Dandruff
Dandruff is a common problem, affecting 15–20% of the population. Dandruff occurs when the skin cells on the scalp die and shed faster than normal, often as quickly as every two to seven days, as opposed to people without dandruff, who shed only monthly.
These are seen as small white or yellow flakes of skin, visible either in your hair or on your shoulders, especially after brushing your hair. The cause of dandruff is not fully understood, but a variety of factors are thought to be involved, including a type of yeast living on the scalp.
Often dandruff will cause the scalp to be itchy. Dandruff is not infectious and cannot spread from person to person. It is not a sign of bad hygiene.
Dandruff tends to come and go over time. It can usually be treated very effectively but often returns after treatment stops.
Although dandruff can occur in anyone, it is more likely to occur after puberty, in males, in people with oily hair or scalps, or in those with a poor diet or with certain medical conditions (such as Parkinson's disease or following a recent heart attack).
See Your Pharmacist or Medical Professional
If you have a weakened immune system, serious medical condition, or the person with the dandruff is aged less than 12 years, you should always talk to a pharmacist. Also talk to a pharmacist if:
Your scalp is very itchy, red, or has sores or crusts
Your scalp has lumpy or irregular patches
Other parts of your body are also affected, such as your eyebrows, forehead or ears
You have patchy hair loss
You have tried a number of anti-dandruff shampoos and the dandruff has not gone away
Your symptoms started after using a new type of hair product (e.g., shampoo, hair dye, gel, and hairspray)
You have allergies to topical medicines.
Treatment Tips
Regular hair washing (at least twice per week) with your normal shampoo will help reduce dandruff; however, anti-dandruff shampoos have a more dramatic effect
Avoid wearing dark clothes while your dandruff is particularly bad
Do not use hair spray or other products that can irritate your scalp, such as hair dyes
Some treatments may work better than others – you may need to try several
Dandruff is likely to return so you may need to treat it again, or from time to time, to stop it recurring
Follow directions on the shampoo label. If it irritates or burns your scalp, rinse it away thoroughly and do not use it again. Ask for advice from your pharmacist on choosing a different product
Do not use dandruff products if your skin is broken, and avoid contact with your eyes
Stress can trigger dandruff or make it worse. Take time out to relax and try to manage stress
Eat a healthy diet. Diets rich in zinc, B vitamins and certain types of fats may help prevent dandruff
A little bit of sun on the hair is good for dandruff but avoid too much and don't get sunburnt!
Treatment Options
Always discuss treatment options with your pharmacist to ensure the best outcome.
Medicated shampoos for dandruff
[GENERAL SALE]
e.g., Head & Shoulders, Neutrogena T-Gel, Nizoral Shampoo 1%, Selsun Blue Shampoo range, Selsun Treatment
[PHARMACY ONLY]
e.g., Ketopine, Nizoral Shampoo 2%, Sebizole, Stieprox
Shampoos containing zinc pyrithione (such as Head & Shoulders), selenium sulphide (such as the Selsun range), and coal tar (such as Neutrogena T-Gel), help relieve scaling and itching. They help stop the growth of some yeasts and fungus and help treat dandruff
Do not use selenium sulphide-containing shampoos, such as the Selsun range, for 48 hours before or after colouring, bleaching or perming your hair. Selenium sulphide may discolour jewellery
Coal tar products can make your scalp more susceptible to sunburn, so avoid strong sunlight. Coal tar products are best avoided during pregnancy and breastfeeding unless recommended by your doctor. These products may stain bed linen, towels and clothing, so rinse thoroughly
ketoconazole (Nizoral Shampoo) and ciclopirox (Stieprox) are very effective antifungals which stop growth of yeast and other fungal infections, providing relief from dandruff. They are often successful when other treatments have failed
ketoconazole 2% shampoos [PHARMACY ONLY] should be massaged into the scalp and left for three to five minutes before rinsing. Use twice a week for two to four weeks. Leave at least four weeks before repeating the course. The 1% strength [GENERAL SALE] can be used regularly, up to twice a week
Ciclopirox (Stieprox) should be used two or three times a week. Apply twice each time, rinsing between applications. Leave in hair for a total of three to five minutes over the two applications
Any other shampoo product can be used on the days when the ketoconazole or ciclopirox shampoo is not being used
ketoconazole and ciclopirox shampoos may occasionally cause discolouration of white, grey or artificially coloured or damaged hair. They are best avoided during pregnancy and breastfeeding unless recommended by your doctor.
Medicated ointment for dandruff
[GENERAL SALE]
e.g., Coco-Scalp ointment
This product contains coal tar which helps reduce scaling and itching, and salicylic acid, a keratolytic agent
It should be used once a day for three to seven days until dandruff improves – it can then be used once a week to prevent dandruff coming back
It should only be used in children under 12 years if recommended by a doctor
See above under medicated shampoos for more advice on coal tar-containing products.
Natural/herbal products/supplements
e.g., apple cider vinegar, fish oil, tea tree oil shampoos
Apple cider vinegar has antifungal properties
Fish oil provides omega-3 fatty acids which can be beneficial in dandruff
Tea tree oil is a natural antiseptic, antibiotic and antifungal agent. Daily shampooing with tea tree oil shampoo may reduce the incidence of dandruff.
More Information
Availability of medicines
GENERAL SALE available through pharmacies and possibly other retail outlets.
PHARMACY ONLY available for sale through pharmacies only.
PHARMACIST ONLY may only be sold by a pharmacist.
Consumer Medicine Information on some medicines is available at the government website www.medsafe.govt.nz
