suffer from dandruff and spend roughly $300 million annually on products to control it. Dandruff can occur in any age group.


A scaly scalp without inflammation (redness, swelling, heat or pain) or loss of hair.

When to see a doctor

    • If home treatment with anti-dandruff products does not improve the condition.

    • If scaling is greasy and yellow.

    • If the dandruff is localised in a few patches and is very itchy. This may indicate a condition such as psoriasis (red, scaly eruptions on the scalp) or seborrhoeic dermatitis (an inflammatory skin disorder, possibly resulting from fungal infection).


Mild cases often improve with careful shampooing using over-the-counter anti-dandruff products. These can also be alternated with a regular shampoo.

Shampoos containing coal tar, salicylic acid, pyrithione zinc, selenium sulphide or sulphur are safe and effective for the treatment of dandruff.

For best results, shampoo daily, leaving the lather on for at least ten minutes before rinsing. Massaging the scalp vigorously as you shampoo helps to loosen the flakes so that they can be rinsed away. Rinsing is essential, since shampoo residue can aggravate skin problems. When the condition clears up, keep it in check by shampooing with medicated shampoo once or twice a week (these products are too harsh for daily use). Let your hair dry naturally instead of blow-drying it.

Brushing hair with a moderately stiff, natural-bristle brush can be of benefit. Full strokes from the scalp to the tips of the hair will distribute the hair’s natural oil away from the scalp to the hair strands.

In stubborn cases, a doctor may prescribe the following:

    • Steroid lotion or cream applied to affected areas to suppress flaking.

    • Coal tar or salicylic acid lotion to loosen thick scaling. This is usually applied and left on overnight under a shower cap. This treatment will help shampoos to work more effectively.

    • If psoriasis of the scalp is the underlying problem, a coal-tar shampoo and topical steroid may be needed.

Herbal remedies may relieve the itching and dryness, but a tar-based product is usually needed to subdue greasy scales.

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