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Humans shed, a lot. We shed so much, in fact, that 20% of the bacteria on our floors is from our hair, skin, and noses (Hospodsky, 2012). But despite each and every one of us shedding skin cells every single day, it can feel like a social stigma if your shedding is visible.
Dandruff, those itching, white flakes on the scalp, can feel especially hard to deal with since it cannot be covered up with long sleeves or pants and may show up on your shoulders in addition to your head. Though it can feel isolating, up to half of the world’s population, post-puberty experiences the skin condition (Turner, 2012). Even the dinosaurs had dandruff (McNamara, 2018).
What causes dandruff?
But to understand how we can lessen or banish the pesky flakes, we need to understand what causes them. There are several causes of dandruff, but some are more common than others. Though dry skin can cause an itchy scalp and white flakes that make it look like dandruff, this is a completely different condition. If you’re not quite sure which you have, check out our article on dry scalp vs. dandruff for more information.
The most common cause of dandruff is seborrheic dermatitis, and you can get this condition anywhere you have oil glands, like your scalp, eyebrows, groin, armpits, and even alongside the sides of your nose. Even babies get seborrheic dermatitis, and frequently enough that the condition has its own name: cradle cap. This type of dermatitis causes your skin to become oily, red, and scaly, and the flakes it causes can be either yellow or white.
The yeast-like fungus Malassezia is another common cause of dandruff. This fungus is attracted to the oil glands on your scalp, face, and upper trunk, and can not only cause dandruff but also exacerbate other skin conditions. It can also cause redness, itching, and flaking, but symptoms tend to be to a less severe degree than when dandruff is caused by seborrheic dermatitis. Since Malassezia likes oils, it takes up fatty acids from your oil glands and breaches the scalp skin barrier, leading to water loss that can cause the dryness and flakiness we associate with dandruff (Wuthi-udomlert, 2011).
It’s less common, but dandruff can also be caused by other forms of dermatitis such as eczema or psoriasis, diet, or an allergic reaction to hair products. If you’re suffering from dandruff, it may be worth getting a blood test to check for nutrient deficiencies as low levels of riboflavin (vitamin B2), niacin (vitamin B3), zinc, and pyridoxine (vitamin B6) are associated with seborrheic dermatitis (Borda, 2015).
Dandruff: symptoms, causes, treatment, prevention
Home remedies for dandruff
Many of us have heard that regular shampooing may be damaging our hair. While that may be the case for people with naturally low oil production, people with higher amounts of natural oils who are prone to dandruff actually do need to shampoo regularly. This helps strip out the excess oil that can build up and spur the fungal infection that leads to the appearance of dandruff flakes in formerly healthy hair. These home dandruff remedies, backed by scientific evidence, may be able to help if you’d like to try a natural option before considering a prescription or standard dandruff shampoo.
Apple cider vinegar
Many of the health claims about apple cider vinegar when it comes to treating dandruff, such as the idea that the vinegar can encourage your body to shed dead skin cells, simply have no scientific backing. But we do know that apple cider vinegar has antifungal properties against certain kinds of fungus (Mota, 2015; Kang, 2003). There are no studies showing that apple cider vinegar can act directly on the type of yeast-like fungus called Malassezia that’s associated with dandruff, though.
Baking soda can go to work combatting your dandruff in two ways: first, as a gentle exfoliant that can remove unwanted flakes from your scalp, and second, as an antifungal that diminishes the source of these flakes. One test-tube study found that baking soda was able to stop fungal growth for 79% of the types they tested, and reduce growth in another 17% (Letscher-Bru, 2013). Another study that looked at how baking soda baths affected people with psoriasis found that these treatments successfully reduced itchiness and irritation (Verdolini, 2005).
But you may want to be careful with baking soda. The pantry staple has a pH of 9, which makes it alkaline. Alkaline treatments have been shown to potentially cause damage to the hair fibers, which may lead to hair breakage and frizziness (Dias, 2014). Other studies show that alkaline treatments may throw off the hydration of your skin, causing it to become dry and scaly, which would undo all exfoliating the baking soda did in the first place (Gfatter, 1997). If you want to try baking soda, start conservatively to see how your skin reacts.
Dandruff may be exacerbated by eczema, but that’s where coconut oil comes in. Applying coconut oil for eight weeks reduced symptoms of atopic dermatitis, a type of eczema, by 68% in one study (Evangelista, 2014). This type of eczema is known for causing flakiness and inflammation. Dry skin can also make dandruff worse, though again, dry scalp is different from dandruff. Another study found that coconut oil was just as effective at treating dry skin as mineral oil (Agero, 2004).
Tea tree oil
If you’re familiar with essential oils, you already know that tea tree oil is considered a Swiss Army knife of oils used to treat a wide variety of conditions. Dandruff is no exception. Tea tree oil is well known for its antiseptic, antimicrobial, and anti-inflammatory action (Carson, 2006), but it also has an antifungal activity that can specifically target Malassezia. By targeting this type of yeast, tea tree oil may be able to alleviate symptoms of seborrheic dermatitis (Gupta, 2004). One study that tested the efficacy of shampoo with 5% tea tree oil found that, compared to shampoo with added placebo, this formula reduced the severity of dandruff symptoms by a considerable 41% (Satchell, 2002).
How to get rid of dandruff: tips, remedies, and treatments
Shampooing with a product made with lemongrass oil successfully treated dandruff by targeting Malassezia, one study showed (Wuthi-udomlert, 2011). But you do want to look for a specific concentration if you’re looking to try this particular natural remedy. One study tested solutions with 5, 10, and 15% concentration of lemongrass oil and found the 15% solution to be the most effective. It didn’t take long to see significant results, either. After seven days, participants’ dandruff had improved by 51% and was 74% improved by day 14 (Chaisripipat, 2015).
First things first: If you want to use eucalyptus oil to treat dandruff at home, you need to dilute the essential oil in a carrier oil, a neutral oil that’s gentle on the skin such as almond, jojoba, or coconut oil. Eucalyptus has been shown to have anti-inflammatory properties, which may help alleviate the symptoms of seborrheic dermatitis (Hotta, 2010). But it also has antiseptic, antibacterial, and antifungal properties and has been shown to treat bacterial dermatitis, which may help against several sources of flaky scalp (Orchard, 2017). One compound extracted from eucalyptus, 1-8 Cineol, was shown by a 2012 study to successfully combat dandruff (Selvakumar, 2012).
Aloe vera is promising as a treatment for dandruff, but there’s little research directly studying its effects on the condition. The topical use of aloe vera may be beneficial as a treatment for skin conditions such as psoriasis, and it has historically been used to treat hair loss (Aloe Vera, 2016). Past research has noted that the antibacterial and antimicrobial activities of aloe vera help prevent dandruff and that the plant also has antifungal properties that may protect against alopecia (hair loss) (Hashemi, 2015). There’s currently no research that addresses whether aloe vera can help with dandruff-specific fungus. But aloe vera also has anti-inflammatory properties that, at the very least, may lessen the symptoms or severity of dandruff (Vázquez, 1996).
What is eczema of the scalp?
Other treatment options
If none of these natural remedies work for you, there are other options for dandruff treatment. Anti-dandruff shampoo is available as a prescription, but there are also over-the-counter (OTC) products. Many dandruff shampoos use an antifungal agent such as zinc pyrithione (also called pyrithione zinc), selenium sulfide, or ketoconazole. You may also see salicylic acid, which can help strip excess scaling from your scalp before it gets the chance to turn into dandruff flakes. But you may want to test your reaction to salicylic acid before committing to a bottle, since it may dry the skin and cause excess flaking in some people. If you’ve tried OTC options before and haven’t seen results, talk to your dermatologist about your prescription options.
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Dr. Mike is a licensed physician and the Director, Medical Content & Education at Ro.