How to Get Rid of Severe Dandruff?

Written by: Victoria Fanslau Reviewed by: Amy Dougherty, FNP-BC, AGAC
Victoria Fanslau
Categorized as Health Tagged
Victoria Fanslau
Categorized as Health Tagged

Dandruff is a common problem that affects about half the population. There are some other conditions that may be confused with dandruff. If you have dandruff that is severe you should see a healthcare provider. They will be able to differentiate between dandruff and similar conditions. 

The most commonly used dandruff treatment are medicated shampoos. These can be purchased over the counter at most retailers, pharmacies, or online. There are several products on the market that can be purchased to help in the treatment of dandruff but if your dandruff is severe and any products you have tried don’t help, you should see a healthcare provider. 

What is Dandruff?

Dandruff is skin flakes from the scalp. The causes of dandruff can cause itchiness and irritation which causes the skin of the scalp to flake. Dandruff is not contagious but it can be embarrassing for some people. It is easier to see on people with dark hair or skin colors. Dandruff affects all ethnicities, races, ages, and genders. The severity of dandruff can vary from mild to severe.  

What Causes Severe Dandruff?

It is not exactly clear what the main cause of dandruff is and it may differ for each individual. The most common cause is a mild form of seborrheic dermatitis. This is a skin condition that causes redness and scaly patches on the scalp and sometimes other parts of the body. Other common culprits include irritated, oily, or dry skin which may be caused by hair care products or other skin conditions such as psoriasis or eczema. 

Another lesser-known cause is a fungus called Malassezia which lives on the scalp. It doesn’t bother or hurt most people but in some circumstances, it can cause irritation to the scalp that causes dandruff. Malassezia affects approximately 3% – 5% of the population1

Figuring out what is causing your dandruff may take some analysis on your part. Ask yourself the following questions:

  • How often do you wash your hair?
  • What is your hair care routine like?
  • What hair care products are you using?
  • Do you make any recent changes to your hair care? 
  • Do you have any other skin conditions? 
  • When did your dandruff start?

If your dandruff is severe you should see a healthcare provider. They will assess you and be able to determine the best course of action. In some cases, you may just need to make a simple change. In other circumstances, you may need medicated products. A healthcare provider will be able to help you determine if you have a simple form of dandruff or if you are suffering from something more complicated. 

Can Hot Water Cause Severe Dandruff?

Hot water can cause dandruff in some cases. The hot water can cause your scalp to dry out, become irritated, and cause dandruff. If you think this may be the cause of your dandruff try washing your hair with lukewarm water instead. 

How to Get Rid of Severe Dandruff?

If you are having severe dandruff you should see a healthcare provider, they can determine the cause and best treatment. In mild to moderate cases, there are simple over-the-counter treatments or home remedies you can try. 

Change and Reduce Your Haircare Products 

As discussed previously, take an inventory of the hair products you have been using. These products may be drying out or irritating the skin of your scalp and causing dandruff. Look at your shampoo, condition, hair dye, and styling products. You may want to eliminate or reduce the use of some of these products. Read product reviews and see if anyone else is having dandruff from these products.

Talk with your hairdresser to see if they have recommendations for changes. There are medicated shampoos that are recommended for people with dandruff. 

Wash Hair With Lukewarm Water

Avoid using hot water to wash your hair. The heat can dry out the skin of your scalp and cause it to become irritated. Try using lukewarm water instead. 

Plant Extracts

Some studies have shown that plant extracts may be useful for treating dandruff. These extracts can be difficult to obtain, are not regulated by the Food and Drug Administration (FDA) and there are no dosage or frequency recommendations. More research and testing are needed but the following are some extracts that may be useful in treating dandruff in combination with conventional methods, 

  • Green Tea
  • Aloe vera
  • Mint
  • Lemon
  • Hibiscus Leaves

Although more research is needed about the effectiveness of plant extracts, some studies show that they can be useful for treating dandruff.  A 2019 study suggested that green tea extract may help dandruff and hair growth

Healthy Lifestyle 

Maintaining a healthy lifestyle may also benefit your skin and slcap. Excessive stress can exacerbate skin conditions that may affect your slcap. Also eating a healthy diet could benefit your skin, hair, and slcap health. 

Severe Dandruff Shampoos to Use

The most common treatment for dandruff is over-the-counter dandruff shampoos. The commonly used active ingredients in these dandruff shampoos include pyrithione zinc, coal tar, salicylic acid, selenium sulfide, and ketoconazole. The American Academy of Dermatology Association recommends the following 4 tips when using dandruff shampoos and treatments

  • It is important to follow the directions on the shampoo bottle. Shampoos will have different ingredients and different directions. Some may require you to let it sit for a few minutes, rinse right away, use daily, or use only a couple times a week. It is essential to follow the instructions provided by the shampoo manufacturer.
  • Use a normal shampoo daily and a dandruff shampoo twice a week if you are Caucasian or Asian. If one type of dandruff shampoo doesn’t help try another dandruff shampoo that has a different active ingredient. You can also try alternating different dandruff shampoos with different ingredients so see what combination works best for you. 
  • Only shampoo once a week with dandruff shampoo if you are African-American. 
  • Be cautious when using shampoo that has coal tar. It can discolor light hair colors and make the scalp more sensitive to the sun. 

In 2020, CNN talked to dermatologists to get their take on the best dandruff shampoos on the market. They recommended the following dandruff shampoos

  • Nizoral A-D Anti-Dandruff Shampoo was voted as the best overall dandruff shampoo. This is the first shampoo dermatologists usually recommend for dandruff treatment. 
  • Neutrogena T/Gel Therapeutic Shampoo was voted as the best dandruff shampoo for inflammation. It uses coal tar to reduce inflammation, flaking, and itchiness. 
  • Dove DermaCare Scalp Dryness and Itch Relief Anti-Dandruff Shampoo was voted as the best drugstore dandruff shampoo. It uses pyrithione zinc to help relieve dandruff symptoms. 

To check out the full list and article from CNN, click here

Can Dandruff Be Cured Permanently?

Unfortunately, there is no permanent cure for dandruff. It can come back again and requires ongoing management. The good news is that it can usually be easily controlled once you find a treatment plan that works for you. 

Why Does Dandruff Keep Coming Back?

There is no cure for dandruff. It is recurring and will most likely continue to come back unless you use ongoing treatment. Once you find a product or routine that reduces your dandruff you should stick with it to keep dandruff at bay. If your routine begins to not work as well as it once did, then you should try an alternative and switch up your routine. 

When to See a Doctor?

If you have severe dandruff, itchiness, redness, or irritation that is not responding to over-the-counter treatment you should see a healthcare professional for treatment. You may be suffering from a skin condition that is more than just dandruff and needs more attention. 

Get Help From an Online Doctor

Technology has now allowed patients to connect with healthcare providers quicker than ever before. At DrHouse you can connect with a board-certified online doctor in as little as 15 minutes. This is convenient when it comes to getting medical treatment faster. 

It will take some primary doctor’s offices days to get you in for an appointment. With DrHouse you could see a doctor in less time than it takes you to cook a meal or take a shower. You won’t even have to leave your house. This will save you time and allow you to get quick treatment for your needs. 

Key Takeaways

  • Dandruff is a common problem that affects about half the population. Dandruff is skin flakes from the scalp. The severity of dandruff can vary from mild to severe.  
  • The most common cause of dandruff is a mild form of a skin condition called seborrheic dermatitis. 
  • The number one solution to dandruff is analyzing, reducing, and changing the hair products that you use. Your current products could be drying out or irritating the skin of your scalp. 
  • There are many different dandruff shampoos available on the market. 
  • If your dandruff is severe or hasn’t responded to over the counter treatments then you should see a healthcare provider because you may be suffering from a different skin condition. 


DrHouse articles are written by MDs, NPs, nutritionists and other healthcare professionals. The contents of the DrHouse site are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.

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