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