Patient information from BMJ

Dandruff

Last published:Apr 24, 2025

Seborrhoeic dermatitis is a skin condition that can cause flaking and irritation on your scalp. In adults and children, this is called dandruff. In infants, it can also cause yellowish crusts, which is called cradle cap. Different products can help manage this.

You can use this information to talk to your doctor or a pharmacist and decide which treatments are best for you or your child.

What is seborrhoeic dermatitis?

Seborrhoeic dermatitis is a skin condition that causes flaky or inflamed skin. Doctors aren’t exactly sure what causes seborrhoeic dermatitis, but it seems to be linked to yeasts that naturally live on everyone’s skin. Yeasts are a type of fungus. Normally this yeast is harmless. But if it grows too much, it can cause irritation, especially in oily areas like your scalp or around your nose.

When seborrhoeic dermatitis affects your scalp, it can cause large flakes of skin. In adults and children, this is called dandruff. In infants and young children, this is called cradle cap.

Some dandruff is normal, because the top layer of your skin naturally sheds over time. But seborrhoeic dermatitis causes lots of dandruff and may need treatment.

What are the symptoms of dandruff and cradle cap?

Flakes of dandruff caused by seborrhoeic dermatitis tend to be oily, and they may be a white or yellowish colour. You may also get itchy or inflamed skin that looks a bit like a sunburn.

In infants, cradle cap appears as greasy, yellowish crusts on the scalp.

What are the treatment options for dandruff in children and adults?

Lots of products are available to help with dandrufff, including anti-dandruff shampoos and lotions. Just washing your hair normally will help to remove flakes, but anti-dandruff products also contain chemicals to control yeasts or reduce inflammation on your scalp.

Most of these treatments are available over the counter. However, some stronger options may require a prescription from your doctor.

Try to avoid getting anti-dandruff shampoos in your eyes, and rinse well with water if you do.

Over-the-counter products

Well-known brands of anti-dandruff shampoo display the names of the active ingredients clearly on the labels, so it's easy to check whether they contain the treatments listed below.

Most people start off by trying a commonly available anti-dandruff shampoo, such as one that contains pyrithione zinc.

Other common anti-dandruff products contain coal tar. Some people don't like the smell of tar shampoos or lotions, but many products are scented to help mask this. Coal tar can help reduce itching, thickening of the skin, and germs on the scalp, but it can sometimes cause irritation.

You could also try a shampoo that contains salicylic acid. Salicylic acid is a chemical that helps to break down hard or scaly skin. 

For more severe dandruff, you can try a shampoo containing ketoconazole or miconazole. These are antifungal treatments that can kill yeasts.

Some people find that ketoconazole irritates their scalp. This is more likely if you've recently used a corticosteroid treatment on your skin (see below).

Other treatments for dandruff include shampoos containing either ciclopirox or selenium sulfide.

Side effects are rare with selenium shampoos, but some people may get skin irritation. Some people find that the shampoo bleaches their hair slightly or turns their scalp an orange colour.

Treatments you can get from a doctor

If you or your child have severe dandruff caused by seborrhoeic dermatitis, and other treatments haven't helped, your doctor may suggest using a corticosteroid shampoo or lotion. Corticosteroids can help reduce redness and itching. Common options include fluocinolone or hydrocortisone lotions. These are only used in children over 2 years old.

Using strong corticosteroid lotions for a long time can cause skin thinning, stretch marks, lighter skin, and visible blood vessels. To avoid these side effects, your doctor will only recommend them for a short period of time.

What are the treatment options for cradle cap?

Cradle cap in infants can usually be managed with gentle moisturisers like olive oil. Applying a small amount to your child’s scalp once or twice a day can help soften the crusts. In most cases, this is all the treatment your child will need.

If your child has severe cradle cap that lasts longer than 3 months, their doctor may recommend a corticosteroid lotion, like hydrocortisone.

What happens next?

Treatment is often enough to control dandruff and cradle cap. For dandruff, you may need to use anti-dandruff treatments regularly, or only during flare-ups. Flare-ups might happen when you are more stressed. Cradle cap usually goes away as your child gets older.

It's important to follow your doctor’s advice on how often to use treatment for either condition.