Dandruff is a common, harmless scalp condition that causes white or grey flakes and an itchy scalp; it is not caused by poor hygiene and you cannot catch it from others. It is usually a mild form of seborrheic dermatitis, a chronic skin condition that tends to come and go and can be controlled with treatment rather than permanently cured. Dandruff often responds to over-the-counter medicated (anti-dandruff) shampoos used regularly for about a month; per NHS guidance, a doctor's input is needed if that does not help or if symptoms are severe.
Available without a prescription — follow each label.
Ketoconazole 1% shampoo Nizoral A-D Topical antifungal (azole) | An antifungal anti-dandruff shampoo that targets the Malassezia yeast associated with dandruff. NHS and MedlinePlus both list ketoconazole as a standard anti-dandruff option; a 1% strength is sold over the counter in the US (higher strengths are prescription-only). Per the Drug Facts label it is typically used about twice a week, then less often to help keep flakes from returning. For external use on the scalp only; stop and ask a doctor if irritation, rash, or worsening occurs. |
Selenium sulfide shampoo Selsun Blue Topical antifungal / antiseborrheic | Helps reduce flaking and the yeast and skin-cell turnover associated with dandruff. Listed by both NHS and MedlinePlus as a core anti-dandruff ingredient. Follow the Drug Facts label, rinse thoroughly, and avoid contact with eyes; it can discolor light, gray, or chemically treated/dyed hair. Often used for moderate flaking and itch. |
Pyrithione zinc shampoo Head & Shoulders Topical antifungal / antibacterial | A widely used everyday anti-dandruff shampoo; MedlinePlus lists zinc among the standard OTC ingredients. A common choice for routine, ongoing control of mild-to-moderate flaking and itch. Use as directed on the label; external use only and keep out of the eyes. |
Coal tar shampoo Neutrogena T/Gel Topical keratolytic / antiseborrheic (coal tar) | Helps slow the shedding of skin cells, which can ease flaking and itch; recognized by NHS and MedlinePlus as an anti-dandruff option. Can make skin more sensitive to sunlight, may have a strong odor, and can stain light hair, skin, or fabric. May help when scaling is more stubborn. Follow the Drug Facts label; not for use on broken or infected skin. |
A doctor may prescribe these — not for self-treatment.
Prescription-strength antifungal shampoo or cream (e.g., higher-strength ketoconazole, ciclopirox) Topical antifungal | For dandruff or seborrheic dermatitis that does not improve with OTC shampoos, a clinician may prescribe a stronger antifungal. MedlinePlus lists ketoconazole and ciclopirox among prescribed options. These are chosen and dosed by a doctor after examining your scalp; do not source or self-start prescription strengths on your own. |
Topical corticosteroids (scalp lotions, solutions, or shampoos) Topical corticosteroid (anti-inflammatory) | A doctor may add a short course of a topical steroid when there is significant redness, inflammation, or itch. These require a prescription and clinician guidance because overuse or long-term use on the scalp or face can thin the skin and cause other side effects. Only use under medical supervision. |
Topical calcineurin inhibitors (tacrolimus, pimecrolimus) Topical calcineurin inhibitor (non-steroidal anti-inflammatory) | Listed by MedlinePlus as a prescription option for seborrheic dermatitis, sometimes used on sensitive areas like the face to limit steroid use. Prescribed and monitored by a clinician; not available or appropriate to self-start. |
Sodium sulfacetamide (topical) Topical antibacterial (sulfonamide) | A prescription antibacterial preparation that MedlinePlus notes for seborrheic dermatitis. Because it is an antimicrobial sulfa drug, it requires a diagnosis and prescription; people with sulfa allergies must avoid it. A clinician decides if and when it is appropriate. |
Start with a single over-the-counter anti-dandruff shampoo and use it consistently as directed for about a month before judging whether it works, per NHS guidance. For routine mild flaking and itch, pyrithione zinc or selenium sulfide is a reasonable first choice; if there is thicker, stubborn scale, a salicylic acid or coal tar shampoo can help lift it; if flaking persists, an antifungal such as ketoconazole targets the associated yeast. Some people get better results by rotating between two different shampoos (for example an antifungal and a tar or salicylic acid product) and by leaving the lather on the scalp for several minutes before rinsing. Because dandruff and seborrheic dermatitis tend to be chronic and to come and go, you may need to keep using a maintenance shampoo less frequently (for example, once a week or so) to help prevent flare-ups rather than expecting a one-time cure. Evidence comparing individual OTC shampoos head-to-head is limited, so finding the product that works best for you can be partly trial and error; switch products if one stops helping. Dandruff is not a hygiene problem, but washing hair regularly can make flakes less noticeable, and stress and cold weather may worsen it.
See a GP or healthcare provider for evaluation if your dandruff does not improve after about a month of using an anti-dandruff shampoo, if it is severe or your scalp is very itchy, or if there is redness or swelling of the scalp, per NHS guidance. Also get checked if flaky, itchy patches appear on your face, eyebrows, ears, chest, or elsewhere, which may point to seborrheic dermatitis or another skin condition. Seek prompt medical care if the affected skin oozes fluid or pus, forms crusts, or becomes very red, swollen, or painful, as MedlinePlus notes these can signal infection. Children with severe scalp scaling and anyone whose symptoms keep returning despite treatment should be evaluated so a clinician can confirm the diagnosis and consider prescription options.
General reference, not medical advice, and not a substitute for your doctor or pharmacist. The right choice depends on your symptoms, health conditions, age, and other medicines — always read each label and confirm before taking anything.
Salicylic acid shampoo Neutrogena T/Sal Topical keratolytic | Helps loosen and lift scale and flakes, and is often combined with coal tar; named by NHS and MedlinePlus. Most useful when there is thicker, adherent scaling. Rinse well and avoid the eyes. May be alternated with an antifungal shampoo for better control. |