Scalp Health · Dandruff
How to Get Rid of Dandruff: Causes, Treatments and What Actually Works
Medically authored & reviewed by
Dr Abdishakur M Ali
General Practitioner · Telehealth Expert · Clinical Director
Last reviewed: March 2026
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Medical disclaimer: This article is for informational purposes only and does not substitute personal medical advice. Always consult a qualified healthcare professional regarding your symptoms. Our prescribers are GPhC-registered pharmacist independent prescribers.
Dandruff affects up to half of all adults in the UK at some point in their lives. It is not contagious, not caused by poor hygiene, and — crucially — it is highly treatable. Whether you are dealing with mild flaking or a persistent, itchy scalp linked to seborrheic dermatitis or psoriasis, this guide covers every option available, from over-the-counter shampoos to prescription scalp treatments.
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Start Your Consultation →What Is Dandruff?
Dandruff — also known as pityriasis capitis — is a common scalp condition characterised by flaking dead skin cells, often accompanied by an itchy or irritated scalp. The flakes are typically white or grey and become more noticeable on dark clothing or after brushing hair.
It is closely linked to seborrheic dermatitis, a broader inflammatory skin condition caused by the overgrowth of a naturally occurring yeast called Malassezia. When Malassezia overgrows, it irritates the scalp and accelerates skin cell turnover — producing visible flakes faster than normal shedding.
Key fact: Dandruff is not caused by dirty hair or poor hygiene. Infrequent washing will make existing flakes more visible, but it does not cause the condition itself.
What Causes Dandruff?
Several underlying conditions can trigger or worsen dandruff:
Seborrheic Dermatitis
The most common cause. Malassezia yeast overgrowth triggers an inflammatory response, producing itchy, flaky skin. Can also affect the face, ears, and chest.
Scalp Psoriasis
A chronic autoimmune condition causing thick, silvery-scaled red patches. Often requires prescription treatment. Accounts for up to 42% of hard-to-treat psoriasis cases.
Eczema
An allergic condition causing dryness, itchiness, and flakiness on the scalp — often alongside eczema elsewhere on the body.
Tinea Capitis
Scalp ringworm — a fungal infection that mimics dandruff. More common in children. Requires antifungal treatment rather than standard anti-dandruff shampoo.
Contact Dermatitis
An allergic reaction to hair products — gels, dyes, hairsprays — causing scalp irritation and flaking.
Home Remedies for Dandruff
Before reaching for medicated treatments, some practical steps can meaningfully reduce mild dandruff:
- Wash your hair regularly with a gentle shampoo — at least every 2–3 days for oily scalps
- Use a good-quality anti-dandruff shampoo and leave it on for at least 5 minutes before rinsing
- Avoid scratching — this worsens inflammation and risks infection
- Manage stress where possible; elevated cortisol increases sebum production
- Reduce very hot showers which strip natural scalp oils and worsen dryness
- Avoid hair products with high alcohol content which dry and irritate the scalp
Anti-Dandruff Shampoos: Which Active Ingredient Works Best?
The key to choosing an effective anti-dandruff shampoo is the active ingredient. Each works through a different mechanism:
| Active Ingredient | How It Works | Best For |
|---|---|---|
| Ketoconazole 2% | Broad-spectrum antifungal — directly targets and eliminates Malassezia | Persistent or severe dandruff; seborrheic dermatitis |
| Zinc Pyrithione | Antifungal and antibacterial; slows Malassezia growth and cell turnover | Mild-to-moderate dandruff; maintenance use |
| Selenium Sulphide | Potent antifungal; also reduces scalp cell turnover rate | Moderate dandruff; oily scalps |
| Coal Tar + Salicylic Acid | Coal tar slows cell growth; salicylic acid exfoliates dead skin cells | Stubborn, thick flaking; scalp psoriasis |
| Piroctone Olamine | Newer antifungal with good tolerability | Sensitive scalps; regular maintenance |
Tip: For best results, massage the shampoo into the scalp and leave it for a full 5 minutes before rinsing. Use at least twice a week for the first month.
When to Consider Prescription Scalp Treatments
If over-the-counter shampoos have not controlled your dandruff after 4–6 weeks of consistent use, or if your scalp is significantly inflamed, itchy, or shows signs of psoriasis, prescription treatments may be appropriate:
Betacap Scalp Application (betamethasone valerate 0.1%)
A prescription topical corticosteroid applied directly to the scalp. First-line for scalp psoriasis and severe seborrheic dermatitis during flare-ups. Available from Access Doctor following an online consultation.
Betnovate Scalp Application (betamethasone valerate 0.1%)
Equivalent potency to Betacap; used for inflammatory scalp conditions including psoriasis and eczema.
Etrivex Shampoo (clobetasol propionate 0.05%)
A potent corticosteroid shampoo for moderate scalp psoriasis. Applied to the dry scalp for 15 minutes, then rinsed. Maximum 4-week course without review.
Ketoconazole 2% Shampoo
Prescription-strength antifungal shampoo. Available from Access Doctor following a consultation.
Cocois Ointment
Contains coal tar, salicylic acid, and precipitated sulphur in a coconut oil base. Effective for thick, stubborn scaling in psoriasis and seborrheic dermatitis.
When to seek urgent care: See a doctor promptly if your scalp develops open sores, signs of bacterial infection (warmth, pus, rapidly spreading redness), or if you experience significant hair loss alongside your scalp condition.
Do Natural Oils Help Dandruff?
Coconut oil and tea tree oil are popular home remedies. Some evidence suggests tea tree oil has mild antifungal properties, and coconut oil can help with scalp dryness. However, neither is as effective as dedicated anti-dandruff shampoos for controlling Malassezia-driven dandruff. They may complement treatment but should not replace it for moderate-to-severe cases.
Access Prescription Dandruff Treatments Online
Access Doctor is a GPhC-registered online pharmacy. Our pharmacist independent prescribers can recommend and prescribe the right treatment for your scalp, including Betacap, Betnovate, Etrivex, and ketoconazole shampoo.
View Dandruff Treatments →Frequently Asked Questions
What is the best treatment for dandruff?
Anti-dandruff shampoos containing ketoconazole 2%, zinc pyrithione, selenium sulphide, coal tar, or salicylic acid are the most effective over-the-counter treatments. For dandruff linked to scalp psoriasis or seborrheic dermatitis, a prescription treatment such as Betacap scalp application may be recommended.
What causes dandruff?
Dandruff is caused by accelerated skin cell turnover on the scalp, producing visible flaking. Common underlying causes include seborrheic dermatitis, psoriasis, eczema, scalp ringworm (tinea capitis), and reactions to hair products.
Is dandruff contagious?
No. Dandruff is not contagious. It is a very common scalp condition affecting millions of people in the UK and cannot be passed from person to person.
Does not washing your hair cause dandruff?
Not washing your hair does not cause dandruff. However, infrequent washing makes flakes more visible as they accumulate in the hair and on clothing.
How long should I leave anti-dandruff shampoo in my hair?
For best results, anti-dandruff shampoo should be left on the scalp for at least five minutes before rinsing. This gives the active ingredients adequate contact time to work effectively.
What is Betacap and when is it used for dandruff?
Betacap is a prescription-only topical corticosteroid (betamethasone valerate 0.1%) applied directly to the scalp. It is particularly effective for dandruff caused by scalp psoriasis or seborrheic dermatitis during flare-ups.
Can I get dandruff treatment online in the UK?
Yes. Access Doctor is a GPhC-registered online pharmacy offering regulated online consultations. If a prescription treatment such as Betacap is appropriate, our GPhC-registered pharmacist independent prescribers can prescribe and dispatch it for next-day delivery.
References
- NICE. Seborrhoeic dermatitis — management. Clinical Knowledge Summary, 2023. cks.nice.org.uk
- NICE. Psoriasis — management (NG96). Updated 2022. nice.org.uk/guidance/ng96
- NHS. Dandruff. nhs.uk/conditions/dandruff
- Borda LJ, Wikramanayake TC. Seborrheic dermatitis and dandruff: a comprehensive review. J Clin Investig Dermatol. 2015;3(2).
Access Doctor is a GPhC-registered online pharmacy (registration number 9011198). All prescriptions are issued by GPhC-registered pharmacist independent prescribers. Medicines supplied are MHRA-compliant UK-licensed products.