What causes dandruff?
Dandruff is a mild form of seborrheic dermatitis, where the skin reacts to a yeast that normally lives on oily areas. It causes flaking and itching on the scalp, and sometimes red, flaky patches on the eyebrows, sides of the nose, behind the ears or on the chest.
It tends to come and go, and is often worse in winter and with stress. In babies, it shows up as cradle cap.
Listed in Ontario’s minor ailments program as: Seborrheic dermatitis (dandruff).
Common symptoms
- White or yellowish flakes on the scalp, hair or shoulders
- Itchy scalp
- Red, greasy-looking, flaky patches on the face or chest
- In babies: thick, crusty patches on the scalp
How a Kennedy pharmacist can help
Your pharmacist will look at your scalp or skin, ask what you’ve tried, and check it isn’t psoriasis or another condition.
They may recommend or prescribe a medicated shampoo and explain how to use it properly: leave the lather on for 3 to 5 minutes before rinsing, 2 or 3 times a week at first, then once a week to keep it away. For red, itchy patches, they may prescribe a mild cream or lotion for a short time.
If we think you’d be better served by a doctor, we’ll tell you, and help you figure out where to go.
Medicines a pharmacist may consider
- Ketoconazole shampoo (Nizoral)an antifungal shampoo, often the most effective
- Zinc pyrithione (Head & Shoulders, Selsun Blue) or selenium sulfide shampooeveryday anti-dandruff shampoos
- Coal tar or salicylic acid shampooloosen thick scale
- Hydrocortisone or betamethasone valerate scalp lotion, or roflumilast foam (Zoryve)for red, itchy flare-ups
Your pharmacist chooses based on your symptoms, age, pregnancy, allergies and other medications, so not every option is right for everyone. Brand names are examples. We often use the generic version, which works the same and usually costs less.
What it costs
The assessment is free with a valid Ontario health card. It’s paid for by the province, just like a visit to your doctor.
If you’re prescribed something, the medicine is paid for like any other prescription: through your drug plan, the Ontario Drug Benefit (65+ and other eligible people), OHIP+ (under 25 without a private plan), or out of pocket.
Good to know: Some plans cover medicated shampoos like ketoconazole, and prescription lotions or foams, when a pharmacist prescribes them. We’ll check yours.
No Ontario health card? Text or call us first and we’ll tell you the fee before we start.
When to see a doctor instead
See your family doctor, a walk-in clinic or a nurse practitioner if:
- Thick, silvery plaques, or patches on your elbows and knees too (it may be psoriasis)
- Hair loss, bleeding, oozing or a painful scalp
- A baby’s cradle cap is spreading or looks infected
- It isn’t better after 4 weeks of treatment
Not sure? Call Health811 (dial 811) any time to speak with a registered nurse, free.