Dandruff and Thinning Hair

Medically Reviewed by Hansa D. Bhargava, MD on February 19, 2013
2 min read

If you're a guy with thinning hair and dandruff, you've got a lot of company. Men often have both.

Thinning hair and dandruff don't share the same cause. Thinning hair is about your hair. Dandruff is about the skin on your scalp.

The way some guys treat hair loss can make their dandruff worse, says New York dermatologist Michele Green, MD.

Everyone sheds some hair, and men often notice it in the shower. Seeing their hair float toward the drain makes some men quit washing their hair, Green says. That's a mistake, especially if you're prone to dandruff.

"They feel like they lose more hair when they wash, so they stop, and that's not that healthy. In fact, it's just the opposite," she says. "If you have dandruff, you should be washing your hair every day or every other day."

Washing your hair makes little difference in the amount of hair you lose, says Jeffrey Benabio, MD, a dermatologist for Kaiser Permanente in San Diego. If you avoid washing your hair for a few days, you'll see more hair in the shower when you finally do reach for the shampoo.

It's as if your hair loss is making up for lost time. "It falls out a bit if you wash every day and a lot if you wash every 3-4 days, because it accumulates on the days you don't wash," Benabio says.

The bottom line: Skipping the shampoo doesn't help your dandruff, and it doesn't slow hair loss. So you might as well lather up.

Green says minoxidil, which is used to treat thinning hair, can cause dandruff-like flaking as a side effect. The alcohol in minoxidil can dry out your scalp, and after a few months of treatment, dandruff may set in.

In most cases, Green says, you can solve the problem by switching to another medication or by using a dandruff shampoo -- or if its really bad, a prescription steroid cream.

Finasteride, another medication for hair loss, does not cause flaking, Green says.

Dandruff is what Green calls a "cosmetic disease." It's not serious, it's not contagious, and it won't lead to other health problems. But if left untreated, it can become so itchy and inflamed that it causes temporary hair loss. That's another good reason to wash your hair with a dandruff shampoo. Once you've treated your scalp, the hair will probably grow back.

If you're a guy watching your hairline retreat, there's a small silver lining if you also have dandruff. Benabio says that as you lose your hair, you'll likely lose some of your dandruff along with it.

"Dandruff," he says, "tends to stay in areas where there is hair."