The 7 Myths of Seborrheic Dermatitis (a.k.a., Dandruff)

Do you have unsightly greasy, scaly rashes on your face and scalp?  Do your eyebrows, nose, ears, chin, chest or scalp appear red and dry? You may have something called seborrheic dermatitis (pronounced seb-uh-ray-ick dur-muh-tie- tis) – better known as dandruff. In babies, it is commonly referred to as “cradle cap.”

This is an extremely common condition that I see on a daily basis in my dermatology practice. Some patients don't even know that they have a rash that can be treated. That said, seborrhea can be very challenging to have as well as tricky to treat. So often patients try to figure out what is wrong with their skin and are frustrated when their home remedy does not work. But, as a board-certified dermatologist, I am an expert at treating this skin problem and want to help!

Here are some common misconceptions I hear regularly about seborrheic dermatitis.

Hopefully, this will clear up any myths about it that you may have and help to make you feel more comfortable in your own skin!

1. Why do I have seborrheic dermatitis if I wash my face and hair every day?

Seborrheic dermatitis is absolutely not due to a lack of hygiene! Scalp dandruff is not a result of not washing your hair frequently enough. It is a rash. It’s also not due to a dry scalp from washing your hair too often! The exact cause of this issue can be complicated, as you'll see below. Using a medicated dandruff shampoo (such as Foaming Zinc Shampoo and Cleanser) and scalp scrubber will help with scalp dandruff. Using a similar facial cleansing soap will help too. My popular Calming Zinc Soap has helped many people who suffer from facial seborrhea.

However, it is important to know that you may not be able to treat your seborrheic dermatitis on your own. Thick scale sometimes requires oil scalp treatments and even prescription-strength medications to slough it off. 

2. Is seborrheic dermatitis a sign that I have an allergy?

The cause of this skin problem is not completely understood, but we do know that it is associated with overgrowth of yeast (fungus) called Malassezia that is in oil-secreting areas of our skin. This leads to inflammation, scale and sometimes swelling of the skin from the inflammatory reaction Malassezia causes. Pyrithione zinc containing shampoos and cleansers are very important to use in order to cut down on the amount of yeast on the skin of people with seborrheic dermatitis.  In my practice I have used two pyrithione zinc cleansers for years with excellent results. My patients love Calming Zinc soap for the face and Foaming Zinc Cleanser for the scalp or body.  Both contain the highest amount of pyrithione zinc allowed which is 2%. 

3. My redness on my face is from rosacea, so why do you say I have seborrheic dermatitis?

Seborrheic dermatitis overlaps with two conditions. The most common overlap I see is with rosacea. People may have a combination of any rosacea subtype AND seborrheic dermatitis. Understand more about this correlation and rosacea in Dr. Bailey's free downloadable guide entitled Rosacea: Understanding What Rosacea Is and What You Can Do about It.

I treat both conditions with my Facial Flaking and Redness Solution Kit. This kit combines the Calming Zinc with Green Tea Antioxidant Skin Therapy and the right facial moisturizer to heal inflamed skin from these two skin problems.  The Green Tea is a key ingredient in healing facial redness and seborrhea. It is a product that I never travel without because my complexion is prone to both rosacea and seborrhea. 

Click here to learn more about my Dermatologist's Facial Flaking and Redness Solution Kit.

The second most common skin problem I see in combination with seborrheic dermatitis is psoriasis. When these two conditions overlap it is called “sebo-psoriasis.” Fortunately, the Facial Flaking and Redness Solution Kit is good at calming both conditions, which makes things a bit easier.

4. Since seborrheic dermatitis is more common in greasy areas (the T-zone), should I avoid moisturizing my skin?

It’s actually very important to moisturize your skin when you have seborrheic dermatitis not only to soften those pesky flakes, but to also soothe your skin that is inflamed and allow the damaged skin barrier to heal. The Green Tea Antioxidant Skin Therapy  is packed with antioxidants to soothe inflammation and put out the fire driven by seborrheic dermatitis!

5. Seborrheic dermatitis is not only skin deep.

When seborrheic dermatitis is very severe, it could actually be related to other internal conditions. I keep certain medical problems in the back of my mind when I see a patient with really stubborn and widespread seborrheic dermatitis. Here is a list:

• Parkinson’s Disease
• Stroke
• HIV
• Alcoholism
• Nutritional Disorders

6. I love my favorite shampoo, so I can’t switch to anti-dandruff shampoo!

Guess what?  You can use both!  You can use your favorite shampoo first to clean your hair, and then your anti-dandruff shampoo second (make sure to leave it on for five minutes before washing off).  Of course, you can also use your favorite conditioner afterward. Problem solved - it's as simple as that!

7. Did I catch dandruff from someone?

Seborrheic dermatitis is not contagious, so you can not catch it. It’s also not possible to “cure,” but we can certainly control it with the measures mentioned above.