Do you dread wearing dark sweaters in winter? Unsightly white flakes on your shoulders and an itchy scalp are signs of dandruff, which can become more troublesome during cold weather.
Combination Treatment for Winter Dandruff:
Q. I have struggled with itchy scalp. I started using Nizoral shampoo a few years ago.
Often, I first wash my hair with Head & Shoulders, then rinse well and shampoo again with Nizoral. This method works well for me to control my itchy scalp. Nizoral is a bit expensive, but it’s a great product for dandruff.
A. You have created an innovative approach to treating winter dandruff. Nizoral was once a prescription-only shampoo, but it has been available for years as an OTC product. The active ingredient, ketoconazole, is a powerful anti-fungal compound that helps control the Malassezia yeast that contributes to itchy flakes. Adding another anti-dandruff ingredient, zinc pyrithione from Head & Shoulders, probably creates an especially effective anti-dandruff treatment.
Dry Air and Dry Scalp:
Cool weather might aggravate dandruff because cold dry air outside and heated dry air inside tend to dry the skin of the scalp. As a result, you get itching and flaking.
One reader found that sitting in a steam room for 10 minutes a few times a week made a huge difference for his winter dandruff. Just adding moisture to the air at home might also be helpful.
Less Sunlight:
Another hypothesis is that the Malassezia yeast that contributes to dandruff is held under control when skin is exposed to sunlight. In the winter, when we cover our heads with hats outdoors, the yeast may thrive.
Dandruff may be embarrassing, but it is not considered serious. Skin cells are shed from the entire body every day, but on the scalp where they are trapped or protected by hair, they may build up into noticeable flakes.
Seborrheic Dermatitis and Dandruff on the Face:
If inflammation due to Malassezia is responsible for flakes, they may not be limited to the scalp. Seborrheic dermatitis can affect the scalp, but it can also be seen in the eyebrows, on the forehead, chin and sides of the nose. Malassezia yeast is a normal skin inhabitant, and dermatologists don’t know quite why some people have inflammatory reactions to the yeast while others do not (Experimental Dermatology, online Sep. 29, 2014).
People are sometimes advised to treat dandruff by washing the hair and scalp more frequently. While this may help get rid of flakes, it can be overdone, contribute to dry skin and cause more flakes. It may take experimentation to find the correct frequency (and the right shampoo).
Treating Seborrheic Dermatitis:
Those who are struggling with Malassezia and seborrheic dermatitis may get relief from dandruff shampoo. Products containing zinc pyrithione (Head & Shoulders, for example) or selenium sulfide (Selsun Blue and others) interfere with the growth of the yeast. Remember to leave the suds on the scalp for at least five minutes to give them time to work. An antifungal shampoo containing ketoconazole such as Nizoral can also disrupt the yeast. Some readers have found that washing the face with a sea salt solution can help control seborrheic dermatitis.
Avoiding Resistance:
Malassezia can develop resistance if repeatedly exposed to the same compounds, so we recommend rotating through several different types of dandruff shampoo, a few weeks at a time. You can learn more about dandruff control in our Guide to Hair and Nail Care.
Many people find that home remedies such as soaking the scalp in vinegar (diluted in twice as much water) or old-fashioned amber Listerine before shampooing is helpful against dandruff. Yogurt with live cultures can be applied to the scalp for 15 minutes and then washed out. This appears to make the skin less hospitable to yeast.
Color Your Plate:
Other readers have suggested that eliminating “whites” from the diet–sugar, white flour and everything made with them–has been beneficial in controlling dandruff. Since this is a good step towards a healthful diet anyway, it could be worth a try.
Milk of Magnesia Against Winter Dandruff:
Q. I have a terrible case of dandruff that I can’t get rid of. Months ago, you wrote about milk of magnesia on the scalp for seborrheic dermatitis. As I understand it, that is basically dandruff.
Do you have any details about how to use milk of magnesia? Is it applied to the scalp prior to shampooing for a number of minutes then shampooed out? Or is there some other regimen? Thanks for any information you can offer.
A. There are no studies on milk of magnesia against dandruff, but several readers have praised it. They apply it in the shower and leave it on the scalp for several minutes while they shower. Then they wash it out.
Another popular approach involves rinsing the scalp with old-fashioned amber Listerine. It has antifungal activity that may be helpful against yeast.
You can learn more about these and other dandruff remedies in our book, The People’s Pharmacy Quick & Handy Home Remedies. It includes hundreds of remedies for common ailments.
Dandruff Shampoo:
Q. I use dandruff shampoo every other day but get no relief. I am a 57-year-old woman.
A. If you have been using the same old dandruff shampoo for weeks on end, that may be contributing to the problem. Dermatologists suggest that it is best to alternate different anti-dandruff ingredients.
In practical terms, that means using a product with selenium sulfide (Selsun Blue, Head & Shoulders Clinical Strength, Exsel) for a week or two and then switching to a tar-based product such as Neutrogena T/Gel, Denorex or Biotene. That may be followed up with a product containing zinc pyrithione (Head & Shoulders).
If you need more details on this regimen, you will find them in our Guide to Hair and Nail Care. If you are still in need or dandruff relief or want to try out a home remedy that many of our readers swear by, you may want to consider pre-treating your scalp with amber Listerine or milk of magnesia before shampooing on the days when you are not using a dandruff shampoo.
Lyn wrote about her discovery:
I too have been plagued with dandruff and itchy scalp for years. Tried prescription shampoo and drugstore brands, including the “tar” shampoos. What finally worked for me was using a drugstore shampoo that has Argon Oil in it. Gave me immediate relief. I leave the suds on while I shower, then rinse. Such a blessing to be dandruff/itch free.”
Apple Cider Vinegar:
One woman wrote:
My husband had terrible itching and flaking. We heard about apple cider vinegar which he would use as a rinse, about a cup full for the last rinse. It worked well but his hair went from black to white. Then we heard about mouthwash, the cheapest you can buy and rinse with that. The odor goes away in about 15 minutes and the dandruff leaves also. He never had dandruff again.”
Tea Tree Oil:
Donnie tried a different remedy:
I use a tea tree oil rinse, and alternate with an apple cider vinegar rinse. I can’t use dandruff shampoo, because they all contain ingredients that cause allergic reactions and asthma flare-ups.”
