May 15, 2007 11:31 PM   Subscribe

I am male. I have had dandruff or flaky scapl for as long as I remember. The OTC shampoos do nothing. Sometimes I think it might just be dry scalp. What can I do?
posted by contog to Health & Fitness (38 answers total) 8 users marked this as a favorite
Give your scalp a massage with tea tree oil? Rinse well; the stuff reeks.
posted by houseofdanie at 11:46 PM on May 15, 2007

Neutrogena t-gel worked wonders for me. I suppose you've tried that already? If that didn't work, go see a dermatologist.
posted by special-k at 11:54 PM on May 15, 2007

A dermatologist will see what the cause of dandruff is (too oily, too dry, microorganisms), and can prescribe stronger formulas of the OTC stuff. Tea tree oil is maybe not a good idea if your hair gets dandruff when it's oily.
posted by stereo at 12:21 AM on May 16, 2007

Dr. Bronner's soap (either the peppermint or tea tree oil varieties) works well on dry scalp, as long as your hair isn't too fine.
posted by thisjax at 12:21 AM on May 16, 2007

Have you tried Nizoral? I've tried other OTC shampoos (including T-Gel) for many years, with limited results. But when I switched to this new shampoo, I was pretty startled at how effective and immediate it was.
posted by jaimev at 12:30 AM on May 16, 2007

What everyone else said.
I love the Nizoral on occasion when it fits the budget.

And then:
A good friend of mine was in beauty school here in the US and had to do some practicals. She gave me this thing that involved a cholesterol scalp treatment and massage. It was divine and solved a lot of my scalp problems.
posted by lilywing13 at 12:36 AM on May 16, 2007

houseofdanie, I'm scared. I only use a light tea tree oil treatment for my feet.

contog, please tell us what products you normally use. I had plenty of dandruff but also used nasty product, e.g. Suave/AquaNet. I assume you do not, but knowing what you do use should help people more in the know.

The only rather obscure issue might be to drink more water. I drink at least 40-60 oz. of water per day, but I've not always done so.

I too tried different treatments to no avail. Eventually my problem went away but I'm not smart enough to know what did it.

Knowing your age range might help.

I take awesome supplements more regularly these days...
posted by prodevel at 12:52 AM on May 16, 2007

I used to have mild dandruff, and what helped me was conditioner. I used my normal conditioner in the shower, but now use a leave in conditioner when I get out of the shower. No more dandruff.
posted by m3thod4 at 12:57 AM on May 16, 2007

Fructis A-D shampoo works here, none of the other OTC do. But it took a week of using only it every morning. After than I only need it every 2nd or 3rd day, using normal shampoo other other days.
posted by lundman at 12:58 AM on May 16, 2007

I'm sort of similar to jaimev. Neutrogena T/Gel (and T/Sal) never seemed to help much. Nizoral worked immediately for me, but seemed to sort of diminish in effectiveness after a few months. Now I use Head & Shoulders Intensive Solutions regularly and Nizoral every couple of weeks. Works alright, not perfect but it's the best solution I've found so far.
posted by good in a vacuum at 1:00 AM on May 16, 2007

Nothing works? What's your diet like? Getting those essential fatty acids?
posted by i_am_joe's_spleen at 1:15 AM on May 16, 2007

What stereo said - get to a doctor (dermatologist ideally) and get something that's not OTC.

Examine the ingredients of your AD shampoos. I believe Fructis A-D mentioned by lundman contains piroctone olamine, and shampoos containing it also seem to work best for me. If one doesn't seem to work there's not a lot of point spending money on shampoos with similar active ingredients though.

Ultimately though, see a doctor.
posted by edd at 1:51 AM on May 16, 2007

My boyfriend had similar problems and it turned out anti-dandruff shampoo was making it worse. The stuff was too harsh and making his dry scalp flake off and get painful. He switched to a supermarket level dry scalp shampoo and conditioner which really helped (don't know what type, possibly sunsilk), and just throws in the anti-dandruff stuff every couple of weeks or so. He has short, thin hair so protecting/moisterising his hair isn't an issue, you might need something better quality. Going harder, i.e. stronger anti-dandruff products, may definitely be necessary. OTC stuff isn't always the best you can get. But if it really is more dry scalp related then they're going to make it worse and you need to go softer. Better quality conditioner can do a lot for a dry scalp.

The first person I'd ask is my hairdresser. They know products and can see what's going on up there better than most people. At the least they can tell you what it looks like so you have an idea of what your symptoms really are. If it's real bad or intractable then yeah, a dermatologist is the way to go.

Definitely also consider what else you're putting on there (any hair products? getting too much sun? sweating a lot so it's filled with salt?) and look at your diet. Do you have dry skin elsewhere? That would be a good hint there's something more systematic going on.
posted by shelleycat at 2:24 AM on May 16, 2007

Besides the shampoo/diet stuff, make sure you keep your hands off your scalp. This may not apply to you, but if you "pick" at your scalp, or run your hands through your hair to get rid of the dandruff, this may make your dandruff worse.
posted by BozoBurgerBonanza at 4:35 AM on May 16, 2007

Try the Nizeroal first, it is essentially what the doctor will prescribe, but at a lower dose. If you still have the dandruff after few weeks with that then go see the doctor.
posted by caddis at 4:39 AM on May 16, 2007

Definitely try various conditioners.

After you shampoo your hair, let your hair drip dry for a few seconds, then put a quarter-sized blob of conditioner in your palm, squish it around between your two hands, and spread it around all of your hair. Work it into your scalp by pretty vigorously scratching your scalp all over with the pads of your fingers (not the fingernails) for a few minutes. Leave it in your hair for 5 or so minutes, then rinse it out.

I did this for a week and the dandruff I had for several years went away immediately.
posted by yellowbkpk at 4:45 AM on May 16, 2007 [1 favorite]

I would recommend yellowbkpk's suggestion for a first try - using something slightly oily to exfoliate your scalp can be really effective at getting rid of built up dead skin. I have really coarse dry hair, so I can do this with olive oil and get away with it.

I get a tea tree shampoo at the local Regis mall-salon chain that works better for me than the Neutrogena.
posted by Lyn Never at 5:44 AM on May 16, 2007

I've had the same problem my entire adult life. No one shampoo has ever worked and I've tried everything - T-gel, Nizerol, tea tree, and all the popular OTC stuff. I've seen several derm's and the prescription stuff only seems to help for a little while. The only thing that has ever helped long term is to alternate the different types (every few days) while using a good shampoo and conditioner in between. One doctor told me the best thing I could do would be to shave my head and get pletty of sun - and I have noticed it is better for a week or so after I've been to the beach. Oh, and I second drinking plenty of water.
posted by JimBobNoPants at 5:59 AM on May 16, 2007

I went to a dermatologist, he prescribed me some shampoo, and POW!, it was gone.
posted by popechunk at 6:12 AM on May 16, 2007

2nding the H&S Intensive Solutions. I ran out of it for a month, and used regular shampoo. This brought back the dandruff drastically. So I bought T-Gel, and it did absolutely nothing for me. I finally got around to buying intensive solutions again, and suddenly I was back to normal.
posted by ZackTM at 6:41 AM on May 16, 2007

Coal Tar. I'm not kidding, it's brilliant.
posted by krisjohn at 6:48 AM on May 16, 2007

You might make it a practice to do controlled studies of some length. It can take a couple of weeks for your hair and scalp to react to a product, so if you're trying something for two days, "Eh, not working, toss it," then lather-rinse-repeat (sorry), you might not be getting the full effects. Same if you are mixing a bunch of products without knowing how each one works on you.

Then, unless it's big chunks of dead skin shooting out of your head which people can see from afar (in which case, it's serious dandruff and hie thee to dermatologist), I agree with trying to treat "dry scalp" instead of "dandruff" for a while. The hard-core OTC dandruff shampoos might really be working against you, as shelleycat pointed out.

Head & Shoulders makes a less-medicated product for dry scalp that could be gentle enough to meet your needs. I would also dump any 2-in-1 products, which are very high-detergent and can exacerbate dry scalp.

Conditioners are made to moisten hair, not skin. I know that people have had success with using it on dry scalps but that's luck and a side effect, and not by design. A direct scalp application might be what you need -- like the aforementioned oils, or a product like this one that you apply and leave on for a while before shampooing.

You might take a critical look at any hair styling products you use and see if they are contributing to the problem. Gel is usually full of alcohol, which is very drying.

Dry scalp can also come on if you're washing your hair too often, such as shampooing in the morning and again at the gym later. Even daily shampooing can be too much for some people.
posted by pineapple at 6:52 AM on May 16, 2007

My girlfriend's hairdresser said that sometimes supermarket-style stuff can cause dandruff because it's loaded with waxy fillers. I switched from Suave anti-dandruff stuff to something slightly more upscale (Joe Shampoo, though I don't think the brand matters). Worked like a charm.
posted by rafter at 7:23 AM on May 16, 2007

Although I've only had occasional dandruff, when I do get a bit of it, I shampoo once with vinegar (apple cider smells the best).

The theory is that using caustic soaps on your scalp all the time shifts the pH of your skin. A mild acid like the acetic acid in vinegar reverses some of this problem. Harsher detergent shampoos (Head & Shoulders) just strip off a layer of skin, which leads to worsening problems and chronic dependency.

Beats me, all I know is it works like a charm for me. Hair feels great afterwards too.
posted by anthill at 7:25 AM on May 16, 2007

What worked for me: drinking more water, using tea-tree-oil shampoo (conditioner too {not tea-tree-oil conditioner, just regular conditioner}, fwiw), and taking fish oil capsules every couple of days.
posted by Alt F4 at 7:52 AM on May 16, 2007

I used Nizoral for years (before it became available OTC) and then it fairly suddenly stopped working. Struggled for a while, then tried some Dermarest Scalp Treatment - the active ingredient is the same as the T/Sal shampoos (salicylic acid) that had seldom done anything for me, but I think the difference is that you leave this stuff in. It's been pretty much a miracle for me. It's not super greasy, and the scent is, if not comparable to roses, pretty inoffensive (and actually gives my hair a nice shine, go figure).

Worth a try, it might not be the medications your having trouble with, but the amount of exposure.
posted by jalexei at 7:55 AM on May 16, 2007

I used to have very bad dandruff. Always itchy, sometimes scabby. Yuck. Then I tried vinegar. What can I say, I was desperate!

I put some into an old shampoo bottle with a pop-open lid, wet my hair, and dribbled it on, and rubbed it in. It stung. But after three days of that, the itch (and stinging) was gone. After a week, most of the flaking was gone. After two weeks, there wasn't any sign of dandruff.

Now I use vinegar, with a good rinse so I don't smell like salad, almost exclusively. Shampoo is for when I work under the car, or get a haircut.

I can go 3 or 4 days without vinegar and not worry about recurrence, but not longer than that.
posted by kc0dxh at 7:59 AM on May 16, 2007

I used to have awful dandruff - here are a few ideas.

There's the old vaseline trick, which is gruesome: you rub vaseline all over your scalp and then rub a comb all over your head to loosen the dandruff - I mean you really scrape it up, which is kind of fun in a grisly way - and then you comb it out with the vaseline, which kind of clumps it all together and lifts it out while moisturizing your scalp big time. This is an old cradle cap solution for babies as well but the problem is that getting the vaseline out of your hair is sometimes worse than the dandruff ever was.

You can do a thyme rinse: boil a whole lot of dried thyme, cool and strain, rinse your hair with it. This works surprisingly well.

Or, and this is what finally worked for me: wash your hair less. Like, a whole lot less. I only wash my hair twice a week now and my hair is healthier and happier and my dandruff is basically gone.
posted by mygothlaundry at 8:07 AM on May 16, 2007

Seriously, talk to a derm. There are some great rx shampoos and treatments.
posted by radioamy at 8:17 AM on May 16, 2007

Prescription Nizoral 2% shampoo (better than the OTC product) plus Synalar/triamcinolone scalp solution.
posted by docpops at 8:29 AM on May 16, 2007

I'm a male, 30, and have had dry, flaky scalp. I've never went to a dermatologist at all, but I've had the problem for years. It never seemed to match the typical dandruff that most OTC shampoos seem to be geared towards and that's an oily-skin type dadruff with large flakes. Mine were very small and dry - almost powdery

But then a couple weeks ago I made a change - I've been trying to grow my hair out and I got tired of the George McFly look the gel was giving me since my hair was longer, so I stopped using gel all together and instead went to a whipped hair wax to just keep the friz down a bit (I use it very sparringly, like a 1/4 teaspoon a day). And near instantly I stopped having the flakes. So now I don't know if my flakes were skin, or just a buildup of gel that wasn't getting washed off my scalp.
posted by JibberJabber at 9:22 AM on May 16, 2007

I'm in a similar boat. But I don't have any good fixes. I've tried some dandruff shampoos, but after a while it seems my head "gets used to them", and the dandruff is back. I recently got a tea tree oil shampoo, and a leave-in conditioner, but haven't noticed any change. I think vinegar is next for me to try...
posted by ObscureReferenceMan at 9:47 AM on May 16, 2007

Proactiv Anti-Dandruff Shampoo. Takes about a week or two of everyday use. Then just a few times a week.
posted by chrisroberts at 10:05 AM on May 16, 2007

If you avail yourself of any of the anti-microbials people are offering here (I use Nizoral, the active ingredient of which is the anti-fungal P-450 blocker ketoconazole, which supresses testosterone production when given systemically, and probably is somewhat absorbed into the body when applied to the scalp), you might want to use a brush or comb you can sterilize when you wash your hair (I steam mine), or you could just end up perpetually re-infecting your scalp.
posted by jamjam at 11:12 AM on May 16, 2007

This is cheap and it works. Sea breeze astringent (the original kind not the sensitive skin kind). You can find it in the skin care aisle. Shampoo like normal. Then pour the seabreeze into your hair, wait a couple of minutes and then rinse. I recommended this to a friend with scalp psoriasis and it even worked on that. Be careful not to get it in your eyes though.
posted by GlowWyrm at 11:37 AM on May 16, 2007

I've got to second the recommendation to get your Omega-3s. As soon as I started taking flax oil, my lifelong dandruff disappeared. Completely. I haven't had a recurrence since.
posted by longdaysjourney at 11:49 AM on May 16, 2007

Seriously -- this is sad, but I've been waiting for this question to be asked here just so I could answer it as follows:

Seconding the coal tar. A dermatologist recommended Pentrax when none of the "normal" OTC stuff was working. Nothing else has worked for me (even a weaker coal tar shampoo didn't work as well). I've been using it regularly for almost 10 years and it's still effective. I do have to use it almost every time I shower (because I don't do that everyday). If I go without it for a week (on vacation or because I'm out), the dandruff comes back.

There are three problems.

1) It's hard to find. I've only ever seen it in Rite Aids here in southern California. I did manage to find a company selling single bottles and sets of 5 on Amazon last year sometime. I'm finally on my last bottle, and it looks like everyone's out of stock. I'm actually getting a little worried. If you manage to find some, let me know! (These guys say it will be available in Fall 2007.

2) It smells. I used to use it with the normal Herbal Essences conditioner, and I've had people tell me that I smell "distinctive" but not bad. When Herbal Essences changed their formula, one friend started telling me my hair smelled like a smoker's. I've started using a regular shampoo after the Pentrax, and that seems to eliminate the tobacoo-hair.

3) It stains. I had a bathtub that was newly refinished when I moved in. 4 years later, it's this yellow/orange/brown color. Actually, it might just be the crappy finish -- real porcelain may do better. My travel shampoo bottle is a nice translucent brown as well.

Also, there's a warning about avoiding sun exposure on the bottle, but I've never had a problem with it.

Clearly, I love this stuff. It's nasty, but it works.
posted by natabat at 4:47 PM on May 16, 2007

I used to think I had dandruff but found it was actually an allergic reaction my skin was having to soap. So I found a soap free shampoo (uses natural extracts of fruit and so on) and now there's no more flakes.

When I can't get my soap free shampoo, I find that Garnier Fructis' anti-dandruff shampoo works quite nicely too. I still get some flakes with that but far less than I normally do with other brands.
posted by Effigy2000 at 9:04 PM on May 25, 2007

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