You may not know it, but your body is covered with yeast. Yes, yeast. It lives on everyone's skin as part of our microbiome—the normal bacteria and fungus that live symbiotically with us. In some people, the yeast is NBD. In others, their immune system gets angry and tries to fight it off, resulting in inflammation. Translation: An itchy scalp and flakes.
Some suffer from dandruff year-round, while others get it only during the warmer months. In hot, humid weather, we sweat more and oil gets trapped on the skin. More oil means a happy environment for yeast to grow in, and the relatively higher yeast levels may lead to more dandruff.
So how do you finally get it to go away? Try these tips for a flake-free scalp.
Find the key ingredients. With so many dandruff treatments available over the counter, it's hard to know what to choose. Here's a breakdown of ingredients to look out for:
- Zinc pyrithione, selenium sulfide, and ketoconazole. These ingredients actually reduce the yeast levels on the skin. Just like turning off the gas line to your stove, killing the yeast gets rid of the source of inflammation in the skin. They can be found in products like Head and Shoulders, Selsun Blue, and Nizoral shampoos. You can also get prescription antifungal treatments from your dermatologist.
- Salicylic acid. While best-known for its use in treating acne, salicylic acid helps exfoliate dead skin cells and removes excess oil. If you have thick scales on your scalp, salicylic acid is particularly helpful at thinning them out. It can be found in products like T/Sal shampoo.
- Tar. Used for decades to treat conditions like psoriasis, tar has anti-inflammatory properties and is useful in treating more severe forms of dandruff. It's commonly used alongside other treatments, and can be found in products like T/Gel shampoo.
- Topical steroids. Topical steroids directly put out inflammation in the skin, and can be super helpful for improving itchy skin. They're commonly used alongside antifungal treatments for dandruff, and should be used directly on the most itchy spots. Examples include Scalpicin, which is available over the counter. Prescription-strength versions are available from your dermatologist.
Use your anti-dandruff shampoos correctly. While dandruff shampoos will wash your hair, remember that dandruff is a scalp issue—not a hair problem. It can be a bit confusing because they're called shampoos, but these products should actually be looked at as scalp treatments. So, using your fingertips, make sure to massage the products into the scalp, and let them sit there so they can do their job. Applying and then immediately rinsing will not allow enough contact time, so I usually tell patients to apply, sing the alphabet, then rinse.
Leave the steroids alone. As in, once you apply a topical steroid solution, it should be applied and left on the skin. Do not apply for more than two weeks in a row. If that much time passes and you don't see improvement—or if your scalp issue is really severe—make sure to visit a dermatologist for an evaluation.
Accept the facts. Ultimately, whether we develop dandruff or not is determined by our genes and our body makeup. We can't alter genetics that lead to yeast problems, so don't freak out if this is a recurring issue. Just follow the tips above to help keep them under control.