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Treating Scalp Eczema

What is Scalp Eczema?

What is Scalp Eczema? 

dermatologist guide to treating scaly scalp eczemaScalp eczema (or eczema on the scalp) can occur from dandruff, atopic eczema or allergic contact dermatitis to hair care products. All three conditions are eczematous conditions. Technically, the term “eczema” describes what is going on inside the skin including edema and inflammation that you see as redness and scale. You feel it as itch and roughness.

Is scalp eczema common?

These three scalp eczema conditions are very common so we see this all the time in the dermatology office. Many times, patients don’t even realize that their scalp has a rash. They assume it is a problem with hair products or “dry scalp.”  

What does scalp eczema look like?

When the eczema is caused by dandruff, you may have redness, scale and rough skin on your ears, behind your ears, in your eyebrows, and along your nose. Men will have it in the beard and mustache, too.

When the eczema is caused by atopic dermatitis (the classic inherited eczema), you may have itchy, red, rough, and scaly skin in the folds of your elbows and behind your knees. This type of eczema can involve your entire skin surface, too, depending on the severity of your eczema.

Allergic contact eczematous dermatitis of the scalp is an allergic reaction to hair care products so any portion of your skin that the offending product touches can be involved. Usually, this includes the back and sides of the neck and behind the ears.

How do you know if you have scalp eczema?

Scalp eczema is scaly. If your scalp itches, and you find matter in your fingernails when you scratch it, then you have eczema of the scalp.

How do you treat scalp eczema?Best foaming pyrithione zinc cleanser for acne, pityrosporum folliculitis and dandruff

The treatment is based on the cause of the eczema:

Use dandruff shampoos such as Foaming Zinc Cleanser.

Add a scalp scrubber to loosen scale so it can be removed when you shampoo, and rinse your hair clean.a great plastic scalp scrubber brush

For more information on facial dandruff, click here. 

Atopic Eczema:
Some dandruff shampoos help, such as Foaming Zinc Cleanser or Ketoconazole products, because scalps prone to atopic eczema demonstrate increased pityrosporum yeast. These ingredients help control the yeast. Often, doctors also prescribe cortisone lotions to apply to eczema prone skin

Allergic Contact Dermatitis of the Scalp to Hair Care Products:

Try Vanicream shampoo to treat scalp itch.Treatment hinges on figuring out which product you are allergic to first. The ingredients are usually the fragrance or preservatives in a product. Shampoos, such as VaniCream's Free and Clear Shampoo, are my go-to solution to treat scalp eczema due to hair care products.

Once your scalp eczema has healed, then you can test your old products one at a time, giving your skin a week or two to react. Once you find the product that caused the eczema, avoid it! Even natural ingredients such as botanical oils can cause allergic reactions. Para-phenylenediamine (PPD) hair dye is also a notorious allergen. Allergy to hair dye is complicated and best handled with a trip to the dermatologist.    

Can oil treatments soothe scalp eczema?

Oil helps skin heal regardless of the cause. Use hypoallergenic oils like coconut oil, mineral oil or olive oil. My favorite is coconut oil because it has antimicrobial activity and makes your hair wonderfully moist and shiny. Apply the oil to your scalp for 30 minutes before washing your hair. Comb through your scalp gently to help lift scale into the oil, and then, shampoo as normal until all the oil residue has been removed. Repeat these treatments until your scalp is comfortable and scale-free.

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