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By Cynthia Bailey MD.

Dermatologist's treatment tips for body and scalp dandruff

Seborrheic dermatitis is a common rash that can involve the skin of the scalp, face, and body. On the scalp, it is called dandruff. On the body, seborrhea can involve the upper chest and back, and can also occur in the skin folds of the groin and elsewhere.

What are the signs and symptoms that you have scalp and body seborrhea?

Scalp dandruff is characterized by flakey and dry scale. The skin eventually becomes red. The dandruff may be patchy or extensive. Skin itches and may feel oily. There may be tender and itchy pimples too. The ears may have crust and scale in the folds. 

Body dandruff often is subtler. Patchy subtle red skin on the upper back and chest is covered with flakes. It often does not itch. Seborrhea can involve the body folds under the arms, breast, groin and buttocks. Here the skin is red and there is little scale due to sweat and moisture that is present in skin folds. 

In my dermatology practice, I see a lot of patients who think their scaly, red skin is “dry skin” but it is actually seborrhea. Seborrheic dermatitis is so common that almost everyone will suffer with it at some point in their life.  

Why do people get seborrhea and can it be cured?

Unfortunately, no. There is no cure for seborrhea and we don’t even understand entirely why a person gets this common rash. We do know that a normal skin yeast called Pityrosporum is seen to grow more abundantly in skin affected by seborrhea.

Dermatologist explains the best treatment for scalp and body seborrhea?

While there is no cure for seborrhea, the good news is that you can control your seborrhea with the right complete skin care routine.  Here are the important points you need to know to treat seborrheic dermatitis:

  1. Medicated cleansers and shampoos are the best way to treat seborrhea. They work for scalp dandruff and body seborrhea. They clean the skin and leave a layer of medicine behind to treat the problem. Pyrithione zinc is my favorite medicated cleanser and shampoo ingredient. For the scalp, I like the lather massaged onto the skin with a Scalp Scrubber. Body later is best applied with a Salux Cloth or shower brush. The products I use in my practice include Foaming Zinc ™ Cleanser and Calming Zinc ™ Soap.  Other ingredients for non-facial areas include shampoos with salicylic acid, selenium sulfide, tar, ketoconazole, and prescription ciclopirox. Because seborrhea is a form of eczema, other skin care and hair care products should be gentle and non-irritating until the rash has healed. 
  2. For thick, crusty scalp scale, pretreating skin with oil for 30 minutes before cleansing or shampooing really helps. Use coconut oil, mineral oil, olive oil or any other oil. Wet the skin, towel dry, apply the oil, then wait 30 minutes or more. Shampoo or cleanse off the oil, and as a last lather use your medicated shampoo or soap.
  3. For stubborn seborrhea, I have my patients use clotrimazole cream twice a day until the rash is clear, plus a month or so. 1% hydrocortisone cream on top of the clotrimazole is helpful if the rash won’t budge, but this medicine has side effects, including skin thinning at the application site. It should only be used under a doctor’s supervision.

Find products here that I use to treat seborrhea of the scalp and body in my practice. I also have hypoallergenic products on this page that are good for general skin care of seborrhea-prone skin. If you have facial seborrhea too, please see my facial care products and information for seborrhea.