Different Types of Dandruff and How to Stop Them

Dandruff is a common scalp condition that affects nearly half of all adults at some point in their lives. Characterized by flaky, dry skin shedding from the scalp, dandruff can cause social embarrassment and discomfort. While rarely serious, having a flaky scalp can certainly be annoying.

Dandruff has many causes and can take different forms depending on the specific trigger. By understanding the different types of dandruff and what’s behind them, you can be better equipped to treat and prevent dandruff flakes from forming.

In this comprehensive guide, we’ll dive into the various causes of dandruff, outline the different types and their symptoms, and provide detailed treatment and prevention recommendations so you can successfully eliminate dandruff.

What Causes Dandruff in the First Place?

Before jumping into the specific varieties, let’s first understand what causes dandruff. In basic terms, dandruff forms when dead skin cells on the scalp shed faster than normal. Small flakes or scales appear as the dead cells detach from the scalp.

Dandruff can have multiple underlying causes:

• Oily skin – Excess sebum production can cause greasy patches and flakes to develop. A yeast called malassezia feeds on sebum, resulting in more skin turnover and flaking.
• Dry skin – External factors like cold, dry air, harsh hair products, and over-shampooing can cause dry, flaky skin. This exacerbate dandruff in people with naturally dry skin types.
• Sensitive skin – Some people’s skin reacts to certain ingredients in hair care products, foods, or environmental factors, causing contact dermatitis. The resulting inflammation and irritation leads to dandruff.
• Skin conditions – Dandruff is linked to skin conditions like psoriasis, eczema, and seborrheic dermatitis. The inflammatory processes involved causes increased flaking.
• Stress – High stress levels can worsen scalp health and dandruff symptoms. Stress triggers inflammation, aggravates skin conditions, and causes oil gland overactivity – all contributing to flaking.

As you can see, dandruff can stem from a variety of sources, from oily or dry skin to chronic skin conditions and reactions. The treatment approach depends on identifying the specific cause in each individual.

Next, let’s look at the different types of dandruff in more detail.

Types of Dandruff

There are four main types of dandruff, categorized by their causes and manifestations:

1. Seborrheic Dermatitis

One of the most severe and common causes of dandruff is seborrheic dermatitis. This condition causes red, greasy patches covered with yellowish, oily scales that cling to the hair shaft. Dandruff from seborrheic dermatitis often occurs not just on the scalp, but also the face, back of the ears, chest, eyebrows, and anywhere with oil glands.

Causes

Seborrheic dermatitis is thought to result from the overgrowth of a yeast called malassezia globosa that feeds on sebum secreted by the scalp’s oil glands. The malassezia fungus is naturally found on everyone’s skin but certain factors can trigger overgrowth, including:

• Excess sebum production, which feeds the yeast
• An abnormal immune system response to the yeast
• Hormonal fluctuations or stress triggering excess sebum

This malassezia overgrowth causes increased skin cell turnover and shedding. For those with a genetic predisposition, the result is seborrheic dermatitis.

Symptoms

Seborrheic dermatitis varies in severity. Symptoms include:

• Yellowish, oily, greasy scales
• Red, inflamed, itchy skin
• Scalp tenderness
• Scales that cling to hair shaft
• Flare-ups during stress or winter months
• Potential hair loss in severe cases

The scaling and redness can occur on the scalp, face, ears, eyelids, chest, armpits, groin and other oily areas of the body. In infants, seborrheic dermatitis is known as “cradle cap”.

Treatment

Since excessive yeast growth is a main trigger, antifungal ingredients are used to treat seborrheic dermatitis dandruff:

• Antifungal shampoos with zinc pyrithione, ketoconazole, or selenium sulfide help reduce yeast overgrowth and inflammation when used 2-3 times per week.
• Steroid creams or lotions can reduce inflammation and itching in difficult cases.
• Antiseborrheic shampoos containing sulfur or salicylic acid can be prescribed if regular dandruff shampoos are not strong enough.
• Antifungal oral medication may be required if shampoos are insufficient to control symptoms.
• Proper skin care – avoiding irritants, moisturizing, and treating secondary infections if they occur.

With consistent use of antifungal treatments and proper skin care, seborrheic dermatitis can usually be managed effectively. Severe cases may require regular use of prescription steroids or oral medication under medical supervision.

2. Psoriasis

Psoriasis is an autoimmune disease that accelerates the growth cycle of skin cells. The buildup of new skin cells causes thick, scaly patches. Psoriasis can occur anywhere on the body, including the scalp. About 50% of people with psoriasis get it on their scalp.

Causes

The exact cause is unknown, but psoriasis involves dysregulated signaling between immune cells in the skin. This results in a speeded up skin cell cycle. The scales accumulate because new skin cells are produced faster than old cells shed.

Triggering factors for psoriasis flare-ups include:

• Infections like strep throat
• Skin injury
• Certain medications
• Stress
• Cold, dry weather

Genetics play a major role. Having a close relative with psoriasis increases your risk significantly.

Symptoms

Scalp psoriasis has distinct symptoms:

• Thick, dry, silvery-white scales with well-defined borders
• Red, inflamed areas under the scales
• Scalp tenderness and soreness
• Itching which may range from mild to severe
• Potential hair loss in severe cases

The scales have a thick, crumbling texture and flake off in large pieces. Outbreaks tend to come and go.

Treatment

Treatment focuses on reducing cell turnover, inflammation, and scale buildup. Methods include:

• Topical treatments – Prescription steroid creams, gels, foams, and ointments applied directly to affected areas
• Medicated shampoos containing salicylic acid, tar, or antifungals to reduce scaling and inflammation
• Light therapy – Ultraviolet and laser light therapy to slow cell growth
• Oral medications – For moderate to severe cases, drugs like methotrexate, retinoids, and biologics to inhibit the immune response
• Diet – Some find anti-inflammatory diets help reduce symptoms and flare-ups
• Stress management – Managing stress and anxiety can help prevent outbreaks

With ongoing treatment under a dermatologist’s care, psoriasis can usually be kept under relative control, though flare-ups may occur periodically.

3. Dry Scalp Dandruff

As the name suggests, this type of dandruff is caused by simple dry skin and the external factors that strip moisture from the scalp. It is the mildest, non-inflammatory form of dandruff. Those with naturally drier skin types tend to be affected.

Causes

Dry scalp occurs for a variety of reasons:

• Exposure to dry, cold weather seasons
• Frequent shampooing which strips natural oils
• Harsh soaps or shampoos that dry out the scalp
• Not thoroughly rinsing out hair products
• Aging, as skin’s ability to retain moisture decreases
• Skin conditions like eczema or psoriasis

When the scalp becomes too dry, small white flakes shed.

Symptoms

The symptoms include:

• Small white flakes resembling dandruff or powder
• Mild to moderate itching
• No redness or irritation
• Flare-ups worsen during winter months

The flakes are smaller and look “dustier” compared to other dandruff varieties. Itching may occur with flaking.

Treatment

Relieving a dry scalp involves simple moisturizing treatments:

• Use a hydrating, gentle shampoo and conditioner free of harsh sulfates or detergents. Shampoo no more than 2-3 times per week.
• Apply an over-the-counter moisturizing lotion or cream to the scalp after shampooing.
• Try essential oils like coconut, argan, tea tree, lavender, or rosemary oil to moisturize the scalp. Dilute in a carrier oil before applying.
• Take shorter, lukewarm showers instead of hot showers that strip moisture.
• Use a humidifier during dry winter months.
• Stay hydrated by drinking plenty of water.
• Scalp massages can boost circulation and enhance moisturizer absorption.

With consistent gentle cleansing and moisturizing, dry scalp dandruff is easily treatable. Severe or persistent cases may require prescription moisturizers and lotions.

4. Contact Dermatitis

Contact dermatitis refers to dandruff resulting from contact irritants. This could be an allergic reaction or sensitivity to some substance touching the scalp, whether it’s hair products, metals, foods, or chemicals.

Causes

Common triggers for contact dermatitis on the scalp include:

• Reactions to certain ingredients in hair care products – preservatives, fragrances, oils, etc.
• Nickel or other metals touching the scalp, like in hair accessories
• Airborne allergens from substances like dust mites or pollen
• Dyes or other chemicals from hair treatments
• Foods like eggs or shellfish that are touched then transferred to the hair/scalp
• Pool chemicals like chlorine absorbed in the hair and scalp

When the scalp has prolonged contact with an irritant, the resulting allergic reaction and inflammation causes flaking and dandruff.

Symptoms

Symptoms of contact dermatitis include:

• Red, itchy, inflamed areas on affected parts of the scalp
• Small flaky scales or scaly patches
• Potential oozing or weeping lesions if severe
• Hair loss if reaction is severe
• Burning or stinging sensation

Reactions are typically isolated to areas of contact with the irritant. Without treatment, the condition can worsen with repeated exposure.

Treatment

Treatment involves identifying triggers and preventing contact:

• Keep a diary to track occurrences and try to pinpoint triggers like new products.
• Patch testing may be done by a dermatologist to identify allergens.
• Avoid any known or suspected allergens touching your scalp.
• Over-the-counter cortisone cream can provide relief, but avoid long-term use.
• Tar shampoos may help reduce scaling and itch.
• Oral antihistamines help if airborne allergens are the cause.
• In severe cases, immunosuppressant creams or oral steroids may be prescribed.

Once triggers are identified, avoiding contact is critical to prevent recurrence of contact dermatitis dandruff.

Now that you understand the major causes and types of dandruff, let’s go over how to treat and prevent those pesky flakes from appearing in the first place.

Treating Dandruff

Depending on the type of dandruff you have, various shampoos, medications, and lifestyle measures can get it under control.

Medicated Dandruff Shampoos

One of the easiest first steps is to start using an over-the-counter medicated dandruff shampoo. These contain active ingredients aimed at reducing fungal overgrowth, inflammation, and flaking:

• Zinc pyrithione – This antimicrobial ingredient inhibits fungus and bacteria overgrowth. It is effective against seborrheic dermatitis.
• Selenium sulfide – This slows cell turnover by reducing malassezia growth. It also has anti-inflammatory properties.
• Ketoconazole – This is a potent antifungal medication that fights malassezia and works well for seborrheic dermatitis.
• Coal tar – Made from coal, this ingredient slows skin cell growth and reduces scaling, itching, redness, and inflammation.
• Salicylic acid – This gently exfoliates by breaking down scalp skin cell bonds. It also has anti-inflammatory effects.

Using a shampoo containing one of these ingredients 2-3 times per week can significantly reduce dandruff. Let it sit on the scalp 5-10 minutes before rinsing out. If one shampoo doesn’t seem effective after 6-8 weeks, try switching active ingredients.

Essential Oils

Many essential oils have anti-fungal, anti-inflammatory, and antimicrobial properties that make them useful in battling dandruff. Oils to try include:

Tea tree oil – The terpinen-4-ol in tea tree attacks malassezia fungus. It also deeply penetrates to soothe the scalp.

Coconut oil – Contains lauric and caprylic fatty acids with antimicrobial effects to reduce fungus overgrowth. Also hydrates.

Rosemary oil – This stimulates circulation in the scalp to flush away dead cells. It also has antifungal abilities.

Lavender oil – Soothes and calms the scalp while deterring fungal growth.

Peppermint oil – Cools, stimulates the scalp, and has antimicrobial properties to fight dandruff fungi.

Lemongrass, clove, patchouli – Other oils with antifungal effects.

Dilute a few drops of the essential oil in a carrier oil first like coconut, grapeseed, or olive oil. Do an allergy patch test before widespread use. Massage the mixture into the scalp and let sit 30 minutes before showering.

Lifestyle and Diet Changes

Certain lifestyle measures and dietary adjustments can also help treat and prevent dandruff outbreaks:

• Drink plenty of water and stay well-hydrated. Dehydration worsens dry, flaky skin.
• Reduce stress through yoga, meditation, massage, or other relaxation methods. High stress aggravates dandruff.
• Get 7-9 hours of sleep per night. Lack of sleep increases inflammation.
• Manage chronic conditions like diabetes, eczema, and psoriasis that can worsen dandruff.

• Avoid severe calorie restriction or crash diets. Rapid weight loss stresses the body.
• Eat anti-inflammatory foods like fatty fish, colorful fruits and vegetables, and healthy fats.
• Take a vitamin D supplement since deficiency is linked to dandruff.
• Reduce alcohol intake which can dry the skin and scalp.

With a consistent skin and hair care routine using medicated shampoos and natural oils, along with healthy lifestyle habits, your dandruff can be brought under control.

Preventing Dandruff

Once your dandruff is treated and subsided, the next step is trying to prevent it from recurring. Here are some tips:

• Stick with a regular shampoo routine of 2-3 times per week max. Over-shampooing dries the scalp.
• Alternate your dandruff shampoo with a gentle moisturizing shampoo to avoid excessive drying.
• Use shampoos without sulfates, parabens, or fragrances that can irritate the scalp.
• Let shampoos sit on scalp 5+ minutes before rinsing for optimal effectiveness.
• Avoid hot showers and harsh scrubbing which strip the scalp’s oils.
• Apply moisturizer designed for the scalp after shampooing if you have dry skin.
• Use a shower filter to remove chlorine and minerals that damage hair and scalp.

• Never share hairbrushes, headgear, towels or other personal items that contact the scalp.
• Wear shower caps in pools or lakes to avoid chemical/microbe exposure.
• Handle hair gently when washing, toweling, brushing and styling to avoid injury.
• Practice stress relief habits like exercise, meditation, or yoga daily.
• If you get dandruff in the colder months, use a humidifier to add moisture to the air.
• Stay hydrated and eat a balanced, anti-inflammatory diet.

With diligent prevention methods and consistency, you can keep dandruff at bay for good. Pay attention so you can identify triggers early when flakes start to return.

When to See a Dermatologist

Most mild to moderate cases of dandruff can be managed with over-the-counter shampoos and natural treatments. But if you’ve tried these options for 2-3 months with no improvement, it’s time to make an appointment with a dermatologist.

Signs your dandruff may need professional treatment:

• Severe, painful, or inflamed red patches on your scalp
• Excessive scale buildup that is difficult to manage
• Hair loss or extreme shedding along with dandruff
• Flaking/scaling in additional areas like the face, ears, and body
• An unusually oily or smelly scalp
• Immune system weakness or disease

A dermatologist has access to prescription strength shampoos and medications that may be needed for severe seborrheic dermatitis, psoriasis, or stubborn dandruff cases.

Prescription treatment options include:

• Corticosteroid lotions or creams – More potent versions of OTC hydrocortisone cream to reduce inflammation and itching.
• Ketoconazole shampoo – 2% prescription strength formulas to fight fungal infections.
• Salicylic acid shampoos – Prescription formulas with higher concentrations of salicylic acid to penetrate scales.
• Immunosuppressants – Medications like cyclosporine that reduce immune reactions can help severe seborrheic dermatitis and psoriasis.
• Oral antifungals – In stubborn seborrheic dermatitis cases, oral medicines like itraconazole may be prescribed.
• Biologics – Newer injected medications like adalimumab that target specific immune pathway inflammation.
• Phototherapy – Ultraviolet light applied to the scalp under medical supervision to reduce scaling and inflammation.
• Combination therapy – Using prescription shampoos along with light therapy and oral or injectable medications.

A dermatologist can pinpoint the cause of your persistent dandruff through skin evaluation and lab tests. They can then customize an appropriate stronger treatment regimen based on the severity and type of your dandruff.

The Takeaway

While dealing with an itchy, flaky scalp can be annoying, there are many effective ways to treat and prevent dandruff. Understanding the type you have and what’s causing it allows you to target the right treatments.

Consistent use of medicated shampoos, natural oils, and lifestyle adjustments keeps most mild to moderate dandruff cases under control. For more severe seborrheic dermatitis or scalp psoriasis, prescription medications and close management under a dermatologist’s care are key.

With the customized tips in this guide, you can get rid of pesky dandruff flakes once and for all. Try not to become frustrated – it often takes some trial and error to find your optimal shampoo, oil, and prevention routine. But with diligence, you can have healthy, flake-free hair restored.