By Dr Richard Russell 
James Cochrane Practice

Question: please help – I’ve got terrible dandruff?
A. Dandruff is a common skin condition that causes white or grey flakes of skin to appear on the scalp and in the hair.
The flakes are often noticeable if they fall from your scalp on to your shoulders. 
Your skin constantly produces new skin cells and sheds old cells to stay healthy. 
Dandruff can occur when this cycle of skin renewal speeds up.
This leads to patches of dead skin forming on the scalp that come away into the hair.
Your scalp may also feel dry and itchy.
The main treatment for dandruff is anti-dandruff shampoo. There are a number of types available to buy from supermarkets or pharmacies.
Look for shampoo containing one of the following ingredients:
•zinc pyrithione 
•salicylic acid 
•selenium sulphide (or selenium sulfide) 
•ketoconazole 
•coal tar 
Make sure you read the instructions that come with the shampoo before using it to check if it’s suitable for you and see how often it should be applied. A pharmacist can offer advice if you need it.
It’s particularly important to leave the shampoo in your hair for at least five minutes before washing it out.
Try these shampoos for a month to see if your dandruff improves. You might need to try more than one type to find one that works for you.
You may be able to use the shampoo less often once your symptoms improve, but your dandruff will probably come back if you stop using it completely.