Where
Plot No 13D/B, Wellington Rd, Vikrampuri Colony, Karkhana, Secunderabad, Telangana 500009.
- Serves Trimulgherry, West Marredpally, Bowenpally, Alwal
- Formerly BNR Skin & Vitiligo Hospital
Hyderabad
Dandruff and seborrhoeic dermatitis treatment
Dandruff comes back because it is a chronic condition being treated as an acute one. Clearing it takes a fortnight. Keeping it clear takes a maintenance routine, and that is the part nobody is usually given.
45 years in dermatologyDermatologist & dermatosurgeonKarkhana, SecunderabadBooking on WhatsApp
At a glance
- What it is
- Inflammation with an overgrowth of Malassezia yeast
- Why it returns
- Chronic condition; needs maintenance
- Also affects
- Eyebrows, sides of nose, chest, ears
- Confused with
- Scalp psoriasis
- Hair loss
- Possible while inflamed; usually recovers
- Clearance
- 1–2 weeks; maintenance ongoing
Why it keeps returning
You cleared it. You did not change the conditions.
Seborrhoeic dermatitis is an inflammatory reaction to a yeast, Malassezia, which lives on everyone’s skin and thrives where there is oil. Treating it reduces the yeast and the inflammation. Stopping treatment lets both return, because nothing about your scalp has permanently changed.
That is why the intermittent pattern is so familiar: two weeks of medicated shampoo, clear scalp, back to normal shampoo, flakes return within a month. The fix is not a stronger product. It is continuing a reduced schedule, typically once or twice a week, indefinitely.
It is also worth checking whether it is dandruff at all. Thick adherent silvery scale in sharply bordered patches, extending past the hairline, is scalp psoriasis and needs different treatment.
Before you decide
Who is treating you, and what his patients said.
Dr. (Lt Col) Khagendra Varada
- 45 years in dermatology and dermatosurgery
- 25 of them in the Indian Army Medical Corps
- MBBS, Osmania Medical College
- Dip. Practical Dermatology, Cardiff · Dip. Dermatology, AAAM
Reg. No. 10461, Hyderabad State Medical Council
Full background →“I have been going pillar to post to get my son cured of his white spot on his left side of lip and chin. It appeared 8 years back. I was told it’s special type of nerve vitiligo which has no cure. After reporting to him he told us that it is SEGMENTAL VITILIGO and unlikely and difficult to be cleared by medications alone. He suggested for surgical melanocyte transplant… I was amazed after around one month that he started rapidly getting pigmentation. I wholeheartedly suggest please do not waste time like I did.”
“Dr. Varada is an incredibly patient, knowledgeable and wonderful doctor. He sorted out an issue that I had been dealing with for years in one appointment and there’s been no looking back since!”
What is actually happening
Oil, yeast, and the flaking.
Dandruff is not dryness and it is not poor washing. Sebaceous glands produce more oil than usual, a yeast that lives on everyone’s scalp feeds on it, and the scalp reacts to the products of that. The flaking is the reaction, not the cause.
- 1Greasy scale
- 2Yeast living in the oil
- 3Inflammation underneath
- 4Oil gland, working overtime
This is why an ordinary moisturiser does nothing and why medicated shampoo has to stay in the routine after it clears. Nothing here removes the glands or the yeast — treatment holds the balance.
- Greasy scale
- Yeast living in the oil
- Inflammation underneath
- Oil gland, working overtime
Illustration, not a photograph.
The protocol
Clear it, then hold it
Confirm what it is
Seborrhoeic dermatitis, scalp psoriasis, or a fungal infection. They look similar at a glance and are treated differently.
Clear the flare
An antifungal shampoo (ketoconazole, zinc pyrithione or selenium), used correctly, with a short anti-inflammatory course if the scalp is very inflamed.
Use it properly
Applied to the scalp, not the hair, and left for several minutes. Most treatment failure is application failure.
Drop to maintenance
Once or twice a week, ongoing. This is the step that decides whether it returns.
Beyond the scalp
The places it goes that people don’t connect.
Redness and fine scaling at the sides of the nose, in the eyebrows, behind the ears, in the beard and on the central chest are the same condition, and are frequently treated as unrelated dry skin or as a fungal rash for months.
Recognising them as one condition simplifies treatment considerably, and explains why the facial redness improves when the scalp is treated properly.
If it’s actually psoriasisFace and chest too
Same condition, gentler preparations. Potent steroids on the face are not the answer.
Worse in winter and stress
Both are recognised aggravators. Increasing maintenance frequency before winter works better than reacting to it.
Where to book
One clinic, in Secunderabad
Consulting rooms, phototherapy and the surgical list at one address in Secunderabad. The practice was formerly known as BNR Skin & Vitiligo Hospital.
How to book
On WhatsApp: one number, answered by the clinic team, who confirm a time and say what to bring.
- Photographs welcome before you travel
- Video consultation arranged the same way
Does dandruff cause hair loss?
Indirectly and usually temporarily. An inflamed, itchy scalp gets scratched, and scratching sheds hair. Treating the scalp properly generally allows it to recover. Persistent loss after the scalp is calm needs assessing separately.
Questions patients actually ask
Dandruff questions
Why does my dandruff always come back?
Because it is a chronic condition treated as an acute one. The yeast and the oily conditions it thrives in do not go away, so treatment has to continue at a reduced frequency, usually once or twice a week, rather than stopping when the flakes do.
Is it dandruff or scalp psoriasis?
Psoriasis scale is thicker, silvery and stuck down, forms sharply bordered patches, and typically extends past the hairline. Dandruff is finer and more diffuse. Checking elbows, knees and nails usually settles it.
How should I use medicated shampoo?
On the scalp rather than the hair, worked in with the fingertips, and left for several minutes before rinsing. Applying it like ordinary shampoo is the single commonest reason it appears not to work.
Does dandruff cause hair loss?
Temporarily, mostly through scratching and inflammation. Hair generally recovers once the scalp is controlled. Loss that continues after the scalp is calm needs separate assessment.
Can I treat it with oil?
Coconut and similar oils can worsen it, because Malassezia feeds on the lipids. Oil is useful only for softening thick adherent scale before washing it out. Not as a leave-in treatment.
Is it contagious?
No. The yeast involved lives on everyone’s skin. What differs is the inflammatory reaction to it, and that is not transmissible.
References
The clinical statements on this page follow the guidance and evidence below. They are independent sources. None of them is connected to this clinic, and none of them sells the treatments described here.
- Seborrhoeic dermatitisDermNet (New Zealand Dermatological Society)
- DandruffNHS (United Kingdom)
- Scalp psoriasisDermNet (New Zealand Dermatological Society)
Keep reading
Related on this site
The first appointment is a diagnosis.
Not a treatment plan sold on the spot. Message the clinic and bring your history.