If it can possibly go on your head, i've tried it...
April 28, 2011 7:49 AM   Subscribe

How do I get rid of my dandruff for good?

I have had flakes in my hair for about a year now and it's driving me crazy. I did not have dandruff before last spring and it won't go away. It's worse right after a shower and the dandruff ranges from light powdery-looking dusts to heavier, larger bits (sorry for the grossness).

I went to a dermatologist last year and he gave me some topical medicine that did not work. I am considering seeing another dermatologist but before I do I want to make sure that I have tried everything.

Stuff I have tried:

apple cider vinegar
baking soda
tea tree oil
coal tar shampoo
Head and Shoulders
Selsen Blue
going a few extra days without washing (I usually wash every 2-3 days)
washing my hair every day
hot olive oil treatments

I am almost at my wits end. Is it not dandruff? Am I missing something? It definitely gets worse when I brush my scalp. It's starting to get really embarrassing. Could it be dry scalp instead, and is there another remedy for that?
posted by anonymous to Health & Fitness (21 answers total) 18 users marked this as a favorite
What people call dandruff can be dry skin not a disease. I have stopped using shampoo or any hair product, and eat a low carb diet and don't get any of this.
posted by Not Supplied at 7:56 AM on April 28, 2011

Do you use any kind of hair products? Sometimes things like gels can flake, giving the appearance of dandruff.
posted by geegollygosh at 8:03 AM on April 28, 2011

Have you tried Nizoral?
posted by hansbrough at 8:03 AM on April 28, 2011 [1 favorite]

Go back to the dermatologist. There are prescription strength shampoos that actually work. You should also make sure it's actually dandruff rather than psoriasis or eczema or something else.
posted by decathecting at 8:11 AM on April 28, 2011

It could be because you're not cleaning the scalp thoroughly. When you put shampoo on, do you work it right down to the scalp, and massage it in the way that hairdressers do? If I don't do this, my scalp goes itchy and flaky.

Maybe try giving the scalp a really good clean, using two dollops of shampoo if you need to?
posted by LN at 8:12 AM on April 28, 2011

If it's more like psoriasis, you want to ask the dermatologist for Clobex shampoo -- it works really quickly and doesn't have the awful smell of some of the products.
posted by bizzyb at 8:23 AM on April 28, 2011

How hot is the water you are using to wash your hair? Hot water dries out your skin. Try talking cool or cold showers. My dandruff goes away within a week when I start with cold showers again.
posted by Loto at 8:24 AM on April 28, 2011

Dry scalp is not the same as dandruff. I had a dry scalp for years, and using harsh products to fix it just made the problem worse.

What did work for me was switching to sulfate-free and silicone-free products, and using them gently. Depending where you live, you may have to hit up a health food store, but some groceries and chemists are stocking them now. If you're in the US, you should be able to find Burt's Bees fairly easily. If you're in Australia or New Zealand, Trilogy is great, especially their conditioners.

(You may have to try a couple to find the ones that work best for you. Alchemy is another well-known Australian sulfate-free/silicone-free brand, and I had a horrible scalp reaction to their conditioner.)

Technique: Shampoo gently, working the lather into your scalp with your fingertips (not fingernails). Do not scrub. Rinse for longer than you think you need, because product staying on your skin can cause flakes, too. Condition the ends, keeping well away from your scalp. Rinse more. Use tepid water rather than warm/hot.

Avoid blowdrying except for special occasions, and keep heat tools like straighteners away from your scalp if you use them.

My scalp is now flakey-free, even though I wash every day. (I have to because my hair is so fine.) Good luck with yours!
posted by Georgina at 8:24 AM on April 28, 2011 [4 favorites]

Seconding Nizoral. Do not mistake this for its related product, Nizorelle. I don't actually know what Nizorelle does or if it's any better than Nizoral, the only difference I am aware of is that you ask for Nizoral at the pharmacy counter whereas Nizorelle would be out on the shelves.

Once every 3 or 4 days according to the label, you massage in the shampoo, leave it for a few minutes, and rinse out. After a given period of time (see label), you reduce this routine to once a week. After a given period of time the major treatment is over and you just use a maintenance dose once a week.

This is the only thing that has brought my terrible dandruff under control. I have not had a single speck in over 10 years.

I would certainly recommend washing your hair every day, but it's harder to know what shampoo will suit you. I use Alphosyl, another medicinal product, but that's because in addition to dandruff I also have the joy of acne on my scalp and Alphosyl keeps it completely under control without massacring my hair in the process. Since you (I assume) don't have an acne problem, it's anybody's guess what shampoo you will like best. I wouldn't use Head and Shoulders though, that stuff's gross, like, paint-stripper gross. I used to have to use it daily because it was the only product that sort of nearly worked, but then I discovered the joys of Nizoral and dropped the Head and Shoulders like a hot rock.

Of course, we don't know if what you have on your scalp actually is dandruff. If it is, the Nizoral will almost certainly abolish it. So I'd try the Nizoral regime and if it isn't gone by the time period specified on the label, go to a dermatologist again.
posted by tel3path at 9:15 AM on April 28, 2011 [2 favorites]

Georgina has suggested exactly what I was going to . I had an itchy flaky scalp for years until switching to something without those products. Previously. Try this before going back to the dermatologist. It costs less, and can't hurt to try.

Other thoughts: Did something in your health change at that time? Did you start using some product? Did you move? The water quality can definitely affect your skin/scalp. Are you having skin problems anywhere else on your skin? Has your diet changed? Sometimes eating too much sugar is bad for your skin.
posted by annsunny at 9:25 AM on April 28, 2011

The only thing that has ever worked for me has been topical steroids. Clobetasol to be exact.
posted by TheBones at 9:55 AM on April 28, 2011

Nizoral did wonders for my scalp, but the effect didn't start to last more than a few hours until I switched to a sulfate-free shampoo (and a silicone-free conditioner). I think the old SLS stuff was really irritating the hell out of my scalp. I use Shikai shampoo now, it has no sulfates and I can't recommend it highly enough. I'm sure there are other truly sulfate-free shampoos too, they are just hard to find - a lot of them actually turn out to have sodium myreth sulfate or some other SLS-lookalike.
posted by dialetheia at 10:05 AM on April 28, 2011

The brand Jason makes a "dandruff relief shampoo" with sulfur (and salicylic acid) that seems to work, at least as long as you're actually using it...stop for a few days (say, because everyone in the house is sick of the way the bathroom, you and your clothes smell) and it seems to come back. But also seconding the hot-water problem (dishpan scalp!) as a contributor.
posted by mittens at 10:17 AM on April 28, 2011

I use Clobetasol as well - it comes in a mousse-like foam (Olux is the brand name) and it's very unobtrusive. I only have to use it about once a month now that I have moved to SLS-free shampoo and conditioner.
posted by Addlepated at 10:17 AM on April 28, 2011

check to see if it is psoriasis... if so, most of the dandruff techniques are just wasting your time... if psoriasis, there is other stuff that can work on it.
- Tim
posted by fozzie33 at 11:21 AM on April 28, 2011

I've had seborrheic dermatitis before, and sometimes some of the associated products (i.e. dandruff shampoos like Selsun Blue, Head & Shoulders, Nizoral) helped. This past winter my scalp was itchy and flaky, and none of the shampoos helped. I finally clued in to the fact that it was the repeated soaping that made my skin dry & flaky. I switched to a non-soap shampoo, and the problem went away. I used SebaMed, which may be hard to find in the U.S.--you could look at Jason and brands like that for an alternative.

Since you've tried a bunch of anti-dandruff shampoos that target the skin fungus M. furfur (involved in Seborrheic Dermatitis) and they didn't work, I would skip the suggestions above that go in the same direction, like Nizoral, sulfur shampoos, etc.
posted by mvd at 11:23 AM on April 28, 2011

What kind of coal tar shampoo did you use? I got amazing results from T-Gel but other less expensive brands were not nearly as effective.
posted by kate blank at 1:27 PM on April 28, 2011

I thought I had dandruff for years and anti-dandruff shampoos never really worked. Then one magical day a hairdresser suggested my scalp might be having an allergic reaction to soap in shampoos. I went out and tried a brand of shampoo with no soap in it and voila! Problem solved! Some good no-soap shampoo reccomendations can be found here.
posted by Effigy2000 at 3:21 PM on April 28, 2011

A lot of people in the thread Effigy2000 linked to recommend Pureology, and I agree - it's fantastic and smells divine, but it costs a freaking arm and a leg. There's a drugstore brand that's a direct competitor called Everpure that I've been using for a year or so and I adore it - my hair has HUGE volume, I only need to use a tiny amount of shampoo to get great lather, and I don't get nearly the flaking or scaling that I used to get when I used dandruff shampoos. The ingredient list is almost identical between Pureology and Everpure, although Pureology smells much nicer.
posted by Addlepated at 3:39 PM on April 28, 2011

I was diagnosed about 10 years ago with sebopsoriasis... I had a consistent itchy scalp with flakes that were regularly up to pinky-nail sized, and occasionally as big as a nickel, along with itchy-flakey flare-ups in my ears and eyebrows from time to time. The prescription shampoo that the dermatologist gave me took care of the itching, but not the flakiness, but I kept using it for quite some time because not itching was at least an improvement.

Eventually circumstances aligned such that I needed shampoo and couldn't make it in to fill the prescription, so I decided to try to just make it through with some dandruff shampoo, even though none of the versions I had tried in the past had done a whit of good. I picked up some KMS dandruff shampoo, in the hopes that it wouldn't be as harsh on my hair as others had been, and ended up discovering that it actually cleared up both my itch and the flakes. I've been using it for 7 or 8 years now, and as long as I don't go more than a day between shampoos, I'm fabulously flake-and-itch-free.

Incidentally, in case you or anyone else gets the ear flare ups as well, I've discovered that Squalane oil from olives applied 1-2 times daily with a q-tip will generally tame those within a few days for me.
posted by polymath at 7:28 PM on April 28, 2011

clobex warning label scared me out of trying it. Nthing no hot water. that's what helped me the most.
posted by screamingnotlaughing at 6:22 PM on April 29, 2011

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