Problems with using dandruff shampoo on face as a cleanser for acne and seborrhea are not often understood by people. I received this question on the topic from a reader and I wanted to share it. His experience demonstrates why using a shampoo as a face wash may dry out facial skin.
Problems with using dandruff shampoo including Nizoral on the face
Hi Dr Bailey
I have seborrhea. It affects my face mostly. The eyebrows and sides of my nose. I have tried everything. I am a male 39 yrs of age. The itch is probably the worst part of it. My doctor told me to wash my face morning and night with Nizoral ketoconazole shampoo and apply Nizoral cream each time. I kept to this regime for 4 to 6 months but I couldn't bare the itch. I then came across a facial wash call "thoroughly clean face wash". It's a tea tree oil face wash made by Desert Essence. I just used it on its own.......no cream because I felt the Nizoral cream was making the itch worse. I am very fearful of Nizoral even though it made my skin look ok the itch persisted. This tea tree oil face wash has been quite good but if I overuse it my face becomes inflamed........must be the tea tree oil!
I tried using this face wash with a Facial Exfoliating Sponge as per your blog but again it was too irritating and left my face inflamed. I have also bought the Clarisonic and used it with this face wash but after a while it flared up. I do like the Clarisonic but I think I cannot use this face wash with it. I have read your tips and am going to try the regime you advise. I am from Ireland and cannot purchase the Calming Zinc Soap. Would it be ok for me to use a small amount of head&shoulders shampoo on a warm facecloth and lather gently as you describe morning and night?
The head&shoulders shampoo contains zinc pyrithione that you say is very good for seborrhea. Should I also use the Nizoral cream with 1% hydrocortisone cream to see how that works or do you advise something else? I really like your blog and am grateful to have found your website because your instructions seem clear and simple. Any specific advice you may have for me would be very welcome. I thank you so much.
I don't ever recommend that my patients use shampoos to wash their face because the inactive ingredients in shampoos can be very harsh. They are also potent allergens. Facial skin is just too sensitive and the seborrheic dermatitis makes it even more so.
The problem with using a shampoo to wash your face is that shampoos contain harsh foaming agents and potent allergens. They may dry-out, irritate, and create itchy allergic reactions to sensitive facial skin. - Dr. Bailey
Only the most tolerant complexions can tolerate shampoo used as a daily face wash. The one exception in my experience is the beard area in men who have facial hair and who need to fight beardruff. Here the foaming agents help dandruff shampoo ingredients penetrate facial hair to reach down on to the skin to treat facial dandruff.
Facial skin barrier weakness due to seborrhea creates sensitive skin.
When skin has a 'rash' such as facial dandruff its barrier strength is compromised meaning skin care products and irritants get in more easily- like putting lemon juice on a cut. It's therefore even more important that a person use really gentle and soothing skin care products when a rash is present, including facial dandruff.
Dermatologist recommended products designed for face skin to fight dandruff and 'fungal' acne
The fragile skin barrier caused by facial dandruff is one of the reasons why the Calming Zinc Bar and the Green Tea Antioxidant Skin Therapy work so well to gain control of the dandruff. They provide the necessary healing ingredients in products that are not irritating to 'broken' skin.
My Calming Zinc Bar Soap and Green Tea Antioxidant Skin Therapy are so effective together that I've created 3 kits with this product combination for facial conditions such as seborrheic dermatitis, 'fungal' acne (Pityrosporum Folliculitis) and rosacea. You will see that in the second I add an acne-friendly moisturizer to help the skin barrier heal. In the third kit, I provide all of these products plus a pH balanced cleanser for sensitive skin to alternate with the Calming Zinc and an SPF to help prevent UV triggering a rosacea flare up or hyperpigmentation from pimples or seborrhea:
Stubborn facial skin problems respond best to a Complete Skin Care Routine™ meaning that you use compatible and synergistic products for the 4 essential skin care steps: Cleanse Correct Hydrate Protect™. This approach is more likely to heal the skin problem. The last kit provides this. I control the ingredients to reduce allergic and irritation side effects, which may be part of the frustration you have been experiencing.
How to heal stubborn facial seborrhea and facial allergic and irritation rashes that itch?
It sounds as though your facial skin has a combination of reasons for itch. Seborrhea itches. Irritant dermatitis from harsh shampoo will itch. Allergic reaction to tea tree oil will itch too. Wow! You may have one or all of these going on based on your story.
In my dermatology practice, I have patients use very mild, over the counter cortisone on their faces for the itch but I personally supervise their use of these products. All cortisone products can be harmful for the facial skin and eyes so this requires physician supervision. I am not familiar with products available in the UK and you need to ask a doctor there for help.
The use of an Exfoliating Facial Sponge and/or the Clarisonic needs to be done very gently when skin is itching because the barrier is undoubtedly broken. They may even provide too much mechanical stimulation to be tolerated until the skin is better healed. Again, the barrier function of skin with an active 'rash' is compromised and gentle care is necessary until the skin's barrier has sufficiently recovered. This can take a month or more once the cause of the barrier compromise is controlled. Barrier damage can occur for the reasons I stated above plus other harsh exposures such as wind, sun and cold weather.
Lastly, I will ask my staff to see if we can mail the Calming Zinc to Ireland. Thanks for your question. It's a good one for many people.
Warm Regards, Cynthia Bailey, MD, Dermatologist
Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only.