If you've ever had dandruff, with its telltale white flakes, you probably know
that it can be a little embarrassing. This is especially true for kids and teenagers,
who may already be self-conscious about their looks.
Fortunately, dandruff is harmless and can almost always be controlled, often with
simple over-the-counter remedies.
Dandruff is another name for a condition called seborrheic
dermatitis, or seborrhea, specifically seborrhea that happens on the scalp. It's
a very common condition in kids and adults alike, regardless of age or race.
Dandruff causes flaky, white, or yellowish skin to form on the scalp and other
oily parts of the body. Other areas that can get seborrhea include the eyebrows, eyelids,
ears, crease of the nose, back of the neck, armpits, groin, and bellybutton.
In some cases, dandruff can cause redness in the affected area and may appear crusty
and start to itch, sometimes pretty badly. On rare occasions, dandruff can even lead
to hair loss if it isn't treated. Any lost hair should grow back once the dandruff
is treated, though.
Dandruff is not contagious or an indication of poor hygiene, and it often can be
controlled by daily shampooing with a gentle shampoo. In more severe cases, a doctor
may recommend a medicated shampoo or cream.
The exact cause of seborrhea isn't known, although some researchers believe it
can be caused by an overproduction of skin oil (sebum) in the oil glands and hair
follicles. A type of yeast (fungus) called malassezia can grow in the sebum along
with bacteria. This may be another factor in the development of seborrhea. Seborrhea
happens in people (like teenagers) with high hormone levels, which also may play a
The flakes associated with dandruff sometimes can be caused by conditions other
than seborrhea, including:
dry skin, such as the kind caused by cold, dry winter air
other skin conditions like eczema, acne, or psoriasis that can cause dead skin
cells to build up on the scalp
shampooing too often or not often enough
using hair-care products or hair dye that leave a dry, flaky residue or having
a bad reaction to these products
Dandruff often runs in families. Men are a little more likely than women to get
it. Other things can also make dandruff more likely, like having oily skin, stress,
a neurological condition such as Parkinson's disease, or a condition like HIV (human
immunodeficiency virus) that harms the body's immune system.
Often, the first symptom someone with dandruff will notice are white flakes of
dead skin in the hair or on the shoulders. The scalp may also become itchy and scaly.
Other signs of seborrhea:
dry, flaky skin that gets worse in cold weather
dry skin on the face, forehead, ears, or eyebrows
flaky skin on the chest or other parts of the body that have hair
greasy or oily areas of skin on the scalp or other parts of the body
mild redness in the affected area
temporary hair loss
When to Call the Doctor
Most cases of dandruff won't require a doctor's visit and can be treated with special
dandruff shampoos available without a prescription.
Sometimes the dandruff is particularly hard to treat, or the rash is coming from
a completely different problem. If your child's dandruff doesn't get better after
a few weeks of using dandruff shampoo, or if the skin becomes red, swollen, or drains
fluid, you should contact your doctor. Also call if your child's seborrhea gets
worse, spreads to other parts of the body, or causes hair loss.
Many cases of mild dandruff can be treated just by shampooing every day with a
gentle shampoo. This will reduce oiliness and keep dead skin cells from building up.
Moderate cases of dandruff usually can be treated with an over-the-counter dandruff
shampoo. Many types are available and not every one works for every person, so you
may need to experiment until you find the one that works for your child.
The different types of dandruff shampoos include:
Selenium sulfide shampoos. These help slow the rate at which
skin cells die and may fight the fungus that can cause seborrhea.
Tar-based shampoos. Made from coal tar, these also slow down
the rate at which skin cells die and flake off.
Zinc pyrithione shampoos. These tackle the fungus on the scalp
that can cause seborrhea.
Salicylic acid shampoos. These help remove flaky skin from the
scalp but may leave it dry, which can lead to more flaking.
Ketoconazole shampoos. These antifungal shampoos, available in
stronger doses with a prescription, are designed to reduce fungus on the scalp.
At first, kids with dandruff may need to use one of these shampoos every day to
get their dandruff under control. After that, most can cut back to once or twice
Have your child massage the shampoo into the scalp and let it sit for at least
5 minutes before rinsing it out. After rinsing, kids can use regular shampoo or conditioner
if they want, as the treatment shampoos tend to be a little smelly.
If over-the-counter dandruff shampoos don't improve your child's dandruff, or if
seborrhea develops in places other than the scalp, talk to a doctor. You may need
to get your child a prescription-strength shampoo, an antifungal lotion, or cream
After treatment, some people will notice that areas of skin that had seborrhea
will be lighter in color than the rest of their skin. This is more common in those
with darker skin. This color difference will fade over time and the skin's color will
eventually return to normal.
Dandruff is a chronic condition, meaning it can't be cured, but it can almost always
be kept under control. Once it's under control, it's usually impossible to detect
and will go from being a problem to something that's barely on your child's mind.