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 myths and misconceptions that 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 or washing too much! 

• 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. Nope, the flakes are due to a rash! 

The exact cause of seborrhea is uncertain but we know that the Pityrosporum yeast (also called Malassezia) plays an important role. Using a pyrithione zinc medicated dandruff shampoo or a pyrithione zinc fortified facial cleansing bar will help. This is because pyrithione zinc has antimicrobial benefits to reduce the population of Pityrosporum yeast on your skin and this helps to treat and prevent seborrhea.

I recommend my popular Calming Zinc Soap for facial seborrhea. It has helped many people who suffer from this vexing and recurrent facial rash. This is also the ideal skin care remedy for seborrhea on your ears and on your chest and back. It has benefits to help fight fungal acne and also reduces the germs that cause body odor in your armpits. Keep a bar of Calming Zinc in the shower and use it daily. 

I recommend a professional 2% pyrithione zinc shampoo for your scalp. Lather first with a normal non-medicated shampoo and rinse. Apply your medicated pyrithione zinc shampoo to your scalp skin, scrub it in with a scalp scrubber to help lift off scale so the medicine can penetrate. Allow the lather to stay in place for 5 minutes then rinse well. You can follow up with your favorite conditioner. 

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 loosen, remove and suppress the formation of stubborn scalp scale. 

2. Is seborrheic dermatitis a sign that I have an allergy to foods or something that I am using?

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 or Pityrosporum. This germ normally lives in oil-secreting areas of our skin. It's presence can lead to inflammation, scale and sometimes swelling of the skin from the inflammatory reaction that it 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 body. For hairy scalps I depend on a full 2% professional Pyrithione Zinc Shampoo. Both contain the highest amount of pyrithione zinc allowed. 

3. My redness on my face is from rosacea, so why do I also have signs of facial seborrheic dermatitis?

Seborrheic dermatitis often overlaps with rosacea. People may have a combination of any rosacea subtype AND seborrheic dermatitis. Understand more about this correlation and rosacea in my free downloadable guide entitled Rosacea: Understanding What Rosacea Is and What You Can Do about It.

I target both conditions with my Facial Flaking and Redness Solution Skin Care 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 Antioxidant Skin Therapy provides a key ingredient in healing facial redness from seborrhea and rosacea. It is a product that I never travel without because my complexion is prone to both rosacea and seborrhea. 

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 therefore has a damaged skin barrier. To heal and restore the skin barrier to good health so that it can resist becoming irritated, you need the right facial moisturizer. My Facial Flaking and Redness Solution Kit gives you a ceramide and squalane rich facial moisturizer to restore skin barrier integrity so that your skin can truly heal.

5. Is it true that seborrheic dermatitis is 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 don't want to switch to anti-dandruff shampoo!

You can use both! I recommend that everyone use their favorite shampoo as their first lather to clean their hair and remove oil, dirt, debris and product residue. Rinse well and then apply your anti-dandruff shampoo second, taking care to apply it to the scalp skin where the rash starts. Scrub it in with the scalp scrubber and leave the lather in place for five minutes before washing off.  Of course, you can also use your favorite conditioner afterward. 

7. Did I catch dandruff from someone, is seborrheic dermatitis contagious?

No, seborrheic dermatitis is not contagious, so you can not catch it. It’s also not possible to “cure,” seborrhea but we can control it with the treatments and skin care routine that I mentioned above.