Dryness and itchiness caused by dandruff can make hair fall out more easily

Dandruff and Hair Loss – How to Treat Dandruff & Regrow Your Hair

With at least 50% of the world’s population effected by dandruff, it’s no wonder that so many anti-dandruff products are currently available on the market (1).

From shampoos and conditioners to peels and scalp creams, the treatment of dandruff is a multi-million dollar industry.

While everyone is desperate to rid themselves of the white flakes commonly associated with the disorder, those with a susceptibility to hair loss may be dealing with much more urgency.

This is because dandruff can lead to hair thinning and may even cause damage to the follicles and hair roots.

So, what can a dandruff sufferer do to treat the root cause of the condition, while simultaneously protecting against hair loss?

I aim to answer this very question below.

First, I’ll explain exactly what dandruff is, including the main cause and symptoms.

Second, you’ll learn of common dandruff treatments on the market, from ketoconazole to zinc.

Finally, I’ll outline the steps you need to take to treat the problem while also preventing hair thinning and perhaps even promoting healthy growth.

What is Dandruff?

Dandruff is a scalp condition, characterized by white flakes and itching (2). It’s clinically known as Pityriasis Capitis, and it’s a disorder which can negatively impact the lives of sufferers.

Dandruff is an extremely common condition which affects upwards of 50% of people worldwide (1).

This is a condition known to appear around the pubertal age, though it can extend to 50 years of age and beyond.

There is a similar condition which is seen in infants and known as cradle cap, though it’s temporary and typically resolves on its own (3).

What Causes Dandruff?

While many believe that dandruff is simply a case of dry scalp, the cause goes much deeper than that.

According to a 2014 research study, the culprit appears to be a species of fungus, known as Malassezia (4).

The researchers found that 84% of individuals with clinical dandruff have levels of Malessezia present in their scalps.

This is in comparison to healthy individuals, with only 30% having the fungus present in their scalps.

Malessezia is also believed to be the cause of seborrheic dermatitis, a more serious version of dandruff, and has also been found to be linked to increased levels of hair fall (5). Dandruff and seborrrheic dermatitis are a continuous spectrum of the same disease. Dandruff is the mild version and seborrheic dermatitis is the severe form consisting of severe inflammation secondary to Malessezia.

What are the Symptoms of Dandruff?

For those who’re suffering from itchy scalp, it may be difficult to distinguish between general irritation and a clinical diagnosis of dandruff. Here’s a list of symptoms which, when combined, may indicate that you suffer from more than just scalp itch.

It can cause itchiness on the scalp

  • Intense itching, requiring constant scratching
  • White or yellowish scale flakes found on the scalp and shoulders
  • Red patches on the scalp (in extreme cases)
  • Sore and tingly scalp
  • Scaly rash on scalp

Additionally, you may feel a tightness or dryness of the scalp, leading to further irritation and itching.

Conditions Similar to Dandruff

Aside from sebborheic dermatitis, which is a more severe form of dandruff, there are other scalp conditions which are similar to dandruff. These conditions, however, are not caused by the same mechanisms and, therefore, require different treatments.

One such condition is scalp psoriasis. This is a chronic and immune-related condition which is marked by silver-colored scaling on the scalp and surrounding areas (6).

Unlike dandruff, which is linked to an overgrowth of fungus, psoriasis is caused by a faulty mechanism which enables skin cells to be produced at an accelerated rate.

This leads to rough, thick scales that are dry, itchy, and sometimes painful.

Seborrheic dermatitis is another condition often mistaken for dandruff but it is essentially a severe form of dandruff.

Seborrheic dermatitis can also be found almost anywhere on the body where there is sebaceous glands (face, scalp, upper trunk, external auditory meatus, and anogenital area).

Seborrheic dermatitis is marked by “well-delimited erythematous plaques with greasy-looking, yellowish scales of varying extents. (7)” These can be found anywhere that sebaceous glands are present.

Interestingly, dandruff and seborrheic dermatitis aren’t completely separate conditions. Instead, they exist on opposite ends of the spectrum, with dandruff being a mild presentation and seborrheic dermatitis being a severe one.

Is Dandruff Linked to Hair Loss?

Dandruff is not a direct cause of hair loss. Instead, those who suffer from dandruff may experience hair thinning and excessive shedding due to the constant scratching of the scalp.

This is because frequent rubbing of the scalp can dislodge hair, especially in individuals who are already susceptible to hair fall.

Additionally, as mentioned above, those with a known Malassezia infection are more likely to experience some degree of thinning. This isn’t a direct result of the fungal infection, but instead a side effect.

Common Methods Used for Treating Dandruff

As dandruff is such a common occurrence, there are a number of treatments which have been scientifically researched over the years. Each of the treatments will vary in effectiveness, and some may also come with less-than-desirable side effects.


Zinc pyrithione is a common ingredient in shampoos, and may be a successful treatment method for those with dandruff (8).

Used in a variety of anti-dandruff shampoos, zinc may also be an anti-androgenetic (9). In fact, a topical solution of 1% zinc pyrithione was shown to induce hair growth (10).

Even though the results were less than those shown in the Minoxidil group, the hair growth was maintained throughout the 26-week study thanks to continued use of the zinc treatment.

Tar-based Shampoos

While not one of the most popular treatments, mainly due to its odor and mess, there was been studies performed which show that tar-based shampoos are just as effective at treating dandruff as other methods, such as salicylic acid 11, 12).

One study found that greater than 70 percent of participants were approving of the results they say when treating their dandruff with a coal tar shampoo (13).

Selenium Sulfide

An ingredient found in popular anti-dandruff shampoos, like Head and Shoulders and Selsum Blue, there’s no doubt that selenium sulfide is an effective treatment for dandruff.

However, the ingredient has been linked to hair loss, even going as far as to damage the roots of the hair (14).

For individuals with androgenetic alopecia or other forms of hair loss, then, selenium sulfide is one treatment to be avoided.

Ketoconazole-containing Products

Hair products, such as nizoral shampoo contain the active ingredient ketoconazole.

A proven promoter of hair growth, ketoconazole has also been shown to reduce the levels of Malassezia fungus on the scalp, especially when used in conjunction with zinc pyrithione (15, 16).

Salicylic acid

For more than 2,000 years, salicylic acid has been used to treat a variety of skin disorders (17). These include acne, scarring, and wrinkles, though it’s also been proven effective in the treatment of dandruff. Now it’s also used in shampoos.

Salicylic acid is commonly used as a peel, both for the face and scalp.

How to Prevent Hair Loss Caused by Dandruff

As previously discussed, dandruff is not a direct cause of hair loss. However, the constant scratching and overall inflammation can certainly contribute to thinning.

Let’s look at a few steps to take if you want to prevent hair loss that may occur as a result of dandruff.

1. See a Doctor

To ensure that you’re treating the right problem, it’s important to see a doctor and get a diagnosis prior to treatment.

As mentioned above, there are many numerous conditions similar in appearance and symptoms to dandruff. These include seborrheic dermatitis and scalp psoriasis.

But as each of the conditions has a different cause, it’s important to know which one if affecting you.

Your physician may diagnosis you, or they may refer you to a dermatologist. They’ll perform a physical examination of the scalp, and ask you questions such as when the symptoms first appeared and what methods you have tried to treat it.

Once dandruff has been diagnosed, they can help you to come up with a successful treatment plan.

2. Use Medicated Shampoos

As dandruff is a fungal issue, you’ll likely need to add a medicated shampoo to your hair care routine at least for the present time. This may be one prescribed by your doctor, or one that you found over-the-counter.

It’s important to follow your doctor’s instructions, or the directions on the package.

During the first few weeks of treatment, you’ll likely need to use this shampoo every time that you wash your hair throughout the week. The amount of times will vary based upon doctor’s recommendations and/or the shampoo you’re using.

However, once the dandruff is under better control, you may be able to reduce usage to once per week or even once per month.

3. Moisturize Your Scalp

When it comes to fighting dandruff, there’s no such thing as too much moisture.

Moisturization of the scalp is a process that enables you to add oils back to the environment but, even more importantly, keep them trapped within the skin.

When you suffer from dandruff, and as you introduce medicated shampoos to your routine, the scalp loses its natural oils at an irregularly fast rate. You must moisturize, then, to preserve the equilibrium and ensure a healthy environment in which your hair can grow.

The easiest way to moisturize the scalp is with a carrier oil, such as coconut or jojoba. These can be applied directly to the scalp and left in overnight to absorb.

This is especially important if you use a particularly drying ingredient in the treatment of your dandruff, such as salicylic acid.

4. Avoid Overstyling

Gel, mousse, hairspray, and heat – these are common tools used in the daily hair care routine.

But for someone with an already sensitive scalp, the use of these products can cause further irritation and may even worsen the condition.

Gels, mousses, and hairsprays are very likely to contain alcohols, which are incredibly drying. They may also contain ingredients that clog the hair follicles and sweat glands which can cause further issues.

Heat styling tools – such as curling wands, straightening irons, and blow dryers – can also dry out the scalp. And inadvertent burns, which can sometimes happen when you use a tool that regularly heats to over 300 degrees Fahrenheit, may have a difficult time healing if dandruff is already present.

5. Soak Up Some UV Rays

You’ve heard that unprotected exposure to the sun and its ultraviolet rays can cause premature aging. This is true.

However, a little bit of sun on a regular basis may be just what you need to keep your dandruff under control (18).

You don’t want to expose yourself to the sun for long periods of time, but a few minutes every day may be enough to benefit your dandruff. Just be sure to apply sunscreen to your face and body, and wear a hat or use an umbrella after your short sun session.


While dandruff is not a direct cause of hair loss, it can negatively impact the lives of those effected and make hair fall more likely to occur. This is due to the actions of said sufferers – namely, scratching – and can lead to the dysplasia of fragile hair.

This is why it’s important to work with a medical professional and consider all of the treatment options available to you.

Do you have any questions about dandruff and how to rid your scalp of it? Drop a comment below!

*This article was reviewed by Dr. Anil Simhadri.

22 thoughts on “Dandruff and Hair Loss – How to Treat Dandruff & Regrow Your Hair”

  1. Will I’ve had really bad dandruff for the past year or so and I feel like it’s making my hair loss much worse. I have also been trying head and shoulders but it doesn’t help at all. I am going to try your homemade shampoo recipe. Is there anything with concern to diet that will help as well? Thanks for the great article btw.

    • Hello Francis, yes I would avoid head and shoulders at all costs. It will only make the long-term health of your hair worse. There is a lot you can do with your diet to help with dandruff. Try adding in more healthy fats such as avocado, coconut and cold-water fish. Try to avoid greasy foods and you should probably avoid gluten as well.

      • In the past I had long periods of dandruff and an itchy scalp. I had lots of dry scales on my scalp and I always had a suspucion that it had something to do with my hair loss (thinning). 2 months ago the dry scales started to come back. But since I’m using your scalp elixer 6 day’s a week it dissapeared in matter of day’s. 1,5 months further dandruff starting slowly to come back.

        1. Why should Francis probably avoid gluten?
        2. Do you have any ideas what I should do?

        Thanks Will!

  2. Hi Will,

    Nice article. I have been suffering from dandruff for the past 8 years. I tried many things, nothing seemed to work. I am currently using Sebowash Shampoo. What is your take on it?

    • Hi Nithi, mostly I’ve found that optimising your diet is the best way to help dandruff. I used to have very dry skin and scalp until I worked on fixing my diet. It can also be a problem with your microbiome in which case you need to get some probiotics in there too.

  3. Really interesting information. I though that H&S is an effective shampoo, I was so wrong. Homemade shampoo is so much better.

    • Hi Cheveux, thanks for the comment. It does depend how you make your own shampoo, but it certainly has the potential to be better. It’s more about the horrible chemicals that go into brands like this. Avoid at all costs is my opinion.

      • Hi will, I’m treating my dandruff with kety soap as prescribed by dermatologist and I moisturize my hair with coconut oil twice a weak and I also use anaboom anti hair fall shampoo twice a week.. Well hair fall is quite decreased right now and dandruff too but I could see my scalp whenever I look in the mirror and that is so annoying. I just want to know after treating the dandruff how many days does it take for hair to regrow back?

        • Hello Harris, there are many factors that come into play. Most important is your hair loss is stablised. Now your hair will have a better chance. I recommend microneedling and LLLT as two good methods to kickstart hair follicle neogenesis.

  4. Where do i begin? I believe all of my hair/scalp problems (I have many other physical and mental issues as well) began when my only child died 5 years ago. This trauma is ongoing as i write this, but I will try not to digress. In May 2016 I went to a local hair salon that was well known and people spoke highly about it. It was right after that I lost a fairly large oval shaped area in the upper back of my scalp. I went to three dermatologists, had two plugs taken out and biopsied. They both came back with same diagnosis, (something?) alopecia which one doctor said usually meant permanent hair loss. I was devastated on top of what i had already been dealing with; but my hair began growing back in after the third dermatologist started me on a regimen of minocycline antibiotic for a one month duration, then cut it down to half of the original dose for another month, but everytime I stopped taking it my scalp would become irritated again with folliculitis symptoms. I couldnt continue taking it. I knew it wasnt good for me so i stopped and thats when the dandruff-like scalp issues began. During this whole time period, I became financially burdened and my sister and her husband talked me into selling my house since the area reminded me so much of my son everywhere i went, but the move was almost as stressful as his death. Back to the issue…i have been using the apple cider vinegar rinses, but not on a regular basis along with lemon juice straight from a lemon. It really helped with the itching. Now, however, ive noticed a huge change in my hair condition and much more thinning. I am 71 years old. Ive always had thick wavy black hair. Now it is almost all gray except where the new hair was growing back. Im afraid im going to lose what little hair has grown back, ever so slowly, before this is over, if ever. I have good insurance. I can go to another dermatologist here in my new home area (El Lago, TX). Do you think i should go see another dermatologist or try your method first?

    • Hi Elizabeth, sorry to hear about this tough time. It’s hard to say without knowing more details, but it certainly sounds like stress is involved. Obviously there is no really direct way to avoid stress, but one thing I have found helps me is to do 5 minutes of breathing exercises per day. After that, I would recommend a review of your nutrition to make sure nothing it holding you back. Having taken antibiotics, a good probiotic and probiotic foods certainly wouldn’t hurt.

    • There is no specific formula for hair that was damaged by dandruff, rather just focus on scalp health and minimising the dandruff from now on and the regrowth should follow.

  5. I hope you might have some insight to this question. I have a dilemma using rogaine. Over a period of 1.5 yrs I have weened myself off of using it 2 times a day and now just use it once at night. I haven’t noticed any regression by cutting back on the frequency of use, but I shed so much hair snd have terrible dry scalp using this stuff.

    I want to stop using it, but I am afraid of what might happen if I do, and if there is an alternative. When I don’t use it for a few days, my hair looks great but like I say I am afraid to stop completely as it could be acting as a calcium channel blocker, etc.

    Any suggestions?


    • Hi Elliott,

      The best way to stop taking Rogaine is to wean yourself as you have been.

      I would recommend you continue to wean yourself as follows:

      Use once every other night for two weeks.
      Use once every two nights for two weeks.
      Use once every three nights for two weeks.

      By the end of this six-week period, you should be okay to stop use entirely.

      If you notice an increase in shedding at anytime during this process, you can return to the previous step for an additional two weeks.



  6. A debt of gratitude is in order for such point by point information, it was extremely helpful. Really fascinating for me. I was suffering from dandruff. A self-constructed cleanser is so much better.

  7. Hi Will ,I am just 17 and my hair is getting lost day by day in the right side of my scalp.I think it’s due to dandruff.What should I do?Is using egg yolk or coconut oil with lemon juice a remedy.

    • Hello Adarsh, hows your water quality, both drinking and showering? Drinking lots of really high quality water and using a shower filter is the first place to start with improving your dandruff condition.


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