Dandruff, those dry, white flakes of skin you brush off your collar or shoulders-is inoffensive. But it can be disturbing and itchy. It is not about your hair or how frequently you wash it. Instead, it's about the skin on your scalp. Mild flakiness can be treated with a gentle day-to-day shampoo. However, a treated cleanser may help, If that does not work. Symptoms may return after.

Don't ignore go to a specialist!

Sometimes even the best anti-dandruff shampoo can’t get rid of your flakes. This may be because it is not just some normal flakiness. It can be originated from a lot of factors:

• You may have a medical condition
  You might have Seborrheic dermatitis, a chronic medical problem affecting not only the head but other parts of the body where oil glands are present. This condition is characterised by redness as well as flakiness of the scalp.
   
• Allergy
  People are allergic to various substances, from peanuts to grass. If there is scalp irritation, soreness or itchiness after using particular oil or shampoo, it can mean that you are allergic to them.
   
• Not shampooing enough
  When you don't shampoo or clean your scalp enough, oil accumulates and builds up and can cause white or yellow flakes. It doesn't mean you don't clean yourself enough, but rather that you don't use enough shampoo or the shampoo you use isn't strong enough to clear your scalp of the accumulated oil.
   
• Dry skin
  Dry skin is one of the most common reasons your scalp feels itchy. And most likely, this is the cause of your dandruff. It might get worse in winter as scalps tend to dry out more.
   
• Yeast overgrowth
  Malassezia is a fungus that exists on the scalp and skin. Some people develop sensitivity towards it which can result in dandruff.

Treating your scalp is sometimes a matter of hit and trial. While not contagious nor painful in most cases, treating yourself can still be a burden. So it's better to go see a specialist (dermatologist) and get to the root of the problem and solve the issue before it becomes a big mess.

How to remove dandruff?

Comb your hair from your scalp down with steady, firm strokes. This helps carry the oil far away from your scalp, where the accumulation of it and dry skin cells can cause your scalp to itch and cause flakiness. 

Dandruff treatment usually includes the usage of some shampoo that will resolve the scalp issue, but not all shampoos are the same; some have different active parts, and some are for different hair types:

• Ketoconazole (Extina, Xolegel, Nizoral A-D)
• Pyrithione zinc (Neutrogena T/Gel Daily Control Dandruff Shampoo, Selsun Blue for Itchy Dry Scalp, Head & Shoulders)
• Selenium sulfide (Dandrex, Selsun, Head & Shoulders Clinical Strength)
• Salicylic acid and sulfur (Sebex, Sebulex)
• Salicylic acid (Neutrogena T/Sal )
• Coal tar preparations (Denorex Therapeutic Protection, Scytera, Neutrogena T/Gel)

How long will the treatment take?

The treatment of dandruff could be completed in two or three washes if not, then it is advised to go seek medical attention. One should wash their head as instructed on the shampoo bottle. Or follow the guidelines:

• If you are Asian or Caucasian, shampoo daily and use dandruff twice a week.
• If you are an African-American, use an anti-dandruff shampoo only once a week.
• Be careful when using coal tar shampoo as it can discolour grey, blond and white hair. 

For most people, it does not require medical attention. However, sometimes the flaking and itching that appears like dandruff is a medical condition, such as eczema, fungal scalp infections, psoriasis, or seborrheic dermatitis. If you want to know how to get rid of your scalp issue or to know more about your scalp, there is a fantastic team of dermatologists at Ayushman who can help you with your hair care plans.