If you’ve ever looked down at your black top to find “snowflakes” dusting your shoulders before (and beyond) winter, you know just how embarrassing and uncomfortable dandruff can be.

“A lot of people are ashamed of dandruff and think it’s a reflection of poor hygiene, but that doesn’t have anything to do with it,” says Francesca Fusco, MD, assistant clinical professor of dermatology at the Icahn School of Medicine at Mount Sinai Hospital and board-certified dermatologist at Wexler Dermatology in New York City.

So, what exactly is dandruff? “Dandruff is essentially scalp flaking caused by inflammation,” explains board-certified dermatologist Joshua Zeichner, MD, director of cosmetic and clinical research at Mount Sinai Hospital. “This inflammation is driven by our skin reacting to yeast on the scalp. Yeast lives on everyone’s scalp, but some people react to it, leading to inflammation, itching, and flaky skin.”

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