Find out what's causing your "dandruff" — then say goodbye to itching and flaking with these products.

By Caroline Shannon-Karasik
Nov 25, 2019 @ 12:00 pm
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Like a cystic acne flare-up, a dry or itchy scalp is one of those embarrassing beauty issues that can make you feel like you're the only person dealing with it. But rest assured that the issue is both incredibly common — and that there's a solution that will have your LBDs devoid of flakes. 

First thing's first though, you have to determine the cause of your dry and irritated scalp so you can choose the best product to treat it. Here, derms explain everything you need to know about what's commonly known as "dandruff" — and the best anti-dandruff shampoos to find relief.

What’s the Difference Between Dry Scalp and ‘Dandruff’?

Just like the skin on the rest of your body, your scalp has the potential to get dry, too, from cold or dry air, says Ranella Hirsch, M.D., a Boston-based dermatologist.

"In general, dry scalp symptoms include flaking, itching, tightness, stinging, or pain when getting chemicals or hair dye applied to the area," explains dermatologist Francesca Fusco, M.D., assistant clinical professor of dermatology at The Mount Sinai Hospital.

However, if your flakes are happening year-round, it's likely a larger issue at play. "With dandruff [otherwise known as seborrheic dermatitis, seborrheic eczema, or seborrheic psoriasis], you could have all of those symptoms, but you'll generally also have a greasy scalp, plus more flakes than what you'd get with typical dry scalp,” she says.

This type of "dandruff" can be persistent and can also cause scaly patches, redness, and larger flakes that can be white or yellow, says Dr. Hirsch. "It tends to affect areas with many oil glands, so we also see it in your eyebrows, on the sides of the nose, and the chest (especially for men)," she says.

This "official" form of dandruff is believed to be caused by two things — a compromised skin barrier and the overgrowth of a yeast that naturally grows on the scalp. While yeast commonly "lives uneventfully on most scalps," Dr. Hirsch says it may cause an immune response and irritation for some people, leading to a flaking scalp.

"When dandruff really revs up a lot, it can feel like thick scales, and if you look at the skin under a microscope, it will look cracked because the protective barrier is compromised," Dr. Fusco explains. "Then, it's just a matter of the yeast getting into the cracks, the cracks getting bigger, and it just takes off from there."

What Are Other Causes of a Dry, Flaky Scalp?

If this doesn’t sound like your situation, but you’re still dealing with a dry, itchy, and flaky scalp, know that it can be caused by several other factors, too, Dr. Hirsch says.

Contact dermatitis: Your dry or irritated scalp could also be an allergy or sensitivity to certain ingredients in your hair care products. If you can pin down the problem-causing product, often all you have to do is discontinue using it to find relief, Dr. Hirsch says.

Scalp psoriasis: About half of Americans that have psoriasis have it on their scalp, but it tends to appear as raised, reddish, and scaly patches, rather than the white flakes associated with dandruff.

Unwashed hair: If you’ve over-relying on dry shampoo in place of a good old wash, then this could be the cause for a dry or flaky scalp. Dr. Hirsch says ignoring hair care can result in skin cells and scalp oils will build up and shed, which will look a lot like dandruff.

RELATED: What Can Happen if You Don't Wash Your Hair Enough

How to Choose the Best Shampoo for a Dry, Itchy Scalp

Once you've determined the case of your dry scalp, the good news is you can find an anti-dandruff shampoo that can help decrease and soothe the itching and flaking that comes along with it, says John Blue, the owner and creative director of Chicago-based BOSS HAIR GROUP.

But no matter the shampoo you choose, it's important to remember that dandruff (and its related conditions) are not directly linked to the hair, but rather the scalp, notes Dr. Hirsch. "The trick with any of these products is to think of it as a scalp treatment rather than a shampoo," she says.

RELATED: Why Are Hair Brands So Obsessed With Scalp Care Right Now?

That's why Dr. Hirsch recommends patients ignore typical wash-and-go shampoo rules and instead leave their shampoo choice on for 10 to 15 minutes with each use. She adds: "Washing it out quickly, as is often the case with shampoo, will not adequately address the root of the problem."

And remember, Blue says, if over-the-counter treatments don’t seem to soothe your angry scalp, then it might be time to pay a visit to your dermatologist. “Excessive dry and irritated scalps can cause more itching, where you could be breaking skin and possibly causing an infection," he cautions.

Ready to get the scoop on the best shampoo for dry scalp and dandruff? Here are a few top-rated and derm-approved options you'll want to check out.

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When it comes to treating seborrheic dermatitis and psoriasis on the scalp, Dr. Hirsch recommends coal tar, an ingredient known for its ability to soothe (and sometimes completely cure) chronic scalp conditions, according to the American Academy of Dermatology.

One user said she tried several prescribed treatments for her seborrheic dermatitis before buying this Neutrogena shampoo and was pleasantly surprised by the results. “This shampoo is 100 percent effective for me after a few days of use,” she said, noting that she uses the treatment twice per week and combined it with her regular tea tree oil shampoo. “This combination worked like magic!"

One note: When using a product with tar, Dr. Hirsch says you might notice your scalp is a bit sensitive to the sun, so wear a hat, opt for shade, or use a hair sunscreen as needed.

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Salicylic acid is the star ingredient in this shampoo and it’s no surprise, Dr. Hirsch says. It’s known for loosening (and washing away) the dry skin associated with dandruff and other itchy, flaky skin conditions. It's paired with soothing plant-based ingredients, like willow bark extract and tea tree oil, which works as an anti-inflammatory and is often used to help clear up acne.

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The peony extract in this soothing shampoo offers more than just fragrance — it also has anti-inflammatory properties that can help calm a dry scalp. One user said the gentle formula helped clear up her seborrheic dermatitis. And, yes, she noted, “it smells amazing.”

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A tried-and-true classic, Selsun Blue — or other shampoos that contain selenium sulfide — is effective for dandruff that is caused by yeast (malassezia), according to Dr. Hirsch.

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Some claim that this shampoo from celebrity hairstylist Kristin Ess cured flakes that traditional anti-dandruff shampoos couldn't. It uses micellar technology to gently lift buildup and leaves behind soothing, moisturizing ingredients like antioxidant-rich aloe vera leaf juice, and castor oil, which is known for its antimicrobial and anti-inflammatory properties.

“I started getting dandruff all of a sudden, and I happened upon this shampoo,” one reviewer said.“[It] doesn't irritate my scalp, but magically seems to sweep up any dry flakes.”

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African black soap, tea tree oil, aloe vera, and willow bark extract help to moisturize a dry scalp and soothe itchy skin.

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The benefits are basically in the name with this shampoo, so it’s bound to draw your attention from the get-go. But the ingredients — including aloe vera juice, which is a rock star at cooling down red, irritated skin — are also worth noticing. One reviewer said her 40-year-long battle with psoriasis (and the itchy, flaking scalp to go along with it) came to an end when she found this shampoo.

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Cut itchiness and decrease flaking with this shampoo's combo of sulfur and salicylic acid to help treat scalp dermatitis, as well as mild psoriasis. Nourishing olive, jojoba, and rosemary oils add a therapeutic boost. 

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The main ingredient in Nizoral is ketoconazole, an effective anti-fungal ingredient that helps nix dandruff (and relieve itching and flaking), according to Dr. Hirsch. In addition to being affordable, it has over 3,000 five-star reviews on Amazon.

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If you have seborrheic dermatitis, then you'll want to look for products with pyrithione zinc, like Head and Shoulders, which have antibacterial and antifungal properties, Dr. Hirsch says.

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