What should you know about demodex dandruff?

Dandruff is a common scalp condition involving visible flakes, sometimes with itch or mild irritation. [Seborrheic Dermatitis](/conditions/seborrheic-dermatitis/) can cause more persistent inflammation, greasy scale, and redness around the scalp, eyebrows, ears, or nose. Demodex may be discussed when there are additional inflammatory features, but seeing mites does not prove they caused the flakes.

The appearance of the scale, the areas involved, hair products, skin sensitivity, and response to treatment help distinguish causes. [Itchy Scalp](/symptoms/itchy-scalp/) and [Flaky Scalp](/symptoms/scalp-flaking/) can occur with several conditions.

Wash the scalp regularly with a gentle routine and avoid scratching, very hot water, and heavy fragranced products. Use any medicated product exactly as directed and allow it to contact the scalp for the recommended time. Do not apply household insecticides or harsh oils.

A clinician may recommend [Medicated Shampoo Treatment](/treatments/medical-dermatology/medicated-shampoo-therapy/) or [Topical Antifungal Treatment](/treatments/medical-dermatology/topical-antifungal-therapy/) when the pattern supports it. Persistent scale may need a different diagnosis or a change in treatment.

Arrange an appointment if flakes continue despite appropriate use of a recommended shampoo, or if the scalp is painful, very red, crusted, oozing, or developing broken hairs. Prompt review is sensible for patchy hair loss or a tender swollen area, which can signal infection or another scalp disorder.

Does this look like dandruff or seborrheic dermatitis? Is there evidence of infection or inflammation? Which shampoo should I use, how often, and for how long? What should I do if the scalp becomes sore or my hair starts breaking?