What should you know about stubborn dandruff?

Dandruff produces visible flakes from the scalp and may be accompanied by itch, oiliness or mild redness. Seborrheic dermatitis can cause more inflamed, greasy scaling and may affect the eyebrows, ears, nose folds or beard area as well as the scalp. Dryness, psoriasis, contact irritation and some infections can look similar. Scratching can break the skin and make irritation harder to settle.

Use a medicated shampoo as directed, allowing it to remain on the scalp for the recommended contact time before rinsing. Follow the schedule consistently and avoid picking flakes. A clinician may recommend medicated shampoo treatment or topical antifungal treatment when inflammation or yeast-related activity is suspected. Keep a note of products, washing frequency and areas affected; this can reveal whether a new hair product is aggravating the scalp. Treatment may need adjustment if the first approach causes burning or does not control scaling.

Seek assessment for painful cracks, pus, thick plaques, bleeding, marked swelling, patchy hair loss or a rash spreading beyond the scalp. Arrange review when flakes persist despite careful use of an appropriate product, or when itching is disrupting sleep. Urgent care is appropriate for facial swelling, breathing difficulty or a rapidly worsening reaction after a product.

Does this look like dandruff, seborrheic dermatitis or another scalp condition? Which active ingredient and schedule suit me? How long should I try it? What should I do if my scalp burns? Do the ears, face or hair loss need separate treatment?