9 Derm-Approved Ways To Get Rid Of Dandruff + The Root Cause  

Flakes are no fun; this should come as no surprise to anyone. They're deeply challenging to treat, too, as the underlying condition can be triggered by a wide variety of factors—making identifying what (exactly) is triggering your current flare-up very difficult. And if we know anything about beauty: If you can't figure out what's causing something, it's near impossible to treat. 

So first, let's dive into what exactly dandruff is. Then how you can better keep it under control with the correct lifestyle changes, products, hair care tips, and so on. 

Dandruff is characterized by flakes—from dry, small flecks to big, oily scales—that shed from your scalp. It's a common condition and can be chronic, seasonal, or just comes in ebbs-and-flows. 

"Dandruff causes an itchy, flaky scalp. Also known as seborrheic dermatitis, a form of eczema, it is caused by a yeast, Malassezia furfur," says board-certified dermatologist Raechele Cochran Gathers, M.D. "The malassezia yeast is common, and people with seborrheic dermatitis are just a little more sensitive to it." It's not always pleasant to think of the plethora of organisms living on our skin (collectively called the skin microbiome), but essentially what's happening in the case of dandruff is one of the strains of yeast that naturally lives on us causes skin to flake off and cause irritation. And while it's not confirmed, there does seem to be a genetic link to this too, meaning many are simply naturally predisposed to get it. 

And while it's most famous for appearing on the head, it can show up a lot of places: "Seborrheic dermatitis can also affect other areas besides the scalp, including the ears, eyebrows, center of the face, eyelids, upper chest, upper back, armpits, and groin area," says board-certified dermatologist Hadley King, M.D.

First things first: Let's note that when a skin condition is "triggered" by an external or internal condition, it's not always the "cause" of said condition. While dandruff's underlying cause has to do with yeast on our scalp, it's flare-ups can be triggered by a plethora of things. "Symptoms often come and go. Flares are common when the weather turns cold and dry, and stress can also trigger a flare," says King. 

Dandruff can also be exacerbated by other illnesses, worsening the severity. "Certain medical conditions increase your risk of seborrheic dermatitis; these include acne, rosacea, psoriasis, Parkinson's disease, epilepsy, stroke, heart attack, alcoholism, depression, and eating disorders," says King. "Some medications can also increase your risk of seborrheic dermatitis, including interferon, lithium, and psoralen."

So, here's the thing: Flakes can happen for a lot of reasons that aren't necessarily seborrheic dermatitis. A dry scalp can produce smaller, white, flecks that look similar to the traditional dandruff flakes but are actually just natural skin shedding that happens when your skin isn't properly hydrated. (In the same way your body or face does.) 

These flakes are a sign that you perhaps need to amp up your hydration levels, via a scalp mask or oil—not necessarily treat an underlying condition. 

Technically, dandruff is a mild form of eczema; it's important to note that there is no current "cure" for it. There are plenty of ways to manage and ease the symptoms, but it won't treat the underlying cause. 

"I think most people think that if they work really hard at it—skin moisturizing, diet change, allergen avoidance—they can control eczema and eliminate flare-ups," says double-board-certified dermatologist Latanya Benjamin, M.D., previously told us about eczema. "Initially, I teach my families to expect occasional flare-ups, despite their best care. Even when the skin is under better control, eczema can still flare for many reasons, including catching a common cold, battling a skin infection, or becoming overheated during play."

So, with that understanding, there are several things you can do to help relieve the symptoms, including OTC antifungal shampoos. "Mild cases of dandruff will respond to over-the-counter shampoos," says Cochran Gathers. "These affordable shampoos will decrease the inflammation on your scalp and help with scaling and itching. Many of these shampoos should be used twice per week, and you should follow the instructions on the bottle."

Now, these tend not to be of the natural variety, but worth mentioning the ingredients in case you're curious: "Ketoconazole, the active ingredient in Nizoral shampoo, is a popular antifungal that can help fix itchy scalp. Selenium sulfide shampoos also help to reduce buildup on your scalp and help cut the yeast that can trigger dandruff. Zinc pyrithione is antibacterial and antifungal and can help fix some types of itchy scalp," says Cochran Gathers. 

If you're looking for a more natural approach, salicylic acid (or sometimes called willow bark) provides great results, too. Plus, it's formulated into several natural or clean shampoos.

"Salicylic acid may be useful, especially when used alongside other treatments," says King. "The main benefit is that it helps to reduce scaling on the scalp. It can help to gently remove buildup from styling products, pollution, and hard water, as well as gently exfoliate to reduce scaling, without stripping the hair of its natural oils."

"Tea tree oil is another ingredient found in dandruff shampoos. It has antibacterial, antifungal, and anti-inflammatory properties," says King. 

One study found that using shampoo that contained tea tree oil was an effective way to improve mild to moderate dandruff1. The group that used the oil for four weeks showed a 41% improvement in symptoms (less itchiness, scaliness, etc.) compared to the placebo group, which had an 11% improvement. These days, many shampoo brands use tea tree oil as an active ingredient, but you can also make your own by mixing 1 tablespoon of baking soda into 1 cup of water and throwing in 5 or 6 drops of tea tree oil.

Taz Bhatia, M.D., an integrative doctor and mbg Collective member, recommends throwing in some peppermint oil, too, for max relief: "Melaleuca oil, better known as tea tree oil, functions as an antifungal and antibacterial. It can help kill candida and, with the help of peppermint, soothe an itchy scalp."

"Apple cider vinegar makes a less favorable environment for the yeast and therefore may halt its growth, leading to less flaking," says board-certified dermatologist Morgan Rabach, M.D., co-founder of LM Medical NYC.

Board-certified dermatologist Rachel Nazarian, M.D., agrees: "Because apple cider vinegar is an antimicrobial2, anti-yeast, and antifungal, it helps to clean bacteria and other organisms from the skin. When used for short contact, such as in a shampoo, it is generally safe and well tolerated."

When your flakes get out of control, a scalp scrub can help break apart the clumps, loosen the buildup, and clear your pores. "When there's a lot of scale, it interferes with the medication and treatments from getting to where the action is," according to board-certified dermatologist and founder of Mudgil Dermatology, Adarsh Vijay Mudgil, M.D.

Plus, there's a plethora of good options available for any and all hair types. 

Since dandruff can be triggered by internal inflammation, it's vital to tend to this for long-term results. Stress, diet, and poor health can all trigger internal inflammation. Derms note that times of stress can also trigger flare-ups, so finding a mindfulness routine that keeps you at ease will help keep your scalp-flake free.

As for diet, the gut-skin connection3 has been extensively studied, and research shows that your gut microbiome has a significant impact on your skin. When you have poor gut health, it triggers inflammation throughout your body. This can trigger inflammatory skin conditions, sebo being one of them. But if you can support your gut health, it can help manage overall inflammation.

Shampooing is a delicate balance for all of us, no matter the hair type. Of course, the specifics of when you should be shampooing are entirely unique to your scalp, hair type, and lifestyle (learn more here). However, if you are prone to dandruff, you may consider increasing the number of times you wash your hair per week. "Shampoo more frequently because this helps to wash away yeast and dead skin cells," says King. 

If you've tried everything, and you're at your wit's end, time to call in a professional. "If these measures are not sufficient to control your dandruff, then see a dermatologist, who may prescribe a topical cortisone for the scalp or other affected areas," says King. "Other possible causes of flaking skin in the scalp include psoriasis and eczema."