Seborrheic Dermatitis and Itchy Scalp: Shampoo and Treatment for Dandruff

This skin condition is fairly common. It affects millions of people in the United States. In babies it is called "cradle cap". Sometimes spelled seborrheic dermatitis, and also referred to as seborrhea or seborrheic eczema (with a sack full of misspellings), it can be a stubborn condition ranging in intensity from light white dandruff to more serious dandruff with thick scales. Specific names based on the part of the body affected are:

seborrhea Cap'itis . Located on scalp.

" Congestive. See Lupus.

" Corporis. Located on the trunk

" Facier. Located on the face.

" Nigra or Nigricans. dark-colored seborrhea.

" Oliosa. Seborrhea with an oily content.

" Rosacea. Middle-age seborrhea that reappears.

" Sicca. Dry form of seborrhea with scales.

Taken from Nutritional_Healing

The seborrheic skin can become itchy and sore. The scalp scale can vary in size from rather light small flakes to large flakes. Some scales get very thick and may take more than one washing with special shampoo to remove. The color of these patches ranges from white to yellow. Other parts of the body possibly involved include: groin, armpits, behind the ears, chest, back, and on the face, especially in oily areas near the nose. All of these affected spots have in common excess production of body oil, also called sebum. These areas are in places where there are many sebaceous glands which secrete the oil.

The reasons for the condition are not known for sure. There could be a genetic link between seborrhea and families. Most physicians believe the condition is somehow tied to hormonal activity. It has been observed in babies and seems to vanish when puberty starts. A common yeast occurring on the skin called malassezia is thought to be responsible. It metabolizes oil changing it from one form to another and creating the oily scales, or plaque (various thickenings due to buildup of cells).

Dandruff seems to improve (symptoms decrease) when washing the scalp frequently. Typical dandruff shampoos should stay on the scalp for at least 5 minutes, while most dermatologist and shampoo containers instruct to leave the lather on for at least 10 minutes. In more serious cases, preparations may be applied to patches to help loosen them. Mineral oil can be applied to help loosen plaque at night, especially in children. I can attest to the effectiveness of this as one of my children was treated thusly. Without such preparations, scratching off areas of heavy scaling can lead to bleeding, and as has been mentioned in other eczema articles, this can lead to crusting, and/or infection. Hair preparations containing alcohol (grooming products) most frequently increase the inflammation. They should be avoided.

SHAMPOOS FOR TREATMENT:

Selsum- which contains selenium sulfide (kills fungus and yeast)

Head & Shoulders - which contains pyrithione zinc

Sebulon - contains pyrithione zinc

Sebutone - which contains coal tar

Tegrin - contains coal tar

Nizoral - which contains ketoconazole

It should be noted that oily, sebum-rich areas of the body other than the scalp can be treated by using the shampoos as lotions. Most shampoo instructions call for daily use. When scales have gone away and inflammation has decreased, most shampoos direct the patient to use them 2-3 time per week. The patient can adjust the weekly use to fit his/her need to control symptoms. For loosening scale the patient can use oil based preparations. Wearing a swim cap can keep the oil in place while sleeping at night.

Corticosteroids

As with many skin ailments, itching and inflamation can be helped using corticosteroids. These medicines help reduce the inflammatory response. The stronger corticosteroids are not recommended due to serious side effects that can occur. Lower strength corticosteroids are frequently used. Hydrocortisone 1% which can be purchased at the drugstore over-the-counter is recommended. The anti-fungal shampoos above should be used to control the seborrhea. Hydrocortisone is often saved for flares. Other lower strength corticosteroids may be prescribed, BUT ONLY BY A PHYSICIAN AND UNDER HER CARE. For a list of this type of corticosteroid (20 of 175) prescribed for seborrheic dermatitis see

Since many people feel diet and insufficient nutrition is a major cause for this dermatitis, there are recommendations to increase and decrease certain foods.

In conclusion, there are several positive notes about seborrheic dermatitis, or dandruff. A doctor or pharmacist can direct you to the most common medications which can be found over-the-counter. This also means the cost for treatment can be reasonable. Though most often a chronic long lasting problem in adolescents and adults, these meds can control the symptoms well. If you do not seem to be responding, immediately seek a physician's expertise, as several other skin disorders can have similar symptoms. One such disorder is psoriasis.

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