Scalp Health

Dandruff & Scalp Treatment

Persistent dandruff often has an underlying cause that over-the-counter shampoos don't address -- an evaluation identifies what's actually driving it.

Book a Scalp Evaluation

Dandruff that comes and goes?

Mild, occasional flaking often responds well to the right over-the-counter approach. An evaluation helps confirm whether that's what you're dealing with, or something that needs more targeted treatment.

Dandruff that won't clear despite trying shampoos?

Persistent dandruff despite anti-dandruff shampoos often points to an underlying condition -- seborrheic dermatitis, fungal overgrowth, or occasionally psoriasis -- that needs a different treatment approach entirely.

Dandruff — flaking and sometimes itching of the scalp — is common, but “dandruff” as a symptom can have several different underlying causes, from simple dry scalp to seborrheic dermatitis (an inflammatory skin condition affecting oil-producing areas) to fungal overgrowth (Malassezia yeast, which plays a role in most dandruff) to, occasionally, scalp psoriasis. Each responds best to a different treatment approach, which is why persistent dandruff that doesn’t respond to standard anti-dandruff shampoos is worth a proper evaluation rather than repeatedly trying different over-the-counter products.

Most dandruff is not a sign of poor hygiene, and using anti-dandruff shampoo more often than recommended is often unhelpful and can be irritating — a common misconception that leads people to overtreat and end up with a worse, drier scalp.

What to Expect at Your Visit

We examine the scalp to characterize the type and distribution of flaking, checking for the redness and greasy scale typical of seborrheic dermatitis, the tight, silvery scale of psoriasis, or signs of a fungal component. We’ll also review what products you’ve already tried and how you’ve been using them, since incorrect usage of otherwise appropriate anti-dandruff shampoo is a common reason treatment appears not to be working.

Treatment Approach

For most dandruff driven by Malassezia yeast overgrowth, medicated shampoos containing specific active ingredients are effective when used correctly — at the right frequency, left on the scalp for the recommended contact time, and used consistently rather than only when flaking is visibly bad.

Where seborrheic dermatitis is the underlying driver, targeted topical anti-inflammatory treatment addresses the condition more directly than shampoo alone. Where scalp psoriasis is present, either alongside or instead of typical dandruff, treatment shifts to address that condition specifically, since standard anti-dandruff approaches are less effective for psoriasis.

Why “The Shampoo Isn’t Working” Usually Has an Explanation

When dandruff persists despite trying multiple shampoos, the most common explanations are an incorrect underlying diagnosis, incorrect usage (not leaving the product on long enough, or not using it frequently enough), or a coexisting condition that needs separate treatment. Identifying which of these applies to you is usually enough to finally get dandruff under lasting control.

How We Evaluate

Scalp examination
Assessment for seborrheic dermatitis, fungal involvement, or psoriasis
Review of hair care products and routine

Treatment Options

Medicated Shampoo Protocols: Targeted anti-fungal or anti-inflammatory shampoo regimens matched to the underlying cause, used correctly for the frequency and duration that actually clears the condition.
Topical Treatment for Seborrheic Dermatitis: Where seborrheic dermatitis is the driver, targeted topical treatment to reduce inflammation and flaking at the source.
Management of Coexisting Scalp Conditions: Where dandruff overlaps with scalp psoriasis or another condition, a treatment plan that addresses both together.

Frequently Asked Questions

How is dandruff different from a dry scalp?

Dandruff is usually driven by Malassezia yeast overgrowth or an underlying condition like seborrheic dermatitis, often with oilier, larger flakes -- while a dry scalp produces smaller, drier flakes from lack of moisture. They're treated differently, which is why an evaluation helps before choosing a product.

What causes dandruff?

Most dandruff is linked to Malassezia yeast naturally present on the scalp, though seborrheic dermatitis, fungal overgrowth, or occasionally scalp psoriasis can also present as flaking. It is not caused by poor hygiene, a common misconception.

Why isn't anti-dandruff shampoo working for me?

This is usually explained by an incorrect underlying diagnosis, incorrect usage (not leaving the shampoo on long enough or using it frequently enough), or a coexisting condition like seborrheic dermatitis or scalp psoriasis that needs separate treatment. An evaluation identifies which applies to you.