Dandruff symptoms are predictably uniform from person to person — flaking, itching, scalp irritation — but the root causes of it vary. Anyone who suffers from dandruff should first identify the underlying issue causing it, as this will inform which dandruff shampoo is best and which active ingredient to deploy to prevent future breakouts.
While most people associate dandruff with poor hygiene or a dry scalp, it’s more complicated than that. Someone may have an excessively oily or irritation-prone scalp, which can trigger flaking no matter how often the hair is washed. Over shampooing can also dry out the scalp — as can air-conditioned rooms, arid environments, dry seasons, pool water, hot showers, or even genetics. Contact dermatitis, an allergic reaction to one’s shampoo or styling products, is another common cause of dandruff.
Even with this intel, it can be difficult to pin down the exact cause of dandruff. Dr. Robin Evans, a board-certified dermatologist at Southern Connecticut Dermatology in Stamford, Conn. said there is not always a specific cause of dandruff, and that an appointment with a dermatologist can be helpful in finding a solution tailored to each unique case, even if it’s an over-the-counter (OTC) shampoo.
Related Stories
Most OTC dandruff shampoos are effective at nixing a wide range of dandruff cases, but they’re one-size-fits-all. Read on for insight on dandruff shampoos and their best ingredients, from Evans and two other board-certified dermatologists: Dr. Michele Green in New York City andDr. Calvin Williams of Essential Dermatology Group in the Dallas-Fort Worth area.
The Best Dandruff Shampoos: At a Glance
Head & Shoulders Anti-Dandruff 2-in-1 Shampoo and Conditioner
Harry’s Extra-Strength Anti-Dandruff 2-in-1 Shampoo & Conditioner
What the Experts Say About Dandruff Shampoo
The Best Active Ingredients for Treating Dandruff
While there are many active ingredients found in anti-dandruff shampoos these days, Williams honed in the six best ones for fighting against flaking and preventing future flare-ups.
- Ketoconazole: “This is an antifungal medication used to treat dandruff caused by a yeast, called Malassezia,” said Williams. “It’s particularly useful for those with a more severe form of dandruff, also known as seborrheic dermatitis.” Many of the dermatologists SPY spoke to on this topic marked this as their preferred ingredient for treating most cases.
- Pyrithione zinc: Also antifungal, and also targeting Malassezia yeast, pyrithione zinc is slightly less potent than ketoconazole, said Williams. “Use it for mild to moderate cases of dandruff. It has an anti-inflammatory effect, too.” This active ingredient is perfect for the guy who occasionally finds flakes but hasn’t had anyone else comment on it yet.
- Salicylic acid: This ingredient is common in skincare products targeting oily skin and acne, since it can seep into the pores and free them of any clogging, while also tempering oil production and exfoliating skin cells at the surface. So, for obvious reasons it’s great for dandruff caused by excessive oil with flaky build-up, said Williams.
- Coal tar: This ingredient sounds unappealing, but it’s actually quite soothing. “Coal tar can slow down the growth of skin cells and reduce inflammation. It’s been shown to be of benefit to patients with psoriasis or severe dandruff,” said Williams.
- Selenium sulfide: Another potent antifungal agent, selenium sulfide is a common pick for severe dandruff or seborrheic dermatitis, said Williams. Studies suggest that ketoconazole is slightly better tolerated en masse.
- Tea tree oil: Tea tree oil is an essential oil with antifungal and antibacterial properties, but should only be used in products that have been cleared by the FDA for use—as opposed to making one’s own oil blend at home. “In dandruff shampoo, tea tree oil is a suitable option for mild dandruff and those who prefer natural ingredients,” said Williams.
On Using the Shampoo Correctly
Dandruff shampoos carry a reputation of drying out the scalp and hair. This makes it extra important, to use it correctly, regardless of the one you choose.
“Be sure to use only a quarter-sized amount of the shampoo and apply it directly to the scalp, not the ends [of the hairs],” Dr. Green said. If it’s difficult to avoid the ends of hairs (like, on short and medium styles), she recommended applying a leave-in conditioner to the strands before lathering up.
Always follow the directions on the shampoo bottle, as these active ingredients need to absorb into the scalp in order to have a lasting effect. Aim for 30 seconds at a minimum, and always follow with a nourishing conditioner (left in hair for at least two minutes) to add nutrients and moisture back into the scalp and strands alike. Also, make sure to rinse thoroughly after each use to avoid excessive scalp build-up.
Frequently Asked Questions About Dandruff Shampoo
Does dandruff shampoo work on beard dandruff too?
Fortunately, dandruff shampoo can also remedy beard dandruff, said Williams. “The same conditions that affect the scalp can also affect the beard area.” And seborrheic dermatitis, an inflammatory condition that causes dandruff, can also impact the eyebrows, ears, and the nasolabial folds (which connect the nose to the corners of the mouth). “Because of this, similar medications that work well for the scalp can also be effective for other parts of the body and I typically recommend trying dandruff shampoos first [as the initial effort],” said Williams.
Are dandruff and seborrheic dermatitis the same thing?
Yes and no. The broad term “dandruff” refers to flakes and scales. Seborrheic dermatitis is an inflammatory condition that consists of flakes and scales, said Evans, but also may include redness and itching. Echoing Williams’ note about dandruff above, Evans adds this: “Dandruff involves the scalp and the beard area. “Seborrheic dermatitis can also cause flaking in the eyebrows, around the nostrils, the ears, and behind the ear areas.”
How can I prevent dandruff?
Dandruff prevention combines strategy in terms of shampoo frequency, supplementation, and the occasional use of active ingredients to temper the scalp. Williams said that merely using an anti-dandruff shampoo once a week would be enough in most cases to keep flakes at bay. Evans added that using a regular (non-dandruff) shampoo at least every other day is often enough to prevent oil buildup without over drying the scalp. She suggested taking omega-3 fatty acid supplements to help regulate sebum production, and using shampoos and conditioners with anti-inflammatory properties to help mitigate dandruff (like tea tree oil, aloe vera, niacinamide, calendula, chamomile and more). She also emphasized the importance of being especially proactive about these efforts in the winter.
When should I use a prescription-strength dandruff shampoo?
Evans said to make an appointment with a board-certified dermatologist when over-the-counter dandruff options are not effective after a few weeks or in cases with severe symptoms. Beyond that timeframe, a prescription-grade approach (which often involves light steroids) might be the best bet, so seek assistance from a doctor.
There are many over-the-counter products labeled “prescription-strength” or “clinical” that use higher doses of their active ingredients, and while they’re not as intense as actual prescription solutions, they do tend to be a step above most regular OTC dandruff shampoos.
Nizoral AD Anti-Dandruff Shampoo
This ketoconazole-powered shampoo is Dr. Williams’ top choice for a clinical-grade option and casts the broadest net of solution for anyone who can’t source the exact cause of their dandruff. (It’s also SPY’s pick as the best shampoo for beard dandruff and scalp itch.)
Why It’s the Best: “Ketoconazole 1% is proven to be very effective against the fungi that are involved in dandruff,” Williams said in recommending this one. This formula is also gentle on gray hair, dyed hair, and chemically processed hair. There’s even a 2% version available via prescription for anyone with extremely severe dandruff.
However, Williams added that there’s never a one-size solution to dandruff, so the picks below might better suit individual cases, depending on severity, dandruff cause, patient preferences, and hair texture/styling needs.
Head & Shoulders Anti-Dandruff 2-in-1 Shampoo and Conditioner
Key Ingredient: Pyrithione zinc 1%
How It Works: As Williams noted, pyrithione zinc is terrific at targeting mild to moderate cases of dandruff, particularly in its standard 1% delivery. This is his go-to brand for mild cases for that reason.
There’s More: This dual pack contains 64 ounces of anti-dandruff shampoo. It’s designed to be used once a week, so it’s fairly low-maintenance and great for prevention.
Harry’s Extra-Strength Anti-Dandruff 2-in-1 Shampoo & Conditioner
Key Ingredient: Pyrithione zinc 2%
How It Works: By doubling the usual dose of pyrithione zinc, this recipe goes from tackling mild cases to more moderate and severe ones.
There’s More: Be sure to select “Extra-Strength Anti-Dandruff” on the Harry’s shampoo page; it defaults to the regular 1% pyrithione zinc option (which is also terrific for mild cases), but anyone wanting a higher dosage should upgrade to the 2% “extra-strength” one.
Selsun Blue Medicated Anti-Dandruff Shampoo
Key Ingredients: Selenium sulfide 1%, menthol
How It Works: Williams recommended selenium sulfide for cases of severe dandruff and seborrheic dermatitis caused by fungal proliferation. This one also cools on contact — a nice soothing touch — thanks to the menthol in its recipe.
There’s More: Selsun Blue has a roster of shampoos with selenium sulfide and pyrithione zinc that target different hair types and scalp conditions.
Neutrogena T/Sal Therapeutic Shampoo
Key Ingredients: Salicylic acid 3%
How It Works: This high-grade salicylic acid shampoo is another favorite of Williams’. It helps balance oil production in the pores, while also unclogging those pores of sebum buildup and trapped skin cells. It exfoliates dead surface cells too, to prevent existing flakeage.
There’s More: Use this one on itchy, flaky beards, especially if the skin underneath is prone to oil buildup and acne.
Neutrogena T/Gel Therapeutic Shampoo
Key Ingredients: Coal tar 1%
How It Works: Coal tar is William’s recommended ingredient for reducing inflammation, making this particularly useful for anyone whose seborrheic dermatitis or psoriasis (or similar inflammatory condition) is causing dandruff or itching up top.
There’s More: It smells funky, yes, but think of it as medicine (which rarely tastes nice either).
Paul Mitchell Tea Tree Special Shampoo
Key Ingredients: Tea tree oil, aloe vera, jojoba extract
How It Works: While the shampoo itself is not a natural recipe, the tea tree oil in this scalp-purifying shampoo is a natural alternative to the active ingredients in other recipes. It’s not as immediate of a fix as those hair-drying shampoos, but it will be more nourishing to hair and skin.
There’s More: Paul Mitchell created an entire Tea Tree hair care line for all types of hair and scalp needs. Stocking up on a couple of options to cover the bases isn’t a terrible idea.
Pura D’Or Scalp Therapy Shampoo
Key Ingredients: Tea tree oil, aloe vera, peppermint oil, argan oil, lavender oil
How It Works: This all-around nourishing and balancing shampoo is a terrific regular-use shampoo in its own right. It’s the gentlest pick on this roster, so it won’t necessarily fight active dandruff but is helpful for ongoing prevention without drying out the hair and scalp.
There’s More: It tingles and soothes upon application, thanks to aloe vera as well as peppermint and lavender oils.
Head & Shoulders Royal Oils Scalp Care Shampoo
Key Ingredients: Pyrithione zinc 1%, coconut oil, apple cider vinegar
How It Works: Curls need constant conditioning, and dandruff shampoos are famous for depleting strands of moisture. This formula is the friendliest to curls and coils due to its inclusion of nourishing coconut oil and scalp-clarifying apple cider vinegar.
There’s More: Target the scalp as best as possible; if the rest of the curls need washing, use a more curl-friendly (non-dandruff) shampoo, and always always follow with a curl conditioner or leave-in cream.
DermaHarmony Dandruff Shampoo Bar
Key Ingredients: Pyrithione zinc 2%
How It Works: This bar soap deploys a moderate grade 2% pyrithione zinc to tackle flakes and inflammation in order to keep bald heads looking polished.
There’s More: It’s all in the brand’s name: DermaHarmony’s pH-balanced bar honors the skin harmony of the scalp, to avoid redness, inflammation, or drying out.