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Let's see what is available over-the-counter for dandruff control.

Pharmacist

These are a few things to keep in mind:

  • With dandruff, the goal is to control it.

  • You may have to try different things before you find what is working for you.

  • You will need patience and stay with a medication to be able to keep it under control. For instance, salicylic acid acts by causing the outer layer of the skin on the scalp to loosen and shed. When this happens, dandruff will obviously get worse for the first 1 or 2 weeks before it gets better. If you are not patient, you will get discouraged and abandon this therapy.

Alright, take a look at how the medications available over-the-counter for dandruff work.

This will give you enough information to take control of things. Then continue to see which approach will work best for you.



Antifungal agents

They help remove or reduce yeast (or the fungus (Malassezia furfur) that can cause dandruff on the scalp.

Shampoo bottle

Examples are ketoconazole, zinc pyrithione , selenium sulfide shampoos.

 

Antibacterial

Reduce bacterial count on the scalp using Antibacterial agents that can hasten the death of skin cells of the scalp.

Shampoo bottle

Example include Zinc pyrithione (ZPT).

 

Keratolytic agents

Keratolytic agents cause the outer layer of the skin to soften, loosen and shed thereby reducing skin flakes and scales.

Shampoo bottle

Examples include salicylic acid, sulfur.

 

keratoplastics

Keratoplastics slow down the over production of skin cells on the scalp. They slow the death and flaking off of skin cells on the scalp.

Shampoo bottle

Examples include coal tar, salicylic acid, sulfur.

 

 

Let's use this information to choose a good over-the-counter remedy based on the nature of this dandruff.

 


How would you describe this dandruff situation of yours right now?
Pharmacist


Choose the nature of this dandruff from the list below and see what is recommended to use over the counter.


 

Selection require a mild approach.
Pharmacist

 

Selection require a moderate approach to manage this dandruff.
Pharmacist

 

Selection require a top of the line approach.
Pharmacist

 

Selection require a careful approach.
Pharmacist

 

Selection require seeing a doctor.
Pharmacist

 

Symptoms require a mild approach and carefully managing the hair.
Pharmacist

 

Symptoms require a mild approach and you will have to see adoctor
Pharmacist

 

Symptoms require a moderate approach and careful hair care.
Pharmacist

 

Symptoms require a moderate case approach and you will have to see a doctor.
Pharmacist

 

Symptoms require a severe dandruff management approach and carefully managing the hair.
Pharmacist

 

Symptoms require a severe dandruff management system and requires seeing a doctor.
Pharmacist

 

Symptoms require careful hair care management and you will have to see a doctor.
Pharmacist

 

Symptoms require mild approach, careful hair care and seeing a doctor.
Pharmacist

 

Symptoms require moderate approach, carefully managing the hair and a doctor visit.
Pharmacist

 

Symptoms require severe case management and a doctor office visit.
Pharmacist

 

Something to prevent?

 

Preventive measures


Use a gentle shampoo daily to prevent oiliness and flaky build up.

Use antifungal shampoo like ketoconazole or selenium sulfide once or twice a week to control the fungal count on the scalp

 

All of these?
You must have this dandruff really bad.
Pharmacist

You will need to see a doctor for this dandruff. This is pretty bad.

 

None of these?
We must have left something out.

Please choose what closely describe your dandruff and see what we recommend to use over-the-counter.

Managing a mild case.

Start with:

Salicylic acid + sulfur or coal tar.

Man washing his hair

You need to soften the outer layer of the skin, loosen it and make it shed. This should reduce skin flakes and scales.

Then:

Use zinc pyrithione for control. This should keep the bacteria count on the scalp in check. Bacteria can hasten the death of skin cells of the scalp.

Or if not too bad, use emollients like lanolin to keep the scalp hydrated.

 

 

Managing a moderate case.

Start with:

Salicylic acid, sulfur or coal tar to soften, loosen the outer layer of the skin on the scalp. You need to reduce skin flakes and scales.

Woman washing her hair

Then:

Once you are confident the outer skin layer is cleared, use an antifungal agent like selenium sulfide or ketoconazole to keep the fungi population in check. 2 weeks of use should take care of this.

You can then maintain hydration with an emollient like lanolin.

 

 

Approach to severe cases.

Start by:

Taking out the top dead cells layer of the scalp. This will allow other medications to penetrate the skin and act.

Woman with severe dandruff

To do this, for about 2 weeks, you will use:

  • Salicylic acid

  • Sulfur OR

  • Coal tar

Know that it is going to appear worse because these agents are scalp scrubbers.

After 2 weeks, switch to:

  • Ketoconazole

  • Selenium sulfide OR

  • Zinc pyrithione

These will kill or reduce the fungi or yeast population on the scalp for another 2 weeks.

Then:

Use emollients like lanolin to help keep the scalp hydrated.

 

 

Oily, dry, blonde or colored?

Oily?

Prefer salicylic acid and or coal tar for taking out the flakes and scales.

Dry?

If the scalp is dry, stay away from salicylic acid and coal tar. They will make things worse.

Blonde, chemical or color treated?

Avoid selenium sulfide. Go with ketoconazole or zinc pyrithione instead.

 

 

See A Doctor.

You will have to see a doctor.

Looking at serious inflammation that will require the use of topical steroids which are not available over-the-counter.

May also be looking at possible scalp infection that will require a good evaluation by the physician.

 

 

Worth doing

1. Keep in mind that dandruff is a chronic condition. It cannot be cured. Your focus should be on control.

2. Once under control, focus on maintenance to prevent it from getting worse.

 

 

Last updated by pharmacist on 08/30/2018 at 11:02:am

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Know this about the safe and effective use of this recommendation.
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Our disclaimer

  • Recommendation is the opinion of a registered US Pharmacist currently practicing as a community pharmacist.
  • Recommendation is not an attempt to discuss all possible self care or treatment approach to this health challenge.
  • The responsibility of the recommending pharmacist is limited to this question:
    "If a patient presents with these symptoms, what will you recommend and why?"
    It is not an attempt to publish an article on the treatment of any condition. Just what would you tell a patient who present with so and so in the usual course of your practice.
  • The pharmacist image presented in this article may or may not be the actual image of the authoring pharmacist.
    Because we insist on using articles written by currently practicing community pharmacists, these pharmacists may choose to remain anonymous especially if they are employed by an employer to avoid being pressured to recommend a particular product to drive sales.
  • Please read the policies and terms of use for self-care OTC, selfcarepharmacist.com and it's affiliates by clicking on the button below.

 

 

 

 

 

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