Figuring out how to get rid of dandruff can be downright stressful. Sometimes a thorough shampoo and conditioning session can help you sort things out, but more often than not those flakes are stubborn. If you’re dealing with dandruff, you’re not alone. It’s a common experience, and most people, at some point, have looked at their shoulders and spotted a few flakes. But if you’re doing battle with dandruff, you might be wondering what causes it? And how can you get rid of it—are there any remedies that actually work? Below, we’ve talked to dermatologists to find out what dandruff is, where it comes from, and—most importantly—how to get rid of dandruff for good and prevent it from coming back.

What is dandruff?

You’ve probably seen dandruff on your scalp before, but you might not know exactly what it is. “Dandruff is more of a lay term for the medical diagnosis of mild seborrheic dermatitis. It can be used interchangeably,” Amy McMichael, M.D., professor and chair of the department of dermatology at Wake Forest Baptist Health, tells SELF.

Though you probably associate dandruff flakes with your scalp, it can also occur on your face, nose, ears, eyebrows, eyelids, and chest, the Mayo Clinic explains. In babies, seborrheic dermatitis is called cradle cap. Still, the result is the same: a flaky and sometimes itchy scalp that can cause discomfort. And even though it’s common, many people feel insecure and embarrassed about their dandruff.

What causes dandruff?

Doctors aren’t entirely sure what causes seborrheic dermatitis, but as SELF previously reported, they suspect a few potential causes. First, those flakes could be the result of an irregular immune response. They may also be from your body overproducing too much Malassezia, which is a yeast found in oil secretions on your skin. “[The yeast] likes the warmth and moisture against your scalp under the hair,” Robert Brodell, M.D., professor and chair of the department of dermatology at the University of Mississippi Medical Center, tells SELF. “It grows there and sets off an inflammatory reaction. That’s what causes itching in the scalp, inflammation of the scalp, redness of the scalp, and dandruff scaling,” he explains.

Here’s the thing: If you have mild itching and flaking, it may not actually be dandruff at all, Dr. Brodell says. Allergic contact dermatitis could also give you a scaly itchy rash on your scalp. Additionally, as SELF previously reported, conditions like eczema and psoriasis of the scalp are often mistaken for dandruff.

How do you treat dandruff?

The good news is that if do find yourself with symptoms that look like mild dandruff, it’s best to try an over-the-counter anti-dandruff shampoo yourself first. “Not everybody needs to go to the doctor,” Dr. Brodell explains. And it’s not hard to find an over-the-counter treatment that works well. Here are a few good options:

1. Shampoo containing salicylic acid

Salicylic acid can help reduce flakes on your scalp, the Mayo Clinic says. Just be sure to use a conditioner with these products because they can be very drying. You can try Neutrogena T/Sal shampoo ($10, Amazon) or P & S Shampoo ($32, Amazon).

2. Selenium sulfide shampoo

Shampoos like Head and Shoulders ($19, Amazon) and Selsun Blue ($11, Amazon) contain selenium sulfide, an antifungal agent that can reduce dandruff. But if you have lighter (or chemically-colored) hair, just know that it can cause discoloration.

3. Ketoconazole shampoo

These shampoos kill the dandruff-causing yeast that lives on your scalp, the Mayo Clinic explains. “You use it either twice a week or every other day,” Dr. Brodell explains. They are available in different dosages, both over-the-counter and by prescription, the Mayo Clinic says. If you’re looking for an over-the-counter option, consider Nizoral A-D ($15, Amazon).

4. Zinc pyrithione shampoo

Zinc pyrithione is an antibacterial and antifungal agent that treats flakes and itchy scalp. Certain shampoos like Head and Shoulders (19, Amazon) and Jason Dandruff Relief 2 in 1 ($19, Amazon) are solid over-the-counter options, according to the Mayo Clinic.

5. Coal tar shampoo

Tar-based shampoos, like Neutrogena T/Gel ($5, Amazon), help slow down how quickly your skin cells flake off, the Mayo Clinic says. However, you should note that if you have lighter-colored hair, it can cause discoloration, and coal tar makes your scalp more sensitive to sunlight, the Mayo Clinic says.

6. Tea tree oil treatments and shampoos

As SELF previously reported, there’s some evidence that it can help treat conditions like dandruff, ringworm, and athletes’ foot. You can find a few shampoos and treatments that include tea tree oil in a SELF product roundup. However, Dr. McMichael does warn that using tea tree oil alone can irritate the scalp in some cases.

7. Moisture-rich hair and scalp masks

If your flakes are caused by dry scalp (or worsened by it), you should make sure you’re giving your head the moisture it deserves. Consider trying a hair mask like Briogeo Don’t Despair, Repair! Deep Conditioning Mask ($36, Dermstore), SELF previously reported.

8. Scalp exfoliation

It may seem like you wouldn’t need to exfoliate your scalp, but as SELF previously reported, exfoliating can help eliminate excess product buildup that could be making your dandruff worse. That said, you should choose an exfoliating scrub that has salicylic acid, like Scalpicin ($10, Amazon).

9. Frequent shampooing

Many dandruff shampoos will tell you how frequently you need to use them. Still, as a general rule, the American Academy of Dermatology (AAD) suggests that you wash your hair every day, and substitute your regular shampoo for your dandruff-fighting brand of choice twice a week. And, if you have natural hair, use your anti-dandruff shampoo once a week, as SELF previously reported. The takeaway is that, unless a doctor has directed you, your dandruff shouldn’t cause you to shampoo less frequently.

Does apple cider vinegar treat dandruff?

Even though this is a popular treatment, rinsing your scalp with apple cider vinegar will not actually treat any of the things that cause dandruff—the shampoos mentioned above are better options. While some people say that an apple cider vinegar rinse might relieve some itchiness, Dr. McMichael says that whatever relief you might feel will only be temporary, so she doesn’t endorse the treatment—addressing the cause is far more effective than potentially relieving itchiness for a few hours.

What can you do to prevent dandruff?

Once you find a shampoo that works for you, be sure to follow the directions. The AAD suggests you use your anti-dandruff brand twice a week (if you wash your hair several times a week), but you might be able to reduce your frequency as things improve. If you have natural hair, you might only use your dandruff-fighting shampoo once each week, but you can still experiment with reducing your use as symptoms subside. Additionally, there are some lifestyle changes you can consider that might prevent flakes. The Mayo Clinic says that a diet that consists of vitamin B might help reduce dandruff outbreaks. Additionally, trying to find ways to reduce stress (which can trigger dandruff symptoms) can be helpful. So this could include getting adequate sleep, exercise, and other things that normally help you manage stress. The Mayo Clinic also suggests getting a little bit of extra sun, but they warn against outright sunbathing (which damages your skin). Instead, slather on sunscreen, and spend a little more time outdoors if at all possible.

Ultimately, try to remember that there’s nothing to be embarrassed about. If you’ve tried at-home treatments and they aren’t working, you “should not despair,” Dr. Brodell explains. Instead, contact your dermatologist and explore possibilities for diagnosis and treatment. “We can get it figured out and get it treated,” Dr. Brodell says.

Source: self.com