Seborrheic dermatitis is a common skin problem that not only affects the skin but also frequently involves the scalp. When the scalp is involved, people usually refer to it as dandruff. Seborrheic dermatitis of the scalp typically causes itching, redness, crusting and scaling usually along the hairline that can be irritating and embarrassing. For some sufferers, the itching can be intense. Fortunately, it’s a condition that can be controlled.
What Causes It?
No one knows the exact cause of scalp seborrheic dermatitis, although it appears to be an inflammatory condition. A variety of factors can aggravate the symptoms including changes in the weather, stress, hormonal changes, inadequate shampooing and illness. Scientists believe that a yeast called Malassezia contributes to seborrheic dermatitis. This yeast is present on the skin of most people, but it causes no problem for most people. For unknown reasons, people with seborrheic dermatitis appear to be exquisitely sensitive to this usually harmless yeast and their immune cells launch an inflammatory attack against it.
The immune system may be involved in another way. People with immune deficiency problems are more prone towards having this skin and scalp condition. People with scalp seborrhea often have overactive sebum-producing sebaceous glands in their face and scalp that create conditions that are ideal for Malassezia to grow and thrive. The itching and scaling are usually most pronounced in areas where there are lots of sebaceous glands.
As with many diseases, genetics play a role in who experiences this skin condition. Seborrheic dermatitis tends to run in families to some degree.
Regular shampooing to remove built-up oil and sebum is essential. When sebum builds up, it makes the flaking and itching worse. Shampoos that contain selenium sulfide or pyrithone zinc are formulated to treat seborrheic dermatitis of the scalp. Until the symptoms improve, shampoo once a day and allow the shampoo to remain on the scalp for 10 minutes before rinsing. Because of the need for frequent shampooing to control the symptoms, look for one that contains natural moisturizers and botanicals along with selenium sulfide or pyrithone zinc. Shampoos that contain salicylic acid also help by loosening up scales so they can be more easily washed away. After shampooing, use as few hair care products as possible to avoid aggravating the problem.
One alternative treatment that’s effective for some people is shampooing with a product that contains tea tree oil. It relieves some of the symptoms, but it doesn’t cure the condition.
For more severe cases, doctors prescribe medicated anti-fungal shampoos that contain ketoconazole or ciclopirox. Some people with seborrheic dermatitis of the scalp experience severe itching. This can be relieved in most cases with hydrocortisone cream 1% available from most drugstores. A doctor can also prescribe a more potent steroid cream, but it’s best to use it for short periods of time and only when needed.
Eliminate Factors That Make the Symptoms Worse
Since stress, fatigue, illness and lack of sleep can make the symptoms worse, it’s important to eat a healthy diet, avoid stress and get enough rest. In some people, certain foods aggravate seborrheic dermatitis of the scalp. Keep a food journal for a few weeks, and see if you can identify foods that trigger the symptoms. There’s also some evidence that omega-3 fatty acids found in fatty fish and fish oil supplements help. Talk to your doctor about giving these a try. People on blood-thinning medications should avoid omega-3 supplements. Sunlight can also improve the symptoms, but don’t overdo it or you could end up with sun damage.
The Bottom Line?
Scalp seborrheic dermatitis is a frustrating and often embarrassing problem. Fortunately, shampooing daily with products formulated to treat this condition and controlling any factors that make the symptoms worse works for most people.