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Dandruff (cont.)

What is the Medical Treatment for Dandruff?

Once a health care practitioner has confirmed an individual has dandruff (seborrheic dermatitis), the main treatment includes antidandruff shampoos, cleansers, and anti-inflammatory creams and lotions. More importantly, often the most effective dermatologic treatments are combination treatments using several different medicated ingredients used at the same time.

Over-the-counter shampoos and steroid cream medications are the usual treatments. More frequent shampooing and cleansing is usually recommended.

For severe cases not responding to a combination of steroid creams, foams, sprays, or lotions, alternate treatments may be tried. A dermatologist may be very helpful for resistant cases that have not cleared with standard therapy.

Rare severe cases may require short-term treatment with oral steroids such as prednisone. Oral pills are not the mainstay of dandruff treatment and should not be routinely used.

Sample escalating (step-up) treatment of adult dandruff by a dermatologist:

Skin care routine for mild dandruff:

  • Wash scalp with dandruff shampoo daily or every other day
  • May use hair conditioner on hair as needed
  • Need more frequent daily shampooing when symptoms are more severe

Skin care routine for moderate or severe dandruff:

  • Wash scalp with dandruff shampoo daily
  • May use hair conditioner on hair as needed
  • Need more frequent shampooing when symptoms are more severe
  • Rub in betamethasone or fluocinonide solution one to two times a day into scalp for itchy skin

What Are the Medications for Dandruff?

  • Antifungal shampoos – Prescription-strength shampoos help decrease the yeast counts on the skin, but work no better than over-the-counter dandruff shampoos.
  • Antibacterial cleaners – Prescription-strength washes such as sulfacetamide help decrease the bacterial counts on the skin, but are of little benefit in the treatment of dandruff.
  • Cortisone shampoos – Prescription-strength steroid shampoos in rinse-off products help decrease the inflammation and decrease itching.
    • fluocinolone acetonide (Capex) shampoo
    • clobetasol (Clobex) shampoo
  • Corticosteroids – Prescription-strength cortisone preparations as "rub in and leave on" products help decrease the inflammation and control itching. These vary in strength, the strongest of which is about 1,000 times the strength of over-the-counter hydrocortisone!

Topical cortisones are safe when used appropriately under a physician' s care and guidance. As there are some, possible long-term side effects of all steroids, they should be used sparingly and only where needed. Many cortisone preparations are available including ointments (more greasy, clear, petroleum-based) creams (thick, white, and lubricating), lotions (light, flowing liquid), solutions (clear watery liquid, often alcohol-based), sprays (clear liquid in propellant), and foams (light, airy mousse).

Medically Reviewed by a Doctor on 10/24/2016

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Read What Your Physician is Reading on Medscape

Seborrheic Dermatitis »

Seborrheic dermatitis is a papulosquamous disorder patterned on the sebum-rich areas of the scalp, face, and trunk.

Read More on Medscape Reference »


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