Dandruff is a skin condition, mainly afflicting the scalp. Typical symptoms are flaking and mild itchiness. Apart from physical discomfort, it causes negative self esteem in sufferers. In a more severe form, the condition manifests as inflammation of the skin or seborrheic dermatitis

The exact cause of dandruff is unknown but several environmental and genetic factors are associated with it. For instance, the condition may worsen in winter.  But it must not be attributed to poor hygiene. The basic problem consists of overgrowth of skin cells.

Treatment is based on symptoms. The typical treatment is via antifungal cream or special shampoo for dandruff containing Ketoconazole. Dandruff afflicts half of all adults. It usually begins in puberty. Men are more affected than women. Intensity reduces after the age of fifty.


The symptoms of dandruff are all signs of irritation caused by root cause of dandruff– the microbe Malassezia Globosa.

These include irritation of the scalp such as:

  • Redness
  • Itchiness
  • Flakes and
  • dryness

Flaking is the most obvious sign of dandruff which may appear on the head as well as shoulders. This happens because there is increase in the speed at which cells renew themselves, resulting in excess cells in the scalp which flake off. This may be a major sign of dandruff, but not the first. Often, itching is the first sign after which flakes are common. Early signs include redness and dryness which can make the scalp feel tight. When these symptoms persist, it is time to use an anti-dandruff shampoo.


Exact causes of dandruff are unknown but here are some possible factors:

  • Seborrheic dermatitis

Persons with this condition have oily, irritated skin. It affects major areas of the skin such as eyebrows, breastbone, sides of nose and back of ears. The skin will be greasy, red and covered with yellow or white scales. The condition is closely linked with the fungus Malassezia which lives in the scalp. When the latter becomes over active, it irritates the scalp and induces it to produce more cells. When such flaky cells fall off they combine with oil to form dandruff.

  • Poor brushing of hair:

Combing the hair regularly reduces dandruff as it helps in normal shedding of skin.

  • Yeast

Those who are sensitive to yeast may develop dandruff. For instance, dandruff reduces in summer when the sunlight reduces yeast formation.

  • Dry skin

Person with dry skin are more prone to develop dandruff.

  • Skin care products and shampoo

Some hair care products can trigger scaling, itchy and red scalp. Frequent shampooing with wrong product may also cause irritation.

  • Skin conditions

Persons with eczema, psoriasis and other skin conditions tend to develop dandruff.

  • Medical conditions

Person with neurological diseases like Parkinson’s and with low immunity due to HIV or chemotherapy treatment are prone to develop dandruff.

  • Mental stress

Stress aggravates the condition of dandruff.

  • In babies

Dandruff develops in newborns and infants in a condition called as cradle cap. It  lasts for a few weeks or months.

Home Remedies

The aim of treatment is to stop the dandruff by slowing down the reproduction of skin cells or repelling the production of yeast, which may be a causative factor.

The strategy depends on age of patient and severity of condition. But there are some home remedies and lifestyle changes that can help:

  • Management of stress

Stress can trigger dandruff in some cases, so managing it can help reduce symptoms.

  • More shampooing

In case you have oily scalp and hair, shampooing regularly can help alleviate the condition.

  • Sunlight

A little exposure to sunlight can ease the condition.

  • Tea tree oil

According to some, tea tree oil application can reduce dandruff. But care must be taken that you don’t have allergy for it.


  • Shampoos and creams for fighting dandruff are available over the counter in most pharmacies. These may control symptoms but cannot cure the condition.
  • Before using special shampoo, crusty or scaly patches on the scalp must be removed as far as possible. This will improve efficacy of shampoo.
  • Some common ingredients in anti-dandruff shampoos include Ketaconazole, Selenium sulfide, Zinc pyrithione, Coal tar, Salicylic acid and Tea tree oil.
  • Ensure that you read the instructions which come with the shampoo, whether it is good for you and how many times you need to apply it. For this, you can consult the pharmacist.
  • It is important to leave on the shampoo in the hair for a minimum 5 minutes before washing it out.
  • Try out the shampoo for a month to see whether dandruff improves. You may have to test more than one type to ascertain what works for you.
  • You can reduce frequency of application if the condition improves, but stopping application might see return of your dandruff.

When to See Doctor

Consult doctor in case:

  • Even after using anti-dandruff shampoo for one month, there is no relief.
  • Your scalp is very itchy and dandruff is severe
  • You have a swollen or red scalp
  • You have a weak immune system- ( due to HIV or chemotherapy)


Read Also: Some Autoimmune Diseases That Women Need to Be Aware of

This shampoo/ cream is essentially a formulation of Ketaconazole and is a broad spectrum, synthetic anti-fungal agent in a concentration of 2% in a cream/ shampoo base. Ketaconazole is an azole anti-fungal which works by preventing growth of fungus.

Shampoo ketomac contains Ketaconazole which kills yeast and fungi by interfering with their cell membranes. It works by preventing the formation of ergosterol- a substance that is a crucial part of cell membranes of fungi. Reducing ergosterol compromises the working of fungal cell membranes making them weak. This weak cell membrane allows content of cells to leak out and escape, resulting in death of the fungal cell. Thus Ketomac kills the fungi and stops the infection.

Topical Ketomac treats symptoms of dandruff like itching, scaling and flaking. It can be used also to treat conditions like jock itch, ringworm, tinea versicolor and athlete’s foot.


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