Treatment for Seborrheic Dermatitis (Dandruff)
By Cynthia Bailey MD.
The medical name for dandruff is seborrheic dermatitis.
Dandruff (seborrheic dermatitis) is so common that almost everyone will suffer from it at some point in their lifetime.
Seborrhea is a frustrating skin problem that is often difficult to hide. My dad had it, I have it and if you have it there is information here that might help. I take seborrhea seriously!
Signs that you may have seborrheic dermatitis include,
- Red, greasy, scaly skin in the nose crease or between the eyebrows in your teens
- ‘Dry’ and itchy scalp starting in your teen years and going on throughout your life
- ‘Dry’, red, scaly skin in the T-zone of your face at any time in life
- Crusty skin on, in, and behind your ears
- Flaking of your eyebrows
- Beardruff in your facial hair
- Crusty scale and itching of your eyelashes (blepharitis), especially in the morning when you wake from sleep
- Greasy, red scaly skin on your chest and upper back
What causes seborrheic dermatitis (dandruff)?
The good news is that with the right Dr. Bailey Complete Skin Care routine you can control your seborrhea; use targeted over-the-counter products to keep your skin and scalp healthy and attractive (instead of red and scaly).
Remember, you always get the best results with Complete Skin Care. My Dr. Bailey Complete Skin Care Routine always involves 4 skin care steps:
Dermatologist recommended Complete Skin Care routine to control seborrhea.
Step 1: CLEANSE
Use Calming Zinc™ Soap for facial seborrhea. Fortified with a full 2% pyrithione zinc, this soap is tough on seborrhea. It can be used on the trunk and ears, too.
For hairy areas like the scalp or thick facial hair use Foaming Zinc. This foaming cleanser acts as a shampoo and is also medicated with a full 2% of pyrithione zinc in a foaming cleanser base.
A Facial Exfoliating Sponge or Salux Cloth can help to remove scale on the face and body. On the scalp, use a Scalp Scrubber. Gentle exfoliation with a rough scrub, such as my Bamboo and Clay Thermal Exfoliating Scrub, can work too.
It's important not to be too rough with exfoliation, because seborrhea is a form of eczema. This means that the skin barrier is compromised and the skin is easily irritated. Because the skin barrier is more sensitive, all skin cleansers need to be gentle and non-drying. Some complexions may find the daily use of medicated pyrithione zinc drying. When that is the case, try alternating the medicated product with a gentle non-medicated product to cleanse affected skin such as my Extremely Gentle Facial Cleanser.
Step 2: CORRECT
Facial seborrhea responds really well to my Green Tea Antioxidant Skin Therapy applied twice a day right after washing. For years I have used this unique product in my practice to control facial redness from seborrhea. I use it myself twice daily. When I run out of Green Tea Therapy my seborrhea invariably flares up. The ultra-concentrated green tea polyphenol antioxidants calm and soothe facial redness from many causes, including seborrhea.
Step 2: HYDRATE
Balance skin hydration to help broken skin barrier heal by applying a good moisturizer. Inflamed skin can't heal without hydrating skin care! Use a non-irritating and therapeutic moisturizer such as one of my two Daily Face Creams (Dry to Normal Skin or Oily to Normal), All Natural Lotion applied to involved non-hairy skin twice daily after washing and applying Green Tea.
I put my Redness Relief Kit together with the right face moisturizing cream in my Facial Flaking and Redness Kit because the combination of these 3 products is key to soothing facial seborrhea.
Beardruff responds nicely to my Omega Enriched Booster Oil.
Step 4: PROTECT
I recommend one of my mineral zinc sunscreens be applied daily. Zinc oxide is the best type of sunscreen because it does not irritate inflamed skin. My Sheer Strength Pure Physical Sunscreens are my top choice. Pick your pure zinc oxide sunscreen based on your skin type.
Dermatologist's tips to heal and control seborrheic dermatitis.
- Avoid allowing harsh products to come into contact with actively inflamed seborrhea or you will add irritation on top of the seborrhea – and irritation looks red and scaly! This applies to cleansers, acne products, anti-aging products, exfoliating products, and sunscreens.
- Medicated cleansers and shampoos are really helpful for seborrhea, so pick the right cleanser for the skin area you are treating. Pyrithione zinc is my favorite medicated cleanser and shampoo ingredient. Other ingredients for non-facial areas include shampoos with salicylic acid, selenium sulfide, tar, ketoconazole, and prescription ciclopirox.
Pharmaceutical-grade green tea helps facial seborrhea. Over my 30 years of practicing dermatology, I’ve found this to be the most important skin care product along with medicated pyrithione zinc. I use these as the cornerstone of any skin care routine I build to treat seborrhea. I created my Facial Redness Relief Kit to fight facial seborrhea and rosacea. It combines Green Tea Antioxidant Skin Therapy ™ with Calming Zinc ™ Bar Soap.
- For thick crusty scale on scalp and ears, pre-treating 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.
- Always moisturize non-scalp areas of seborrhea to help the skin heal. Dry skin heals more slowly.
- Apply facial sunscreen daily if you have seborrhea because, as with most rashes, the barrier of the skin is compromised and sun may pass through to cause damage more easily. Use non-irritating mineral zinc oxide sunscreens matched to your skin type.
- For stubborn seborrhea, I use clotrimazole cream twice a day until the rash is clear for a month or so. This non-prescription anti-yeast cream provides additional control against the Pityrosporum yeast that plays a role in seborrhea. This medicated cream can also be applied to ear and trunk involvement, too. The cream base is too thick to use on hairy areas like the scalp. One-percent hydrocortisone cream on top of the clotrimazole is helpful if the rash won’t budge, but this medicine has side effects that include skin thinning of the application site and, if applied near the eyes, can cause eye damage. It should only be used under a doctor’s supervision.
For more information on facial seborrhea, and to focus on the products that I use for my Facial Seborrhea Complete Skin Care Routines click here.
For more information on scalp and body seborrhea, and to focus on the products that I use for my Scalp Seborrhea Skin Care click here.
Luis J. Borda and Tongyu C. Wikramanayake, Seborrheic Dermatitis and Dandruff: A Comprehensive Review, J Clin Investig Dermatol., 2015 Dec; 3(2): 10.13188/2373-1044.1000019.
Gary G. Optimizing treatment approaches in seborrheic dermatitis. J Clin Aesthet Dermatol. 2013;6(2):44–49.