Dandruff shampoo needs to be used properly to be effective.

“Director, I only used dandruff shampoo for that time, and it doesn’t seem to be effective anymore.”

This is the most common complaint I hear from patients who have a lot of dandruff on their scalp. Most people have used commercially available or hospital-prescribed dandruff shampoos at least once or twice. It may seem effective at first, but as time goes by, dandruff comes back, and you end up becoming a 'shampoo nomad' who switches to a different product with the thought, 'Have I developed a tolerance?' This vicious cycle stems from misconceptions about dandruff shampoos and usage habits. Dandruff shampoo is not just a cleanser, but a ‘medicated shampoo’ with a clear purpose. Therefore, only when you know how to use it correctly, treat the root cause, and improve your lifestyle habits, you can finally be free from persistent dandruff.

1. Dandruff shampoo dilemma: Why is it less effective?

There is a common pattern that many patients experience. Using dandruff shampoo reduces dandruff, so use it consistently every day or once every two days. However, at some point, I feel that my scalp and hair become dull and dry, and the dandruff no longer decreases. If you stop using it because you think it's no longer effective, your dandruff will soon come back worse than before. The reason this phenomenon occurs is because of the properties of dandruff shampoo.

• Resistance occurs:The Malassezia fungus, one of the main causes of dandruff, can become resistant to certain antifungal ingredients after repeated exposure. If you use a shampoo with the same ingredients every day, the bacteria will adapt to the ingredients and will no longer be effective.
• Causes dry scalp:The medicinal ingredients contained in dandruff shampoo have a powerful function of suppressing dandruff bacteria and removing excessive dead skin cells, but at the same time, they tend to break the oil-moisture balance of the scalp and make it dry. A dry scalp can actually produce more dead skin cells, which can make dandruff worse.

2. Which dandruff shampoo is right for me? (Types and Features)

Dandruff shampoos work in different ways depending on their ingredients. Representative types are as follows:

Antifungal shampoos (ketoconazole, ciclopirox, etc.)

• action:It directly inhibits the growth of Malassezia mold, which is the cause of dandruff.
• merit:It is effective against dandruff caused by seborrheic dermatitis.
• disadvantage:Avoid daily use as it is prone to resistance and may dry out the scalp.

Cell proliferation inhibitory shampoo (zinc pyrithione, selenium sulfide, etc.)

• action:It slows scalp cells from multiplying and shedding too quickly, and also has some antifungal effects.
• merit:It is easily available over the counter and is effective for mild to moderate dandruff.
• disadvantage:It can also dry the scalp, and selenium sulfide can rarely discolor hair.

Keratolytic shampoo (salicylic acid, coal tar, etc.)

• action:It helps to gently dissolve and remove dandruff and dead skin cells that have already formed.
• merit:It is also helpful for psoriasis and seborrheic dermatitis with thick dead skin cells.
• disadvantage:The focus is on relieving symptoms rather than suppressing the causative bacteria. In particular, coal tar shampoo has a characteristic odor and can stain clothes or hair.

3. Proper shampoo habits to control dandruff

So what should we do? I highly recommend the following method:

• Use dandruff shampoo as ‘medicine’ only 1-2 times a week:Dandruff shampoo is not a daily shampoo that you use every day. It should be used 1-2 times a week and only on designated days to effectively suppress dandruff bacteria and prevent resistance from developing. On other days, it is recommended to use a mild regular shampoo suited to your scalp type.
• Massage your scalp with your fingertips:It is absolutely prohibited to scratch your scalp with your fingernails when shampooing. This will only cause microscopic wounds to the scalp and worsen the inflammation. Use the soft fingertips of your fingers to gently but thoroughly massage the entire scalp.
• Be sure to dry your scalp after shampooing:Leaving your scalp wet after shampooing is like providing a humid environment for fungi to ‘proliferate freely.’ At least the scalp and hair roots must be dried with cool or lukewarm air from a dryer.

4. Dandruff shampoo is an auxiliary means, fundamental treatment comes first

I would like to highlight the most important fact here. Dandruff shampoo is not a medicine that ‘cures’ dandruff, but rather an auxiliary means to ‘manage’ the symptoms. The reason dandruff keeps recurring is because chronic skin diseases of the scalp, such as seborrheic dermatitis, are at its root. Dandruff shampoo can reduce visible dandruff and temporarily suppress the activity of causative bacteria, but it cannot change the ‘inflammation-prone scalp environment’ itself. Therefore, ‘professional treatment + use of the right shampoo’ is the key formula for conquering dandruff.

5. Healthy lifestyle habits to reduce dandruff

In addition to proper shampoo habits, the following lifestyle habits can be of great help in managing dandruff.

• Clean surroundings:Wash pillow cases, hats, hairbrushes, etc. frequently and keep them clean.
• Diet Management:Reduce your intake of sugar, flour, and fatty foods, and eat foods rich in zinc and B vitamins.
• Stress Management:Stress promotes sebum secretion and lowers immunity, making dandruff worse.

In conclusion, dandruff shampoo is a great treatment tool, but it is not a panacea. You must clearly understand its role and limitations, receive fundamental treatment for scalp diseases, and use it wisely as an auxiliary management tool. When you combine the wisdom of understanding the characteristics of the product and using it correctly with consistent lifestyle management to keep your scalp healthy, you can finally win the battle against the dreaded dandruff.