Dandruff, a common condition characterized by white skin flakes throughout the hair, is caused by a fungus that feeds on oil secretions from the scalp. Contrary to popular belief, experts say dandruff isn't curable. It can, however, be treated effectively.
Overall, experts suggest combating the problem with over-the-counter anti-dandruff shampoos. Formulas with zinc pyrithione, selenium sulfide and ketoconazole have been shown to be the most effective. These active ingredients kill fungus and control production of the oil that fungus feed on. Some dandruff shampoos also contain tea tree oil or green tea, both of which have been shown to have mild antifungal properties. Neither of these, however, has been proven to be as effective as shampoos with the above ingredients.
One noteworthy product, Nizoral (*Est. $15 for 7 oz.) contains 1 percent ketoconazole. This antifungal is slightly more effective than other dandruff-fighting ingredients (it was once prescription only but has been recently released for use in over-the-counter dandruff shampoos), according to Paula Begoun, beauty expert and author of "Don't Go Shopping For Hair Care Products Without Me." Consumers at MakeupAlley.com and Drugstore.com agree, giving the shampoo high overall ratings. The majority of reviewers posting to these sites say that Nizoral clears up dandruff in just a few applications. Some complain of the medicinal scent and the expensive price tag, but most say these are minor inconveniences for the results they get. Manufacturers claim that only one or two treatments are needed per week. Once your dandruff has cleared, you can continue to use Nizoral on an as-needed basis. Users point out, however, that the shampoo can be drying. Most maintain that a good conditioner is a must when using this product. Users also point out that the shampoo is easy to use, but say they got better results when they left it on their scalp for five to 10 minutes, in order to give the active ingredients time to work.
Head & Shoulders Classic Clean (*Est. $8 for 23.7 oz.) is among the least expensive brands that contain the anti-fungal zinc pyrithione, which combats the organisms that cause dandruff. Only a handful of users at Drugstore.com review it, but those posting there give the shampoo good ratings. Most say it does an excellent job of clearing up dandruff and smells better than most dandruff shampoos. Even though Head & Shoulders is gentler than most treatments, reviewers recommend using a separate conditioner for added moisture. On the downside, experts say zinc pyrithione isn't quite as effective as ketoconazole. That said, those with severe dandruff (dandruff that doesn't clear up after a few weeks of using an over-the-counter shampoo) or symptoms like intense scalp itching or burning should consult a physician for a prescription-strength anti-dandruff shampoo.
Neutrogena T/Gel Shampoo (*Est. $15 for 16 oz.) is also an option for people who can't get dandruff relief from anti-fungal shampoos like Head & Shoulders and Nizoral. Neutrogena contains coal tar, which slows the creation of skin cells, making it especially suited to combating scalp psoriasis and seborrheic dermatitis, both of which are scalp conditions that result in red, scaly, itchy skin. Users at MakeupAlley.com say it works for dandruff symptoms as well but can be very drying. Experts concur that coal tar shampoos can be very drying to the hair, and they suggest them only when necessary to control symptoms. Users recommend using a conditioner to replace any moisture lost and also to cover up the medicinal smell. Paula Begoun also points out that coal tar shampoos can cause sun sensitivity. She, too, recommends them only as a last resort.
Another shampoo option, Denorex (*Est. $9 for 12 oz.), relies on sulfur and salicylic acid to combat dandruff. Salicylic acid has antimicrobial properties that can reduce the presence of fungi. Sulfur can also alleviate dandruff symptoms, but Begoun says it can cause damage to the hair shaft. Experts say it's too harsh for many people and is very drying. Only a handful of users at Drugstore.com review Denorex, but most say it is effective, even when other products are not. Like many dandruff shampoos, however, it can be drying and has a medicinal smell. Users also say Denorex can be very difficult to find in stores.