At a glance......
- 1 Types of Dandruff
- 2 Antimicrobial Agents
- 3 Home Remedies for Dandruff/How can I remove dandruff permanently
- 3.1 Eggs
- 3.1.1 Lemon juice with Coconut Oil
- 3.1.2 Garlic
- 3.1.3 Aloe vera
- 3.1.4 Baking Soda and Lemon and Apple Cider Vinegar
- 3.1.5 Fenugreek Seeds
- 3.1.6 Neem leaves
- 3.1.7 Tea tree oil
- 3.1.8 Olive oil
- 3.1.9 Aspirin
- 3.1.10 Listerine mouthwash
- 3.1.11 Orange peel pack
- 3.1.12 Baking Soda
- 3.1.13 Cedar wood oil
- 3.1.14 Egg Yolks
- 3.1.15 Egg oil
- 3.1.16 Ginger
- 3.1.17 Castor oil
- 3.1.18 Lavender oil
- 3.1.19 Rosemary oil
- 3.1.20 Omega- 3 fatty acids
- 3.1.21 Drinking water
- 3.1.22 Relaxing more
- 3.1.23 Baby oil
- 3.2 Prevention
- 3.3 Self-care advice
- 3.4 References
User Review( votes)
How can I remove dandruff permanently? (pityriasis capitis, seborrheic dermatitis confined to the scalp) is a disease that has been around for centuries despite several treatment options.[rx] Dandruff should not be defined only by its clinical presentation, pathophysiology and/or its etiological spectrum. The definition needs to include its impact on society as well. The scaly scalp may look unhygienic and untidy. It could make the sufferer feel self-conscious and embarrassed. Dandruff affects self-esteem and confidence.[rx] Itching due to dandruff also causes great embarrassment to the sufferer in public. Dandruff causes more social and psychological problems than medical ones. The personal care industry conveniently offers its range of products targeting the psychological aspects of dandruff through carefully planned advertisements and through various products for dandruff. Dandruff is often defined as increased scaling of the scalp, representing the more active end of physiological desquamation.[rx] Why does such physiological/clinical presentation occur? The postulate of fatty acid metabolism by the commensal lipophilic yeast of scalp skin – Malassezia – is losing its charm as, in many cases, scaling occurs without the organism being present. The issue is what triggers the rapid scaling and what maintains the state in the continuum? What should be the approach to treatment? Treating the clinical signs and symptoms or eliminating the cause? Dandruff may be a primary disorder in the series of physiological scaling – dandruff, sebborheic dermatitis, psoriasis – and the condition is worsened by the commensal flora, Malassezia. We believe that the commensal organism becomes a saprophyte when abundant food and substrate is available.
Dandruff is the shedding of dead skin cells from the scalp. As skin cells die a, a small amount of flaking is normal, about 487,000 cells/cm2 are released normally after detergent treatment. Some people, however, experience an unusually large amount of flaking either chronically or as a result of certain triggers, up to 800,000 cells/cm2, which can also be accompanied by redness and irritation.
- Treatment aims to stop dandruff by slowing down the reproduction of skin cells or counteracting the yeast production that might be the cause. The strategy will depend on the patient’s age and the severity of the condition.
Shampoos and scalp preparations
- Shampoos and scalp products are available over the counter at most stores and pharmacies. These can control seborrheic dermatitis, but they cannot cure it. Before using an anti-fungal shampoo, individuals should carefully try to remove any scaly or crusty patches on the scalp, as far as possible, This will make the shampoo more effective. Dandruff shampoo is available to treat dandruff in the beard.
Ingredients to look out for
Most anti-dandruff or anti-fungal shampoos contain at least one of the following active ingredients:
- Ketoconazole – An effective anti-fungal. Shampoos containing this ingredient can be used at any age.
- Selenium sulfide – This reduces the production of natural oils by glands in the scalp. It is effective at treating dandruff.
- Zinc pyrithione – This slows down the growth of yeast.
- Coal tar – (Denorex Therapeutic Protection, Neutrogena T/Gel, Scytera)– This has a natural anti-fungal agent. Dyed or treated hair may become stained by long-term usage. Tar soaps may also make the scalp more sensitive to sunlight, so users should wear a hat when outside. Coal tar can also be carcinogenic in high doses.
- Salicylic acids – These help the scalp get rid of skin cells. They do not slow down the reproduction of skin cells. Many “scalp scrubs” contain salicylic acids. Treatment can sometimes leave the scalp dry and make skin flaking worse.
- Tea-tree oil – Derived from the Australian Tea Tree (Melaleuca alternifolia), many shampoos now include this ingredient. It has long been used as an anti-fungal, an antibiotic, and an antiseptic. Some people are allergic to it.
- Pyrithione zinc – (Selsun Blue for Itchy Dry Scalp, Neutrogena T/Gel Daily Control Dandruff Shampoo, Head & Shoulders)
- Aspirin- If you want to avoid the medicated shampoos and want to stick to a strictly home care regime, aspirins should be your go-to remedy. The reason why aspirin is particularly effective in eliminating dandruff is that it contains a fair amount of salicylate, which is an active ingredient in most dandruff shampoos that has salicylic acid as its chief component. This should prove to be a very good substitute to medicated shampoos.
The best strategy is to select a shampoo containing one of these ingredients and shampoo the hair every day until the dandruff is under control.
|Zinc pyrithione||Dandruff Seborrhoeic dermatitis||Antifungal Inhibition of fungal growth Depletes intracellular ATP levels [rx] Disrupts metal homeostasis [rx, rx]|
|Selenium sulphide||Dandruff Seborrhoeic dermatitis||Antifungal Inhibition of fungal growth Antiproliferative [rx, rx]|
|Coal tar||Dandruff Seborrhoeic dermatitis||Reducing agent Antipruritic Antiproliferative [rx]|
|Salicylic acid||Dandruff Seborrhoeic dermatitis|
|Generic Name||Trade Name||Active ingredient|
|Salicylic acid||T-Sal||Salacid 3%|
|Baker’s P and S||Salacid 2%|
|Ionil plus||Salacid 2%|
|Salicylic acid and sulfur||MG217 tar free Shampoo||Salacid 3%, Sulfur 5%|
|Sebulex||Salacid 2%, sulfur 2%|
|Zinc pyrithione||Head and shoulders||Zinc pyrithione 1%|
|Zincon||Zinc pyrithione 1%|
|Dandrex||Zinc pyrithione 1%|
|Sebulon||Zinc pyrithione 2%|
|DHS zinc||Zinc pyrithione 2%|
|ZNP bar||Zinc pyrithione 2%|
|Theraplex Z||Zinc pyrithione 2%|
|Tar||Pentrax||Coal tar extract 7%|
|T-Gel XS||Solubilized coal tar 4%|
|Doak-tar||Solubilized coal tar 3%|
|T-gel||Solubilized coal tar 2%|
|Ionil T||Coal tar solution 1%|
|Zetar||Whole coal tar 1%|
|DHS Tar||Coal tar 0.5%|
|Tegrin||Coal tar solution 7%|
|Reme T||Coal tar 5%|
|Selenium sulfide||Selsun blue||Selenium sulfide 1%|
|Head and shoulders intensive treatment||Selenium sulfide 1%|
|Selenium sulfide 1%||Selenium sulfide 1%|
|Selseb||Selenium sulfide 2.3%|
|Selsun 2.5%*||Selenium sulfide 2.5%|
|Exsel 2.5%*||Selenium sulfide 2.5%|
|Selenium sulfide 2.5%*||Selenium sulfide 2.5%|
|Combinations||Sebutone||Coal tar 0.5%, salicylic acid 2%, sublimed sulfur 2%|
|X-seb T plus||Coal tar 10%, salicylic acid 3%|
|Tarsum||Coal tar 10%, salicylic acid 2%|
According to the severity
Skin care routine for mild dandruff
- Wash scalp with dandruff shampoo daily or every other day
- May use hair conditioner on hair as needed
- Need more frequent daily shampooing when symptoms are more severe
Skin care routine for moderate or severe dandruff-
- Wash scalp with dandruff shampoo daily
- May use hair conditioner on hair as needed
- Need more frequent shampooing when symptoms are more severe
- Rub in betamethasone or fluocinonide solution one to two times a day into scalp for itchy skin
Medications for dandruff
Antifungal shampoos – Prescription-strength shampoos help decrease the yeast counts on the skin, but work no better than over-the-counter dandruff shampoos.
- ketoconazole shampoo
- ciclopirox shampoo
Antibacterial cleaners – Prescription-strength washes such as sulfacetamide help decrease the bacterial counts on the skin, but are of little benefit in the treatment of dandruff.
- sodium sulfacetamide and sulfur benzoyl peroxide cleansers
Cortisone shampoos – Prescription-strength steroid shampoos in rinse-off products help decrease the inflammation and decrease itching.
- fluocinolone acetonide shampoo
- clobetasol shampoo
Corticosteroids – Prescription-strength cortisone preparations as “rub in and leave on” products help decrease the inflammation and control itching. These vary in strength, the strongest of which is about 1,000 times the strength of over-the-counter hydrocortisone!
Topical cortisones are safe when used appropriately under a physician scare and guidance. As there are some, possible long-term side effects of all steroids, they should be used sparingly and only where needed. Many cortisone preparations are available including ointments (more greasy, clear, petroleum-based) creams (thick, white, and lubricating), lotions (light, flowing liquid), solutions (clear watery liquid, often alcohol-based), sprays (clear liquid in propellant), and foams (light, airy mousse).
- clobetasol foam
- betamethasone foam
- clobetasol solution fluocinonide solution
- betamethasone lotion
- clobetasol lotion
- triamcinolone spray
Alternating dandruff shampoo with regular shampoo may help. A specific shampoo may stop being as effective after some time. At this point, it may be a good idea to switch to one with another ingredient.
|TOPICAL||Antifungals||Ketoconazole||2% Shampoo, cream, gel or foam||Scalp or skin: Twice/week × 4 weeks, then once/week for maintenance.||Inhibition of fungal cell wall synthesis.||ICD† in <1% of patients. Itching, burning sensation and dryness in 3% of patients.||[rx,rx,rx,rx–1]|
|Bifonazole||1% shampoo, cream or ointment||Scalp: every other day or once daily.
Skin: once daily.
|ICD in 10% of patients.||[rx,rx,rx,rx]|
|Miconazole||Cream||Skin: 1–2 times daily.||ICD, itching, burning sensation.||[rx,rx,rx]|
|Ciclopirox Olamine||1.5% shampoo, cream, gel or lotion||Scalp: 2–3 times/week × 4 weeks, then once/week for maintenance.
Skin: twice daily.
|Inhibition of metal-dependent enzymes.||ICD in <1% of patients. Itching, burning sensation in 2% of patients.||[rx,rx,rx]|
|Selenium sulfide||2.5% shampoo||Scalp: Twice/week × 2 weeks, then once/week × 2 weeks. Repeat after 4–6 weeks.||Cytostatic and keratolytic.||ICD in ~3% of patients. Orange-brown scalp discoloration.||[,rx]|
|Zinc Pyrithione||1% shampoo||Scalp: 2–3 times/week.||Increased cellular copper interferes with iron-sulfur proteins.||ICD in ~3% of patients.||[,9rx]|
|Cortico-steroids||Hydrocortisone||1% cream||Skin: 1–2 times daily.||Anti-inflammatory, anti-irritant.||Risk of skin atrophy, telangiectasias, folliculitis, hypertrichosis, and hypopigmentation with prolonged use.||,rx,rx]|
|Betamethasone dipropionate||0.05% lotion||Scalp and skin: 1–2 times daily.||[rx,rx,rx]|
|Desonide||0.05% lotion, gel||Scalp and skin: 2 times daily.||[rx,rx–rx]|
|Fluocinolone||0.01% shampoo, lotion or cream||Scalp or skin: Once or twice daily.||[rx,rx]|
|Immuno-modulators||Pimecrolimus||1% cream||Skin: 1–2 times daily.||Inhibition of cytokine production by T-lymphocyte.||Risk of skin malignancy and lymphoma with prolonged use.||[rx,rx–rx]|
|Tacrolimus||0.1% ointment||Skin: 1–2 times daily × 4 weeks, then twice/week for maintenance.||[rx,–rx]|
|Miscellaneous||Coal tar||4% shampoo||Scalp: 1–2 times/week.||Antifungal, anti-inflammatory, keratolytic, reduces sebum production.||Local folliculitis, ICD on fingers, psoriasis aggravation, skin atrophy, telangiectasias, hyper-pigmentation. Risk of squamous cell carcinoma with prolonged use.||[rx,rx,rx,rx,rx]|
|Lithium gluconate/succinate||8% ointment or gel||Skin: twice daily × 8 weeks.||Anti-inflammatory via increased IL-10 and decreased TLR2 and TLR4 in keratinocytes.||ICD in <10% of patients.||[rx,rx–rx]|
|Metronidazole||0.75% gel||Skin: twice daily × 4 weeks.||Anti-inflammatory via inhibition of free radical species.||Rare contact sensitization with prolonged use.||[rx,rx,rx,rx]|
|Phototherapy||UVB: Cumulative dose of 9.8 J/cm2||Three time/week × 8 weeks or until clearing.||Immuno-modulation and inhibition of cell proliferation.||Burning, itching sensation during/after therapy. Risk of genital tumor with prolonged use.||[rx,rx–]|
|SYSTEMIC||Itraconazole||Oral: 200 mg||Once daily × 7 days, then once daily × 2 days/month for maintenance.||Inhibition of fungal cell wall synthesis. Anti-inflammatory via inhibition of 5-lipoxygenase metabolites.||Rare liver toxicity.||[rx,rx,rx]|
|Terbinafine||Oral: 250 mg||Once daily × 4–6 weeks or 12 days monthly × 3 months.||Inhibition of cell membrane and cell wall synthesis.||Rare tachycardia and insomnia.||[rx–rx]|
Note: Shampoos, foams and lotions are better suited for treating seborrheic dermatitis and dandruff on the scalp; gels, creams and ointments are used to treat seborrheic dermatitis on body locations other than the scalp.
- The pathogenesis of dandruff involves hyperproliferation of keratinocytes, resulting in deregulation of keratinization. The corneocytes clump together, manifesting as large flakes of skin. Essentially, keratolytic agents such as salicylic acid and sulfur loosen the attachments between the corneocytes and allow them to get washed off.[rx]
- Salicylic acid is a beta hydroxyl acid keratinolytic agent that is useful in removing scaly hyperkeratotic skin. It decreases cell-to-cell adhesion between corneocytes. This agent is widely used in the AD preparations.
- Sulfur, a non-metallic element has both keratolytic and antimicrobial activity. The keratolytic effect is thought to be mediated by the reaction between the sulfur and the cysteine amino acid in the keratinocytes, whereas the antimicrobial effect may depend on the conversion of sulfur to pentathionic acid by normal flora or keratinocytes.[rx–rx]
Regulators of keratinization
- The zinc pyrithione (ZPT) heals the scalp by normalizing the epithelial keratinization or sebum production or both. Some studies have shown a significant reduction in the number of yeasts after use of ZPT.[rx] A study by Warner et al,[rx] demonstrates a dramatic reduction of structural abnormalities found in dandruff with the use of ZPT; the population abundance of Malassezia decreases, parakeratosis gets eliminated and corneocytes lipid inclusions are diminished.
- Tar is widely used in the treatment of psoriasis and found to be very effective in dandruff as well.[rx] The staining properties, odor, and mess in using tar limit its choice. Tar preparation work through antiproliferative and cytostatic effects, although definitive analysis is difficult because of the large number of biologically active components in coal tar. Tar products disperse scales, which may reduce Malassezia colonization. In the mouse model, it was found that topical application of tar suppresses epidermal DNA synthesis.[rx]
- A clinical trial of the combination of polyester and ZPT based shampoo in Indian population[rx] also show that the combination of the above agents is very safe and effective in controlling dandruff and associated symptoms.
- The parakeratotic properties of topical corticosteroids depend on the structure of the agent, the vehicle and the skin onto which it is used. Corticosteroids work via their anti-inflammatory and antiproliferative effects.[rx]
- It is believed that selenium sulfide controls dandruff via its anti-Malassezia effect rather than by its antiproliferative effect.[rx] although it has an effect in reducing cell turnover. It has anti-seborrheic properties as well as the cytostatic effect on cells of the epidermal and follicular epithelium. The excessive oiliness after use of this agent has been reported in many patients as an adverse drug effect.
Imidazole antifungal agents
- Imidazole topical antifungals such as ketoconazole act by blocking the biosynthesis of ergosterol, the primary sterol derivative of the fungal cell membrane. Changes in membrane permeability caused by ergosterol depletion are incompatible with fungal growth and survival.[rx]
- Ketoconazole is a broad spectrum, antimycotic agent that is active against both Candida and M. furfur. Of all the imidazoles, ketoconazole has become the leading contender among treatment options because of its effectiveness in treating seborrheic dermatitis as well.[rx,rx]
- In contrast to the imidazole antifungals, the hydroxypyridones do not affect sterol biosynthesis; instead, they interfere with the active transport of essential macromolecule precursor, cell membrane integrity and the respiratory process of cells.[rx] Ciclopirox is widely used as an Ad agent in most preparations.
- There are several naturopathic agents which have been claimed to have antidandruff activity. However, in most cases, these naturopathic agents are used in combination with synthetic agents.[rx–rx] Studies from India[rx–rx] have shown that the herbal preparations are as effective as synthetic substances in controlling dandruff both by in vitro and in vivo studies.
Home Remedies for Dandruff/How can I remove dandruff permanently
Omega- 3 fatty acids
There are specific types of fats really effective for anybody combating Omega-3 fatty acids are essential oils that the body requires in order to run smoothly. It helps regulate the bodily conditions, which would include the skin and hair.
Include these omega-3 fatty acid rich foods in your diets, such as certain types of fish and nuts. Some people supplement their diet with omega-3 fatty acids by the use of flax seed oil.
You can reduce dandruff just by staying hydrated. In fact, it is the key to eliminating dandruff. The first step to curing dandruff is seldom given any importance. Dandruff is dry itchy skin, and one very obvious cause of dry skin is dehydration. This can be caused by skimping on your intake of water, or by ingesting too many diuretics such as caffeine or alcohol. Drinking copious amounts of water is one way of preventing a dry scalp and avoiding dandruff.
Skin irritations are often caused by stress and offshoots of stress like depression and so on. Try to eliminate stress from your life by trying out yoga, taking walks, massage therapy, and various similar techniques. Busting that stress is thus a great way of getting rid of dandruff.
Baby oil is another great remedy for dandruff. Its high mineral content helps keep your scalp well-nourished and hence prevent it from getting too dry.
In adults, dandruff and seborrhoeic dermatitis may return at any time.
There is not much you can do to prevent dandruff and seborrhoeic dermatitis from reoccurring. However, using an antidandruff or antifungal shampoo once a week (or as prescribed on the bottle) after the scalp is clear may help to prevent dandruff and seborrhoeic dermatitis of the scalp.
The following steps can help prevent dandruff:
- Try not to scratch your scalp when using shampoo. Gently massage your scalp without scratching as this will not damage your scalp or your hair.
- Brush your hair daily and wash it at least three times a week. After washing your hair, rinse it thoroughly to get all the shampoo out. Using a shampoo that contains tea tree oil daily may help reduce dandruff. It contains an antifungal and antiseptic and can be bought in health shops.
- Avoid using chemicals on your scalp, such as those used in hair coloring products. The chemicals reduce the number of bacteria on the scalp that are needed to fight against yeasts.
- Using hair products, such as hair gels and hair sprays, can build up oils and can irritate the scalp in some people. You may want to stop using a product for a while to see if your dandruff improves, or change products completely.
- Spending time outdoors can help reduce dandruff. However, ultraviolet (UV) light from the sun can damage your skin, as well as increasing your risk of developing skin cancer. Make sure you protect yourself from the sun by using a sunscreen with the appropriate skin protection factor (SPF) for your skin type.
- Managing stress can reduce your risk of getting dandruff. Stress can have an adverse effect on your overall health and can increase your risk of becoming ill. Stress can also trigger dandruff or make existing dandruff worse. If you feel stressed or under pressure, your GP can recommend a variety of different ways to help treat your stress.