Seborrheic Dermatitis Scalp
Seborrheic dermatitis or dandruff is one of the most common type of eczema that makes the scalp’s skin, face and upper torso red, dry, itchy, scaly and flaky.
Similar to other types of eczema, Seborrheic dermatitis can be hard to manage and reveal an unattractive image. Continuous scratching of the scalp results in a dry and flaky skin that tends to cause an endless winter fall of dandruff. In worse conditions, the symptoms of eczema may aggravate resulting in tight skin or sores that weep and crust around.
Seborrheic Dermatitis Scalp Treatment
It is necessary to choose an appropriate shampoo or hair cleanser that works well to subdue the itchiness and dryness of the scalp. When searching for the favorable product, it is important to understand that it might take some time before you find a shampoo which especially works for your symptoms. In addition, the dizzy array of products available in the market make it nearly impossible to figure out the best shampoo for eczema.
Organic shampoos are mostly suggested to treat eczema on the scalp. These shampoos are free from the usual industrial chemical irritants that are common ingredients in the available hair cleansers. Apart from switching to a suitable cleanser, it is vital to seek medical advice to avoid the eczema symptoms from worsening.
Symptoms and triggers are the most important aspects to be managed in order to treat any form of eczema. The treatment for eczema is individual-specific as the symptoms for the ailment may vary from one individual to another. Hence, it is necessary that you are aware of your symptoms and know what leads to eczema flare-ups.
Also Read: Does hard water causes eczema flare-ups?
Additionally, you must be acknowledged of the main ingredients of the eczema shampoo or any product that is included as a part daily-care regime for eczema. You should search for the ingredient list, research and read reviews regarding them. Sometimes these eczema-care products like shampoos, creams, moisturizers may be composed of irritants that may trigger eczema/allergy in few individuals. It is important to choose the product that doesn’t aggravate the symptoms of eczema.
The blog post lists specific ingredients that you should look for, in the shampoos for a dry scalp, dandruff and the ingredients that you must avoid to prevent eczema flare-ups.
Let’s take a look at the key ingredients that must be present in the shampoo to help alleviate the symptoms of scalp eczema.
6 Beneficial Ingredients for Sensitive Eczema Scalp
Ketoconazole is probably one of the most effective ingredient available in the market for treating seborrheic dermatitis. The active ingredient might not work for everyone but definitely it is the first-line treatment recommended to the ones who are recently diagnosed with seb derm. Most of the dermatologists advice to use a 2% ketoconazole shampoo.
Mentioned below is one of the studies that supports its effectiveness in case of severe dandruff and seborrheic dermatitis:
A multicenter randomized trial of ketoconazole 2% and zinc pyrithione 1% shampoos in severe dandruff and seborrheic dermatitis. – ncbi.nlm.nih.gov
How effective is Ketoconazole shampoo in treating dandruff?
- Ketoconazole is an imidazole derivative and acts against a broad-spectrum of fungus, yeast species, including Malassezia (causative agent for the occurrence of Seborrheic dermatitis).
- The positive aspect of using ketoconazole as a shampoo is,it is not absorbed into the bloodstream, hence, the antifungal effects are just restricted to the scalp.
- Additionally, if your symptoms are consistent with a prime fungal infection, the dermatologist may prescribe the shampoo without carrying out any microbial test.
- Ketoconazole shampoos have been used since a long time for treating the skin condition and has even proven to be effective in pivotal clinical trials.
What are the risks associated with using Ketoconazole eczema shampoo?
An overall analysis suggests that the eczema shampoos are very well tolerated and not associated with any harmful effects of the oral formulation. However, 1 in every 100-1000 people may experience the following most common reactions:
- Dry skin
- Abnormal hair texture
- Irritation in the eyes
Zinc Pyrithione is an active ingredient widely used to treat dandruff and/or seborrheic dermatitis. It acts as an antimicrobial that has proven to be effective against many species of fungus and bacteria. There are hundreds of shampoo brands available in the market that contain zinc pyrithione as an ingredient or preservative.
How effective are Zinc Pyrithione shampoos?
- As, Zinc pyrithione is effective against Malassezia yeasts, it is considered as an important remedy in treating seborrheic dermatitis and improving the scalp conditions.
- Zinc pyrithione shampoos are well tolerated and have been available over-the-counter for a significant time but they are considered as a second-line therapy.
- The National Institute for Health and Care Excellence (NICE) recommends the use of these shampoos for seborrheic dermatitis if ketoconazole or selenium sulfide are not effective or tolerated.
What are the risks with using Zinc Pyrithione shampoos?
- Zinc pyrithione is a mild irritant, hence, is only used in rinse-off cosmetics like shampoos.
- Zinc pyrithione is highly toxic if ingested. Different studies suggests that in animals, doses of 0.05g/kg were sufficient to cause vomiting and 2.5g/kg lead to death. For an average adult, ingesting over 7kg of a 2% shampoo can be fatal.
Salicylic acid is keratolytic and anti-inflammatory active ingredient that is widely used in shampoos for treating seborrheic dermatitis and scalp psoriasis. Although, the ingredient is effective alone, it is more often formulated with the other ingredients to provide relief against itching, flaking and redness of the scalp. Most of the salicylic acid shampoos are concentrated at 1.8 to 3% and are required to be thoroughly massaged into the scalp.
How effective are Salicylic Acid Shampoos?
- Salicylic Acid has been approved by FDA as an effective treatment for dandruff caused by scalp psoriasis and seborrheic dermatitis.
- Salicylic acid does not possess any necessary antifungal properties but the keratolytic characteristic helps in the removal of flaky skin.
- A recent study suggests that the combination of salicylic acid with an antifungal agent can help amplify its power and effectiveness.
What are the side-effects associated with using Salicylic Acid shampoos?
- Salicylic acid shampoos should be avoided in case you are allergic to aspirin.
- A healthy skin absorbs a very small amount of salicylic acid into the bloodstream but this figure increases significantly if the skin is damaged. However, the figure is lower in case of shampoos in comparison to creams.
- Prolonged use of a keratolytic agent can cause dry skin, hence, excessive use should be avoided.
Coal tar is one of the oldest and widely known active ingredient used to help combat dandruff. Coal tar shampoos are available in two forms: Crude or raw coal tar and Coal tar extract. Crude form is usually accepted as the most effective form of the substance. However, most of the eczema shampoos today are formulated using a coal tar extract. This form is considered refined and cleaner but takes longer to alleviate the symptoms of the scalp.
Coal tar concentrations are kept between 0.5 and 5 percent, beyond that figure is considered as unsafe. Nowadays, coal tar shampoos are generally formulated with other ingredients in order to elevate their performance and effective.
What are the possible risks of Coal Tar shampoo treatment?
- In most of the cases, no such side effects are experienced but coal tar shampoos may cause skin irritation or rashes in a few individuals.
- When gel and solution based coal tar products are applied, you may experience a mild stinging.
- Coal tar can increase sensitivity to sunlight. Hence, ensure to protect coal tar treated skin from ultraviolet rays to avoid irritation and sunburn.
Selenium sulfide is clinically proven to be one of the most effective ingredients after ketoconazole for treating Seborrheic dermatitis in the individuals. In the United States, the concentration of selenium sulfide in shampoos is restricted to 1% – 2.5% and is sold by the pharmacies, only if prescribed.
How effective are selenium sulfide shampoos?
- Selenium sulfide shampoos are widely recommended by the dermatologists as first or second-line treatments for seborrheic dermatitis, pityriasis versicolor, and tinea capitis.
- Selenium sulfide shampoos are the most preferred alternative to ketoconazole.
- A selenium sulfide 2.5% shampoo is as effective as ketoconazole 2% shampoo in treating moderate to severe dandruff. However, ketoconazole 2% shampoo is considered to be better tolerated.
What are the possible risks of selenium sulfide shampoos?
- Selenium sulfide shampoos may result in the most common reactions like redness, irritation, burning sensations, dry hair, and blistering (in case the shampoo has been left on the skin for a long duration).
- Selenium sulfide shampoos can discolor dyed hair and metallic jewelry.
- The US Department of Health suggests that Selenium sulfide shampoos should not be ingested and must be used in accordance with the recommended dosage.
Piroctone Olamine can be considered as a more recently introduced active ingredient to treat seborrheic dermatitis and dry scalp. It doesn’t quite match the effectiveness of ketoconazole or selenium sulfide, but it’s much gentler and can be used as an everyday shampoo.
How effective is Piroctone olamine shampoo
- Piroctone olamine is well tolerated, hence, can be frequently used to control mild dandruff.
- A study suggested that Piroctone olamine when combined with a coal tar shampoo helped in the significant reduction of Malassezia over a duration of eight-weeks.
What are the possible side-effects of Piroctone olamine?
Extensive safety studies have been performed on piroctone olamine and so far no study results suggest any adverse effects on the health.
Following the list of necessary ingredients, let’s consider the chemicals that need to be avoided to prevent the eczema symptoms from worsening.
8 Ingredients to avoid for scalp care
Today, Sodium Lauryl Sulfate (SLS) is one of the main ingredients in most of the shampoos and cosmetic products. It acts both as a foaming agent and a cleanser. Rather, the cleansing power of SLS is enough to use it as an engine cleaner.
However, the sulfate absorbs the natural oils from the skin and hair, thus, making the area dry. SLS is one of the primary skin irritants and is considered to be the harshest of the sulfates. A cheap alternative of SLS, Sodium Lauryl Ether Sulphate or SLES, was formulated but it acts similar to SLS. Rather, skin can absorb both SLS and SLES that can aggravate skin conditions.
Another type of sulfates, Ammonium Lauryl Sulfate (ALS) and Ammonium Laureth Sulfate (ALES), also functions in the same way as SLS and SLES.
Ensure that your eczema scalp shampoo is not formulated using any of these sulfates to avoid worse scenarios.
The next class of chemicals/ ingredients to be discussed is the alcohols. Two different forms of alcohols is used in the composition of shampoos. One type of alcohol will make the scalp dry, while, the other serves to moisturize, condition the hair and scalp.
The first form comprises of short-chain alcohols like Ethyl Alcohol, Ethanol, SD Alcohol, SD Alcohol 40, Alcohol Denat, Propanol, Propyl Alcohol, Propylene Glycol and Isopropyl Alcohol. The inclusion of these alcohols and/or its derivatives such as Isopropyl Palmitate can make the scalp dry and cause irritation.
The second type is classified as fatty alcohols that includes Lauryl Alcohol, Cetyl Alcohol, Myristyl Alcohol, Stearyl Alcohol, Cetearyl Alcohol, Oleyl Alcohol and Behenyl Alcohol. These alcohols are more commonly derived from the natural resources like vegetable or coconut oils. Fatty alcohols help moisturize the scalp and their characteristics make them a chief ingredient in many moisturizing creams and conditioners.
Methylisothiazolinone was titled as the Contact Allergen of the Year in 2013. When this chemical is combined with the Methylchloroisothiazolinone, the compound is known as Kathon GC. The compound was found responsible for an epidemic of contact dermatitis in 2013 in the UK. These chemicals are commonly used as preservative in many shampoos, creams, and cosmetics. Ensure to look for the ingredient under the preservative list of the shampoo and if present, you know what to do.
A sweet, pleasant smell is a delight to the mind and body but for eczema it might be a trigger for flare-ups. Fragrant products are supposed to be avoided for the prevention of symptoms of eczema from worsening. These pleasant smelling products are often amongst the most common factors behind the occurrence of contact dermatitis and dandruff.
A few of the most common fragrances listed by European Union (EU) that result in adverse reactions are:
- 3-Cyclohexane Carboxaldehyde
- Amyl Cinnamal
- Anisyl Alcohol
- Benzyl Alcohol
- Benzyl Benzoate
- Butylphenyl Methylpropional
- Cinnamyl Alcohol
- Evernia Furfuracea
- Isomethyl Ionone
Phthalates is a widely used chemical in several industries. The chemical is broadly categorized as plasticisers that provide the materials an elastic, durable, malleable property. They are also used in many of the cosmetic products, shampoos and detergents to give fragrance. Phthalates are considered as common triggers for contact dermatitis in few of the individuals.
6. Silicone or Petroleum Oils
A few of the silicone/petroleum oil based products are termed harmful for the eczema affected scalp. The inclusion of these ingredients is to provide moisturization to the scalp. However, some forms of silicone/petroleum oils in shampoos can make the area dry and sometimes instigate eczema. The water-based class of silicone products is considered to be beneficial, while, the others are classified as the contact allergens or irritants.
A few of the silicone/petroleum oils that shouldn’t be present in the shampoos are:
- Cetearyl Methicone
- Cetyl Dimethicone
- Mineral Oil
- Petrolatum Liquidum
- Phenyl Trimethicone
- Stearyl Dimethicone
7. Ethylene Glycol/Polyethylene Glycol (PEG)
Most of the shampoos contain Ethylene Glycol and Polyethylene Glycol (PEG). These additives are used to provide texture, sheen and viscosity to the shampoos. On the other hand, both of these additives are known as allergens to the eczema world.
8. The Parabens
Parabens, including Propylparaben, Methylparaben, Butylparaben, Ethylparaben, Isobutylparaben, are known to be one of the most harmful chemicals used in the shampoos. These chemicals were added to the shampoos as they act as antibacterial agents and prevent the growth of mold. However, they were found to be unfavorable for the hormones and traces of this chemical have been found in cancerous cells.
Ensure to look for the shampoo ingredients for eczema scalp which you should avoid and the ones to be included before buying your Best Shampoo for Eczema.