How To Treat Seborrheic Dermatitis

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So you think you have Seborrheic Dermatitis?

And you want to do something about it?

Before I start, I have some good news and some bad news.

Let’s get the bad news out the way first….

There is no known permanent cure for Seborrheic Dermatitis.

But don’t get downhearted…

The good news is that Seborrheic Dermatitis is a relatively straightforward condition to control.

I’ve suffered from seb derm for the best part of 20 years and no longer suffer a prolonged breakout.

Not ever.

In order to control Seborrheic Dermatitis you have to:

  • Have Seborrheic Dermatitis (this may seem like a glib comment but it’s incredible how many people fall at this first hurdle).
  • Understand what Seborrheic Dermatitis is and how to control it.
  • Know what active ingredients control Seborrheic Dermatitis.
  • Find the best treatment that suits you.

It really is that straightforward.

We’ll cover the basics of this approach in this article.

What’s in this article:

What is Seborrheic Dermatitis?

Seborrheic Dermatitis is a type of eczema. It’s also technically the only form of dandruff. Psoriasis, dry scalp or product build up can cause flaking of the scalp, but they aren’t technically dandruff at all. However, it can be easy to confuse the various conditions.

Seb Derm is also very common. You aren’t alone. Seborrheic Dermatitis is said to affect about 5% of the population. All races, colors, and creeds included.

You’ll often see Seborrheic Dermatitis referred to as dandruff, seb derm, seborrhoeic eczema, seborrhea, sebopsoriasis, and pityriasis. For many people, this condition comes and goes. Changes in the weather or stress can cause flare ups which can die down at other times of the year.

The condition is concentrated around your oil (sebaceous) glands. These glands are very prominent where you have hair follicles. Hence the tendency to have seb derm on the scalp. That said, the condition can also show up on the face, eyebrows, the crease of your nose, the adjoining cheeks, around the ears, the chest and in any areas where your skin rubs together e.g. the groin, under the arms or breasts.

It isn’t dangerous or contagious and you probably had it when you were a baby; cradle cap is another more cuddly name for Seborrheic Dermatitis.

Nobody really knows what causes Seborrhoeic Dermatitis, but there is compelling medical evidence linking it an inflammatory allergic reaction to a type of yeast found on all our skins. This allergic reaction causes your body to overproduce sebum. As a defensive measure of some sort. The body sees the yeast as a threat and responds by overproducing sebum. Sebum is the natural oil on your skin produced by the sebaceous glands. And it’s actually dried sebum that flakes – and is what we now call dandruff.

There are many factors that can contribute to flare ups. Stress and diet play a part. It may also be a genetic disorder. Nobody really knows. Don’t be downhearted though, once you know you have Seb Derm it’s relatively straightforward to control with the right treatment.

The Symptoms of Seborrhoeic Dermatitis

Dandruff from Seborrheic Dermatitis is pretty distinct from other forms of dandruff as the flakes will be yellow in color. They will be crusty, scaly, oily and the grains are relatively large as opposed to the grainy dandruff you get from a dry scalp.

As mentioned, Seb Derm can manifest itself wherever the sebaceous glands are prominent, e.g. your scalp, forehead, chest, nose, eyelashes or upper back

In addition to the crusty yellow dandruff, your skin will typically have red inflamed patches during a flare up which can get incredibly itchy.

It is not contagious. I was once pretty worried about passing it on to people – particularly when I was around children.

Don’t worry! Nobody can catch this from you.

For some people, the condition can cause depression. I remember it was a nightmare until I fully understood what I had and took control of my condition.

If you suspect you have seb derm but aren’t sure I highly recommend visiting a dermatologist. They’ll typically scrape some of the crust and send it away for a very routine examination. The results will come back pretty quickly and then you’ll know 100% what your condition is.

If you are diagnosed with seb derm – don’t fret – take the news as a positive. It’s such a harmless condition and it is often so straightforward to control.

What Triggers Seb Derm

There are a number of situations that can cause a flare up or exasperate the condition. These can be very personal to you, as can the resulting treatment. Stress triggers my condition off terribly. I also notice more flare ups if I’ve been eating a lot of bread or sugar. This sucks as I love bread and sugar, but on the whole, I’ve cut the quantities down. Be aware of your triggers. For some, it is the weather. For others the swimming pool. Not washing enough. Not washing too much. Even a change in hair length can trigger some people!

Keep a mental note of what you are eating or doing when a flare up occurs. Simple changes in your diet and behaviors can go a long way to controlling seb derm.

How To Control Seb Derm

So we know that Seb Derm is linked to a yeast called the Mallassezia yeast. The medical evidence is overwhelming now – the yeast and the condition are inextricably linked. This yeast is actually present on most people but we seb derm sufferers react to it. Our body sees the yeast as a threat and reacts to that threat by overproducing sebum.

In order to control Seb Derm we have two options.   We can:

  • Stop our body from seeing the yeast as a threat
  • Create a hostile environment for the yeast

If I knew how to stop my body from seeing the yeast as a threat I’d be a very rich man.

However, I have had more success in creating a hostile environment for the yeast. And to do that you have to

  • Stop feeding the yeast
  • Prevent the yeast from forming a biofilm
  • Attack the yeast

Stop feeding the yeast

Yeast is a living organism. And like every living organism – it needs to eat to survive. The Malassezia yeast is no different.

Now, most of us will have used or use a moisturizer regularly. Not many people are aware that as many as 90%+ of moisturizers contain oils that feed seb derm.

Similarly, I can’t help but cringe when I hear of people with seb derm applying olive oil to their skin. Their intentions are good – it’s a natural healthy oil. However, Olive Oil is actually used to feed fungus in lab conditions.

As it turns out, up to 85% of Olive Oil is a fatty acid called Oleic Acid. Oleic Acid is literally food for the Malassezia yeast,

In fact, Malassezia consumes any fatty acid that has a carbon chain length of 11 through 24.

If you look through the following list of fatty acids, only Octanoic Acid and Capric Acid will not feed the Malassezia yeast as they have carbon chain lengths of 8 and 10 respectively.

There are a number of invaluable references that comprehensively list fatty acids with their carbon chain lengths.

You need to make sure your moisturizers or conditioners don’t contain these fatty acids.

Otherwise, you are feeding your seb derm.

We have a post dedicated to this very subject

Prevent the yeast from forming a biofilm

Have you ever tried a dandruff shampoo, found it worked then after a period of time, noticed that the shampoo gets less and less effective. The reason for this is the yeast has formed a biofilm.

A biofilm is essentially a protective layer that the yeast forms around itself to protect itself from the active ingredient found in your shampoo. Your shampoo appears to be less and less effective as the yeast is forming a strong biofilm around itself until the active ingredient is virtually useless.

There are a number of ways to penetrate and destroy this biofilm. Selenium Sulfide, for example, is an excellent active ingredient that can destroy this biofilm.

Kill the yeast using an active ingredient

Seborrheic Dermatitis is scientifically proven to be controlled using anti-fungal active ingredients. These ingredients will help control the Malassezia yeast that your body is reacting to.

There are a number of anti-fungal agents commonly found in treatments these days including:

And less frequently:

Exfoliate

Exfoliation is important.  The flakes can form a protective layer,  making it harder for the active ingredient to do it’s thing.

Salicylic Acid is an active ingredient that will help exfoliate your skin by softening and clearing the crust. It’ll help get rid of an existing breakout. It will also help an anti-fungal active ingredient penetrate your skin better. It often found in some excellent combination shampoos (ie a shampoo containing a combination of active ingredients). However,  overuse can dry your scalp if used too frequently.

There are other ways to exfoliate though.

 

One way to help loosen and get rid of the crusty build up is to use a scalp brush. As well as helping distribute your sebum, a scalp brush will invigorate your scalp by removing flakes, build up and dirt.

If you suffer from seb derm on the face, chest or anywhere but the head a superb way to achieve similar results is to use a konjac sponge. These amazing sponges have been used in Japan for over a century to gently exfoliate and clean their skin. These things are also excellent if you suffer from acne or you’re prone to oily skin.

Get plenty of sunshine

There are numerous research papers on the benefits of sunshine on your skin.  However, if like me, you live in a poor climate, there is hope for you yet.  UV light from both natural and artificial sources helps to control the yeast that causes seborrheic dermatitis. Many UV Combs and lamps are appearing on the market. UVB treatment, in particular, can help both dermatitis and psoriasis. Another advantage of using natural sources is the other benefits you get from sunlight; vitamin D in particular.

If you live in an area with little sunlight then top up on the Vitamin D supplements.

Choose the least impact treatment you can find

By least impact, I mean, once you know the most effective active ingredient for your needs,  choose the gentlest formulated product containing that ingredient.  However, gentle means different things to different people.

Manufacturers will often add ingredients known to cause contact dermatitis into shampoos and other treatments. These ingredients can cause allergic or irritable reactions in some of us which can ultimately trigger an outbreak of seb derm.  You read that right. Anti-dandruff treatments can cause dandruff.  However, these reactions are very personal.  You may react to something that few others do.  Likewise, a common allergen may have no effect on you whatsoever.

Make a note of what’s in your treatment and avoid the ingredients that cause reactions in you.

If you haven’t got time to keep up to speed on the active ingredients and contact allergens then the easiest way to find your best dandruff shampoo is to use our search tool. We’ll do the hard work for you in helping you find your most effective treatment.

The Best Seb Derm Treatments

Seb derm can affect us in many areas.  We have a dedicated article on controlling facial or chest seb derm.

But most commonly of all, you can treat seb derm on the scalp using a dandruff shampoo.

The best shampoos for treating Seborrheic Dermatitis

These are among our current crop of staff picks for treating seb derm. But be sure to check in again as the list keeps changing.

Pharmaceutical Specialities Free & Clear Shampoo

Designed to treat Seborrheic Dermatitis, Dry Scalp and Psoriasis

Pharmaceutical Specialties formed in 1974 to “start a company to make better products than were commercially available for people with sensitive skin”. And boy, have they achieved it with this Free and Clear shampoo.

What is perhaps surprising on a website dedicated to dandruff treatments is that this isn’t a dandruff shampoo at all.

It’s rather a "a non-medicated, mild shampoo for sensitive skin and scalp.”

That said, we can’t use a medicated shampoo all the time, and this is my go to shampoo for those “between” washes.

buy now on Amazon

BIOM8 Skin Conditioning Oil

Designed to treat Seborrheic Dermatitis, Dry Scalp

BIOM8 Skin Conditioning Oil is now part of my daily skin care routine. It’s as simple as that. I have lost count of the number of products I’ve reviewed over the years and I can count on one hand the number of products that have impacted me on this level.

If you suffer from dry skin, facial seb derm or rosacea I simply can’t recommend this product highly enough.

It even makes a good beard oil!

buy now

Dead Sea Spa MAGIK Mineral Shampoo

Designed to treat Seborrheic Dermatitis, Dry Scalp and Psoriasis

Dead Sea Spa MAGIK Mineral Shampoo is a combination shampoo containing both salicylic acid and zinc pyrithione.  The thinking behind this shampoo is that the salicylic acid will soften and exfoliate existing build up and the zinc pyrithione will help prevent new build up from forming.

I’m generally a big fan of combination shampoos and this is no exception.  The shampoo feels great, has a nice light smell and leaves the hair feeling extremely soft.  It only contains one known contact allergen too - cocamidopropyl betaine.

If you suffer from mild seb derm I can’t recommend this highly enough.

buy now on Amazon

Vichy Dercos Anti-Dandruff Sensitive Shampoo

Designed to treat Seborrheic Dermatitis

One of the best and mildest shampoos out there for seb derm sufferers with sensitive skin.

Containing both Piroctone Olamine and Salicylic Acid as well as being SLS free, paraben free, artificial color free this shampoo has an absolutely outstanding choice of active and inactive ingredients.

There are still two or three chemicals in there that some may find irritating. Otherwise this would have been a five out of five performer.

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Sebamed Anti-Dandruff Shampoo

Designed to treat Seborrheic Dermatitis

Sebamed is one of the gentle yet most effective seb derm shampoos available.

The active ingredient is Piroctine Olamine - an excellent anti-fungal agent.

The rest of the shampoo has been formulated with panache.

buy now on Amazon

DHS Fragrance Free Tar Shampoo

Designed to treat Seborrheic Dermatitis and Psoriasis

DHS Coal Tar Shampoo is an expertly formulated shampoo containing 0.5% coal tar and is the gentlest coal tar shampoo we’ve yet reviewed

We can't recommend this product or this company highly enough.

buy now on Amazon

Neutrogena T/Sal Therapeutic Shampoo

Designed to treat Seborrheic Dermatitis and Psoriasis

Quite simply the best pure Salicylic Acid shampoo we’ve yet reviewed. The shampoo contains 3% Salicylic Acid combined with a fragrance free, sulfate free and virtually every other nasty ingredient free formulation. It does this and still feels luxurious when washing.

Neutrogena should be exceptionally proud of this top top class shampoo.

buy now on Amazon

Scalp 18 Coal Tar Shampoo

Designed to treat Seborrheic Dermatitis and Psoriasis

Scalp 18 Coal Tar shampoo is a 2% coal tar formulation that has a number of added essential oils to further nourish and soothe the scalp.

These essential oils do contain fragrance but if you're not sensitive to fragrances then this is a superb shampoo.

It is extremely gentle and washes like a high end salon shampoo.

If you’re not sensitive to fragrances then I wouldn’t hesitate to recommend this shampoo.

buy now on Amazon

Maple Holistics Tea Tree Oil Shampoo

Designed to treat Seborrheic Dermatitis, Dry Scalp

Maple Holistics Tea Tree Shampoo is an outstanding Tea Tree shampoo for treating Dry Scalp or Seb Derm. It doesn’t contain any artificial coloring or fragrance, sulfates, parabens, or carcinogens. It contains only three potential contact allergens, with two of the three being tea tree and rosemary essential oils.

The combination of cleansing agents used are gentle, effective and innovative while the shampoo smells ace and washes even better.

If you're looking for a tea tree shampoo, I can't recommend this highly enough.

buy now on Amazon

DHS Sal Dandruff Shampoo

Designed to treat Seborrheic Dermatitis and Psoriasis

DHS Sal Shampoo is a 3% salicylic acid shampoo designed to treat Psoriasis and Seborrheic Dermatitis.

It’s an outstanding shampoo that washes well, contains relatively few ingredients, is gentle and won’t break the bank.

If you’re not sensitive to sulfates and are looking for a good salicylic acid shampoo, this is an excellent performer.

Yet again, DHS have produced a shampoo that we can't recommend highly enough.

buy now on Amazon

Nizoral

Designed to treat Seborrheic Dermatitis

Nizoral is probably the most effective shampoo on the market to control seborrhoeic dermatitis.

It is still my go to shampoo if I suffer from a bad breakout.

The 2% edition is by far the best but the 1% can help too.

However, the 2% formulation can and does control severe cases of seb derm.

buy now on Amazon

Capasal

Designed to treat Seborrheic Dermatitis and Psoriasis

Capasal have taken the unique step of combining 1% Coal Tar with 0.5% Salicylic Acid and added coconut oil.

It's perhaps the most original and interesting shampoo formulation we've yet seen

While the shampoo is SLS, fragrance and paraben free there are still a few known contact allergens in there. Unfortunately it smells like a coal tar shampoo too.

That aside Capasal is an excellent shampoo for those who suffer mild to moderate scalp psoriasis.

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Denorex Extra Strength 2 in 1 Dandruff Shampoo and Conditioner

Designed to treat Seborrheic Dermatitis and Psoriasis

Denorex isn’t the gentlest shampoo, but with 3% Salicylic Acid it’s as strong as you’ll find OTC.

If you don’t use it too frequently and you suffer from mild to moderate psoriasis or seb derm, Denorex is very effective treatment.

buy now on Amazon

E45 Dry Scalp Shampoo

Designed to treat Seborrheic Dermatitis, Dry Scalp

E45 is a brand synonymous with dry skin care.

If you frequently get dry scalps after washing then this shampoo could be an excellent choice.

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La Roche-Posay Kerium Anti-Dandruff Shampoo

Designed to treat Seborrheic Dermatitis, Dry Scalp

La Roche Posay is a combination shampoo, combining both Piroctone Olamine and Salicylic Acid. The Salicylic Acid will help exfoliate existing dandruff build up while the Piroctone Olamine is designed to prevent any new outbreaks. It’s a match made in heaven.

I can’t let a mention of a review pass without commenting on how luxurious this shampoo feels and smells when washing – better than any medicated shampoo I have ever tried. And I’ve tried lots!

There are a couple of harsh ingredients but compared to the majority of the shampoos on the market, this is a first class Piroctone Olamine shampoo.

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Pura Dor Argan Oil Scalp & Dandruff Treatment

Designed to treat Seborrheic Dermatitis, Dry Scalp

Pura's D'or Argan Oil shampoo features an interesting formula that combines traditional therapy and herbalism.

It wears a premium price tag, but it is truly a premium product.

The active ingredient in Pura's product is the familiar zinc pyrithione. It also includes aloe vera and grapefruit seed extract, which have antifungal and antioxidant properties, and a number of fragrant essential oils.

Normally, shampoos containing argan oil send up a red flag for people with seborrheic dermatitis. The oleic acid content can exacerbate the condition. However, the amount present determines the sensitivity level, and a little should have no impact.

After using the shampoo, we found that it delivered a great performance without producing adverse reactions.

If you're sensitive to fragrance, cocamidopropyl betaine or phenooxyethanol, you may want to steer clear of this shampoo, but for many dandruff sufferers, it can achieve complete control of symptoms while providing a pleasant and surprisingly sudsy washing experience along with reliable treatment results.

buy now on Amazon

Maple Holistics Sage Shampoo for Heavy Dandruff

Designed to treat Seborrheic Dermatitis, Dry Scalp

Maple Holistics has created an innovative and gentle shampoo using essential oils rather than traditional active ingredients to control dandruff. Despite being marketed as a sage shampoo, it actually contains a number of essential oils including tea tree, jojoba, sage, tea tree, rosemary, peach kernel and spikenard oils. The thick, white, pearly shampoo smells like tea tree oil mixed with other herbal notes. Considering its lack of sulfates, its foaming abilities are impressive, and it provides an excellent washing experience. Due to the inclusion of panthenol, it leaves your hair feeling extremely soft. Although older formulations contained undesirable ingredients, the only contact allergen listed in the current formula is cocamidopropyl betaine.

If you suffer from mild seborrheic dermatitis or dry scalp, and you’re not sensitive to the fragrances in essential oils, this is a gentle, well-formulated shampoo that we highly recommend.

buy now on Amazon

Regenpure DR Dandruff Shampoo

Designed to treat Seborrheic Dermatitis

Regenure DR Hair and Scalp Treatment is a 1% Ketoconazole formulation shampoo combined with Salicylic Acid. The company ave been particularly clever with their formulation and marketing – positioning the shampoo as a gentler alternative to Nizoral. The company have largely achieved that too. Adding Salicylic Acid to get rid of the dandruff and ketoconazole to remove the dandruff is an inspired combination too.

That said, it’s still a 1% ketoconazole shampoo. Given the choice I’d choose 2% every time, but this would require a prescription in Regenpures largest market – the USA.

Overall a very interesting, innovative shampoo.

buy now on Amazon

Selsun 2.5% Shampoo

Designed to treat Seborrheic Dermatitis

My other go to shampoo when I have a severe breakout.

Not perfect by any means and remains prescription only in the USA.

There's a reasons why doctors continue to prescribe it - it works.

buy now on ebay

DHS Zinc Dandruff Shampoo

Designed to treat Seborrheic Dermatitis

DHS Zinc Dandruff Shampoo is yet another top class shampoo from DHS.

Yes there are two ingredients to watch out for; TEA Lauryl Sulfate and Perfume.

But other than the sulfate and the fragrance there are remarkably only another 5 ingredients in this shampoo (discounting the zinc pyrithione). And one of them is coloring!

I wish every manufacturer would subscribe to the more is less philosophy of shampoo formulation.

If you're looking for a shampoo to treat a mild case of seb derm, you can't go wrong with this one.

buy now on Amazon

Kiehl's Scalp Purifying Dandruff Shampoo

Designed to treat Seborrheic Dermatitis

Kiehl's Scalp Purifying Dandruff Shampoo is a combination shampoo, combining zinc pyrithione and salicylic acid in one excellent but gentle shampoo.

It's the first zinc pyrithione shampoo that has controlled my moderate to occasionally severe dandruff in years - the addition of salicylic acid definitely helps.

Be warned though, long term usage could dry your scalp.

There are one or two unpleasant ingredients in there but if you don't react to perfume or sulfates then this is definitely worth checking out.

buy now on Amazon

Bioderma Node DS Shampoo

Designed to treat Seborrheic Dermatitis and Psoriasis

Bioderma Nodé DS+ shampoo certainly packs an anti-dandruff punch. Its combination of anti-dandruff actives (Piroctone Olamine and Zinc Pyrithione), with keratolytic Salicylic Acid and anti-inflammatory Sodium Shale Oil Sulfonate are also complimented by several scalp soothing ingredients. A heck of an ingredients list only let down by the use of SLES and one or two other potential irritants.

This shampoo is definitely worth checking out.

buy now on Amazon

Sachajuan Scalp Shampoo

Designed to treat Seborrheic Dermatitis

Sachajuan Scalp Shampoo is a beautiful looking Scandinavian shampoo which contains a very effective (new-age) combination of anti-dandruff actives. With Piroctone Olamine and Climbazole ready to defeat dandruff causing Malassezia yeast and Salicylic and Lactic Acids ready to eliminate existing flakes. There really is a lot to love about this formula.

It’s as good on the inside as it looks on the outside.

buy now on ebay

Bioderma Node P Apaisant Anti-Dandruff Shampoo for Sensitive Scalps

Designed to treat Seborrheic Dermatitis

Bioderma Node P Apaisant Anti-Dandruff Soothing Shampoo is a fabulous option for sensitive, irritated conditions of mild to moderate dandruff and seborrheic dermatitis. With a combination of 2 anti-dandruff actives and dry flake busting salicylic acid, its overall efficacy is excellent. It washes and smells great and if it weren't for the presence of fragrances and silicones it would be an almost perfect sensitive scalp friendly formulation.

buy now on ebay

Oilatum Scalp Treatment Shampoo

Designed to treat Seborrheic Dermatitis

This is one of the best shampoos on the market for controlling moderate cases of dandruff caused by Seborrhoeic Dermatitis using quite a powerful anti fungal agent.

Some of the other ingredients leave a lot to be desired though.

buy now on ebay

That’s our picks for best treatments for Seborrheic Dermatitis. There are plenty of other choices out there though so feel free to browse through all of our Seborrheic Dermatitis treatment reviews.

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