There's nothing worse than dealing with a dry, itchy, flaky scalp, especially in the winter. It's not only irritating to have to deal with constant itching and dry skin, but it can even become painful at times. Beyond standard dryness and flaking, it can feel almost unbearable when dealing with skin issues like eczema or seborrheic dermatitis on the scalp.
We asked two trichologists — Jennifer McCowan, Canadian Director of Cosmetology for the World Trichology Society and Dr. David Kingsley, president and board chairman of the World Trichology Society — about how to manage these conditions throughout cold stretches and beyond.
What is the difference between scalp eczema and seborrheic dermatitis?
According to the National Eczema Association, there are seven different types of eczema. A few of them, like atopic dermatitis (commonly referred to as eczema) and seborrheic dermatitis, affect the scalp.
Scalp eczema and seborrheic dermatitis can appear similarly through symptoms like redness, dry patches, itchiness and flaking, which can lead to the misconception that they are the same thing. The difference between the two is that scalp eczema is a dry skin issue, while seborrheic dermatitis is a “sebum-based skin issue,” McCowan explained.
She describes seborrheic dermatitis as a result of a combination of dead skin cells, old sebum (oils) and free radicals in the air that are packing on top of the skin.
Tips for dealing with scalp eczema and seborrheic dermatitis
For both scalp eczema and seborrheic dermatitis, Kingsley and McCowan recommend being mindful of what you eat so you don’t cause any additional inflammation or irritation. “If [you have] a healthier diet, the better it is for your skin,” Kingsley said. McCowan specifically called out refined sugars, bread and yeast as a few ingredients and foods that can cause flare-ups.
How often you wash your hair and what you wash it with can also play a role in managing these conditions. According to the London-based National Eczema Society, scalp eczema can be irritated by normal shampoos that have detergents and fragrance. To soothe the scalp, they recommend washing your locks with a less irritating shampoo or a combination of water and bicarbonate of soda mixed into a thin paste. Similarly, McCowan also recommended opting for a gentler shampoo. “If you use a shampoo that’s way too strong, it’s going to create hyperactivity in the scalp and it’s going to irritate it,” she said.
While your shampoo schedule often depends on your hair type, Kingsley says to have some flexibility with both frequency and products used if you’re dealing with seborrheic dermatitis. While you don’t want to over wash your tresses, you should perhaps consider increasing the frequency if you're only washing it once a week, he noted. "If you don’t shampoo often enough, then the scalp will accumulate skin cells — because the scalp is skin — and then that can cause some flaking to occur. It’s just like if you didn’t wash your face for like a month; you’d get a lot of flaking on your face," he explained.
When looking for a shampoo, Kingsley recommends looking for an anti-dandruff shampoo, though you should be patient when it comes to seeing proper results. “Sometimes when [you're] using an anti-dandruff shampoo or treatment, it can seem as if it’s getting a little bit worse because, if you think about it, the flakes are on the scalp. Your scalp isn’t going to reabsorb those flakes; those flakes have to come off,” he explained. While it might be alarming that so many flakes are appearing after using an anti-dandruff shampoo, that could be a result of the product actually working.
Ultimately, though, when looking for the right hair care or scalp care products, Kingsley said it’s generally going to be trial and error and recommends trying several different ones to find what works best. “You might need a different shampoo in the winter than you need in the summer. Be flexible."
Expert- and shopper-loved products for dry and flaky scalps
If you’re looking for an anti-dandruff shampoo, this Amazon bestseller is probably a good place to start. It has a 4.6-star average and over 43,000 verified five-star ratings. “I thought it would take months to get this under control, but I was really pleased to see significant improvement the first wash,” one reviewer shared.
Finding the right shampoo via trial and error, while necessary, can be costly. Trying budget-friendly options like this one for under $10 can help take some of the pressure off of your wallet. It has a 4.7-star average and reviewers claimed it help with both eczema and seborrheic dermatitis.
When trying to control dandruff and flaking, Head & Shoulders is probably the first brand that comes to mind for most due to the plethora of commercials that flooded TV throughout the 2010s. For people with dry and frizzy hair, their moisture boost line is the perfect combination of relief and hydration. “After using this line two times, I absolutely have a more healthier scalp with a normal itch compared to a very dry and inflamed scalp with intense itching,” wrote one shopper.
This top-rated medicated shampoo from Neutrogena has over 350 five-star reviews at CVS. According to the brand, the formula is designed to help control symptoms of dandruff, seborrheic dermatitis and psoriasis. One recent reviewer said they’ve been using this shampoo for a few months to help their psoriasis and their “scalp condition is almost non-existent,” calling this shampoo the “only one that left their hair feeling great and scalp feeling normal again.”
McCowan highly recommends the scalp care line from CRLAB and specifically called out this smoothing cream. “It deals with everything from seborrheic dermatitis to scalp eczema. It comes with products that help to balance the pH of the skin, remove the old and allow room to generate new,” she said of the line.
“I really love the Rene Furterer line as well,” McCowan said. This silicone-free shampoo contains ingredients like shea oil, soybean and other essential vitamins to replenish moisture, renew softness and enhance shine, according to the brand.
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