Now that we know the difference between dandruff and scalp eczema as well as their cause, the next step is treatment or management. First
though, if you believe that your dandruff is severe or if you think that you
might actually have scalp eczema/seborrheic dermatitis, it is really important
to have this diagnosed by a doctor. The reason is that in severe cases, the
simplest treatments may not work effectively enough on their own and what you
may require is a management plan.
Here are the methods used to treat dandruff and scalp
eczema:
1. Avoid Natural Oils
If you have dandruff or scalp eczema, it is very important
to know that many natural oils actually contain the oil that feeds the fungus Malassezia that causes the condition.
This oil, oleic acid is present in the popular four natural oils - coconut oil, shea butter, olive oil and
castor oil. It would be worth your while avoiding using these oils so as to not
exacerbate the condition.
2. Over the counter Anti-Dandruff
Shampoos
These are the standard first treatment for dandruff. They
are very effective and routinely stop
flaking and itching rapidly. The shampoo contains antifungal agents such as
pyrithione zinc and ketoconazole which work on reducing fungus on the skin.
Many dandruff shampoos require that you wash your hair between 3-5 times per
week to help get the antifungal activity to the right level. After flaking and
itching has stopped, it is indeed possible to go back to whatever your normal
wash routine was using the antidandruff shampoo either as your regular shampoo
or just alternating it with your regular shampoo. If this is not effective, a
prescription strength shampoo may help.
3. Management of Scalp
Eczema
For some people with scalp eczema, simple over the counter
anti-dandruff shampoos may work but for others they will not. The best thing to
do is to work out a management plan with your doctor. You will be able to try
out and see which method of treatment works best for you. The options include
prescription strength shampoos and anti itch creams for the vast majority of
cases. In more specialised cases where there is no improvement, oral antifungal
treatments and even steroid treatments can be considered. This is why it is
important to get scalp eczema diagnosed.
4. Natural Treatments
The general problem with natural solutions is that they have
not been studied in great detail. It would be nice to have a set formula and
method of application but unfortunately the science is really lacking here. I
am however including this section here for the experimentalists out there who
are determined to get an alternative/natural medicine solution. Pure neem oil
is thought to have antifungal properties (Current Science, pp1336-1345,
2002) and tea tree oil has been shown to reduce flaking but not itching in
dandruff. A raw honey/water solution was
shown in one experiment to help stop dandruff within 1-2 weeks (the solution
left on the hair for 3 hours) (Eur J Med Res 2001, pg 306-308,2001).
Wow, this is interesting information. It's always said that coconut oil is good for the scalp. I can't get coconut oil anywhere near my scalp cause it causes itching, but I've been putting it on my husband's scalp cause he has dandruff. He also suffers from acne keloidalis nuchae. I would love some info on any natural oils or products good for dealing with that.
ReplyDeleteFor the acne keloidalis, most dermatologists recommend prevention rather than cure. This means avoiding close shaves (including the beard if possible) and interesting for the neck area, avoiding tight shirts.
DeleteI have scalp eczema. As well as eczema all over my body.
ReplyDeleteWhat works for my scalp: tea tree oil (I used to dilute it using olive oil, but I may have to try a new oil), honey (mixed with water or conditioner and left on scalp/face does wonders) and selsun blue (used once a week, and I put it on my dry scalp, let it sit for 10 minutes then rinse with water)
Since it first started last year, it's gotten so much better, but I have tried everything, and my current routine seems to be working well.
Thanks for your input, I like readers sharing their successes so that others who are looking for something similar can get some ideas.
DeleteThanks for the info. I have eczema also and will give this a try : )
DeleteThanks a lot for this! I do have to deal with (not too much) with eczema on my body. Most likely, this is what effects my scalp to make it itching, flaky after washing my hair 3 to 4 days.
ReplyDeleteYou are welcome
DeleteWhen you say avoid natural oils, do you mean on the scalp or in the hair?
ReplyDeleteStrictly speaking both. If it is on your hair it can travel down to your scalp. The test would be to try not using natural oils and see if the dandruff clears up or reduces significantly with an antidandruff shampoo. If it does then you can eliminate the oils, but if it does not change then the natural oils probably do not aggravate the dandruff.
DeleteI am torn, but I understand the evidence presented though. We always read about the good properties of oils - promote thickness, regrowth and the like. If it is one thing I always stress is that natural oils be used in moderation. So tip #1 for me is an eye-opener. I never knew of their specific aggravation of scalp eczema and dandruff.
ReplyDeleteKnowledge is power!
Thank you.
Oils on my scalp are a big no-no for me, especially coconut oil. I have used neem oil and it helps greatly, and I have tried a peppermint oil/vinegar spray(my favorite remedy so far). I currently use a prescription generic shampoo that does work. I wash my hair as it starts to itch or just before (once a week mostly). I hate when people say 'Oh you have dandruff/eczema? Do you oil your scalp' then they look at me weird when I say oiling my scalp most times make it worse.
ReplyDeleteHow do u make n use the vinegar n pepper mint UOL mixture plz n tnx.
DeleteI fill between a quarter to a third of my spray bottle with vinegar, add a few drops of peppermint oil then fill the bottle with water. Alternately you could make peppermint tea and then mix it with the vinegar.
DeleteI might try the neem oil as I've been suffecring from scalp eczema for a while now and all of the hair products that I have seem to aggravate the condition as they all contain oils. It's an odd situation to be in because the only shampoo that works well on my scalp contains Ammonium Lauryl Sulphate which isn't great for my hair, so I use products that put moisture into my hair (most of them containing an oil or two somewhere in the ingredients) and then I know I should seal the moisture with an oil but that works against my scalp and the cycle goes on and on and on.
ReplyDeleteI will have to try Neem Oil, and I'd love to have that peppermint/vinegar mix recipe as well. I had to learn the hard way that oils on my scalp are a BIG no-no. I also learned that when I find it necessary to use a harsh medicated shampoo, washing my hair in (4) braids helps to minimize the impact on my hair and lets me get directly to my scalp a little easier.
ReplyDeleteThank you for this! I have been struggling with SD for years and the last couple it has really been out of control. I've been using coconut, castor, grapeseed, and olive oil (not all at once) for the last two years. I will definitely be getting rid of these. I'm also going to follow this post to get other tips and natural remedies. I use to take an oral med but the side effects were terrible, plus I just hate medicine I always look for natural remedies.
ReplyDeleteI've been dealing with dandruff/SD since I was about 9 or 10. I've tried nearly everything out there - some of the old standbys either failing to work (Head and Shoulders) or abandoned when I went natural because they were petroleum-based (Dax, Sulphur-8). Right now I'm using Keracare's Dry and Itchy Scalp Moisturizing Shampoo and Conditioner, and it's working pretty well. I've also used this tea tree and neem oil shampoo bar that worked as well: http://www.chagrinvalleysoapandsalve.com/products/details/48/49/neem-tea-tree-body-hair-shampoo.
ReplyDeleteMy only issue is that my hair can't get by without oils! I've already started moving towards less oily products because of build-up (bye bye, Carol's Daughter) but if I eliminate them completely my hair will suffer. Could you suggest some oils/butters that are low in oleic acid? Or should I just avoid oils altogether?
I have had seb Dermatitis after getting a jerry curl at 9 years old. I have tried everything, but the only thing that worked for me was to eliminate all mineral oil products (as well as some other ingredients like triethanolamine which is in ecostyler gel, aloe vera, and slippery elm in kinky curly knot today) I do not put ANY oil on my scalp because anything makes my scalp itch. When I first went to the Dr He prescribed ketaconazole shampoo, and it worked. So I maintain by avoiding irritants etc.
ReplyDeleteNow my skin which was also affected only healed up when I used Coconut oil exclusively!! I don't know why, but my eczema only flares when I use a product that has something that is an irritant to me. I am transitioning to natural, and my skin has never looked better!
That is very interesting. I have read that a few oils have anti-fungal properties (for example: coconut oil, flaxseed oil, primrose oil, mustard oil; tea tree, thyme or rosemary essential oil). So if scalp discomfort can be caused by an overgrowth of the fungus Malassezia, wouldn't it help to use oils with anti-fungal properties?
ReplyDeleteIf I am wrong please correct me, I am very interested to know if those oils truly have no anti-fungal properties.
I would also like to add the mineral oil could actually preserve the life of fungus (http://www.ncbi.nlm.nih.gov/pubmed/6042871) and should probably be avoided from scalp use.
I have bad eczema on my scalp and about a year ago I started using coconut oil on my scalp because I thought the flakiness was occurring because my scalp was dry, however the oil made the situation much worse. Since reading this article about 2 weeks ago I have stopped putting any natural oils on my scalp, including my Carol's Daughter co-wash. In a old shampoo bottle I mixed raw organic honey, colloidal oatmeal and water which I use on my scalp. I use the Carol’s co-wash on the ends of my hair because it gets tangled. My eczema has since cleared up so much. I wash my hair once a week with this mixture.
ReplyDeleteI've recently received a diagnosis of scalp eczema...Dermatological products are SUPER expensive. So this is the regimen I've come up with. I've been using a prescription for ketoconazole and an anti-dandruff shampoo by Nairobi. The Nairobi has been a godsend! The other two products I use are from the Paul Mitchell line, awapuhi shampoo (doesn't contain any of the oils mentioned above) and tea tree conditioner. I do one wash with the awapuhi and dandruff shampoos mixed together, one wash with the ketoconazole, then condition with the tea tree...HUGE improvement...I got a lot of great information from the blogger, as well as other commentors...thanks to you all!
ReplyDeleteThank you so much for your help! I was at a loss of what to use at this point...I'd like to get a haircut before Christmas! (-: Ordered the products you recommended. Wish me luck.
DeleteWow I didn't know this! Thanks so much! I just joined a castor oil hair, eyebrow and eyelash challenge but now I'm scared to because I don't want to get itchy, flaky scalp! Do you think that combining castor oil with tea tree and neem oil may counteract this?
ReplyDeleteI do have another question! I've use emu oil and hemp oil in my hair with seemingly good success! Do you know if any of them harbor or contribute to fungal growth? I know emu oil is refined with heating to inhibit some type of microbial growth not sure which right now! Thanks
ReplyDeleteOoh sorry for the multi-post questions but what about palm oil? I've read that it has tocotrienol which may be good for hair growth! I'm hoping it doesn't have the same effect like castor oil and the others?
ReplyDeleteWhat should i do for a 3yr old who has eczema and scratched so hard that she has scabs on her scalp? she scratches so much that it hurts her head when we wash her hair.her scabs have no time to heal because shes constantly scratching anf picking at her scabs we cut her nails n she also takes medicine for her eczema,eveno shampoo is wat she uses..will leaving her hair down help her scabs heal faster?
ReplyDeleteI feel for your daughter. First you should tell your child's primary care provider (PCP) and maybe he/she may have a suggestion. Since your child is scratching so often thus stimulating the inflammatory response (triggering histamine) you may want to try giving her children's Benadryl temporarily until the healing of the scalp begins. What shampoo does she use? If the shampoo is for eczema you may want to leave it on her scalp for 20-30 minutes or longer.
DeleteI hope this helps.
-CEPJ80
JC,
DeleteI'm so glad that you discussed this topic. I have Seborrheic dermatitis (SD) which has made growing my hair difficult particularly in the winter months. It is a common condition but little is known about it within the general population. I may post some of the things I've done to alleviate symptoms without using steroids.
If anyone is suffering from this condition, you may want to read this there are several journals out there on the treatment of SD):
Adult Seborrheic Dermatitis
A Status Report on Practical Topical Management
James Q. Del Rosso, DOcorresponding author
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100109/
Thank you for discussing the topics that affect the scalp.
-CEPJ80
I noticed a few flakes on my scalp when winter started and thought my scalp was dry so I massaged Virgin Coconut oil on my scalp and went to sleep. I awoke with my scalp on fire and finally had to see a dermatologist as the itching and burning would not stop for weeks and Head and Shoulders wasn't curing me. The dermatologist said it was SD and prescribed me Ketoconazole 2% and a steroid solution. I have yet to try the Keto. as I read about it causing hair loss. Is coconut oil a haven for yeast overgrowth and anyone have great results from using the Ketoconazole?
ReplyDeleteI am dealing with itchy scalp and lose of hair right now. Just saw my GP and was given a prescription for Betamethasone Valerate Foam 0.12% too be applied 2 times a day.
ReplyDeleteSeems that I have been itchy for a month and the scratching it stopped the hair growth. Stop scratching seems to be a big key. I cut my nails as instructed and use a little Benadryl Cream if needed.
I'll stop back here if the foam works and if the hair starts to return.
Unfortunately, Malassezia can feed on any triglycerides with fatty acids of 13 carbons and above. This includes virtually every naturally derived bulk oil we know of. The natural antifungal properties of oils like neem, sesame, and coconut, are not strong enough to make a difference in this case. It can also feed on wax esters, like those from jojoba or lanolin, and phospholipids, like those from lecithin.
ReplyDeleteMalassezia cannot metabolize pure hydrocarbons, like white mineral oil or petroleum jelly.
Fractionated coconut oil, on the other hand, may be of use. The product usually termed "fractionated coconut oil" is a liquid coconut oil derivative in which almost all the fatty acids above C12 have been removed. This yields an oil that is almost all medium chain triglycerides, so it stays liquid even at refrigerator temperatures, and quickly absorbs into skin without a greasy feeling. More importantly for us, medium chain triglycerides cannot be metabolized my Malassezia, as shown by a 1999 paper in Critical Care Medicine. Even better, once Malassezia releases the free fatty acids from the glycerol backbone, they're actually toxic to it, preventing further growth.
Fractionated coconut oil is now being sold on grocery store shelves as "liquid coconut oil", albeit at gouging prices. Even better is capric/caprylic triglycerides, and even further purified form of coconut oil with no triglycerides above C10 - but this can only be found online.
Just thought I'd share what I'd learned from several years of battling with this menace.
Thanks for the info! I will look for this liquid coconut oil! What is the capric/caprylic triglyceride ourified coconut oil marketed as so that I may search for it online? Thanks!
DeleteSince coconut oil is one of the few that can penetrate the hair shaft, does this "liquid coconut oil" penetrate as well?
ReplyDeleteNOW I know why my scalp is so itchy...I have had eczema for YEARS, and I use coconut and olive oils. I am semi-tempted to just take an "L". My hair gets dry and matted, and eliminating oils is a recipe for disaster. I'm going to have to choose one. :(