|Itchy (and dry) scalp is often accompanied|
by flaking skin
|Red patches occurring on the|
scalp with Seborrheic dermatitis
©Science-y Hair Blog 2013
I'm going to suggest some ways to control itchy scalp and Seborrheic dermatitis which are mild to the skin and hair. You're always walking a tightrope between too much washing, which leaves your scalp dried out and irritated and not washing enough, which leaves dead skin and sebum and other things bacteria and fungi like to grow in, on your poor scalp.
The ideal maintenance (un-medicated) shampoo for itchy, flaky scalps has no fragrance, no colors, no formaldehyde-releasing preservatives. Phenoxyethanol is a newer preservative that also has a fairly high rate of irritancy. Mild detergents such as Disodium laureth sulfosuccinate, Decyl polyglucoside, Lauryl glucoside are good to look for. Cocamidopropyl betaine can cause eyelid dermatitis, so be careful with that one. Alkyl sulfonates are good for removing excess oils (C14-18 olefin sulfonate, for example) as long as the shampoo is not highly concentrated. Diluting shampoos is a good idea to prevent over-cleaning. Steer clear of herbal extracts. Such a shampoo should be gentle on skin and hair, but still clean well enough to avoid overgrowth of organisms. Avoid heavily fragranced and colorful conditioners and styling products also, at least when your skin is acting up.
Powdery vs. greasy flakes: You might notice dry, powdery white flakes or greasy, yellowish flakes with or without an itchy scalp. These are usually both signs of skin irritation and breakdown of the skin's barrier function. The treatment is basically the same - but if you have dry, powdery flakes you need to be extra careful not to dry out the skin with hot water and too much detergent and keep your head protected from dry, cold or hot wind.
Sore or itchy bumps: Small cysts, or bumps on the scalp or around the hairline are also symptoms of dermatitis and tend to respond to the same treatments. Do not rub, scratch, or try to "pop" these bumps.
Before going further: Do not apply oil to your scalp and leave it on indefinitely! No matter how much sense this seems to make and no matter how good it might feel right now, any extra oil or scalp grease you apply is food for oil-loving fungi on your scalp. When they get a lot of food, they start eating and growing and reproducing and this is all very irritating to your skin. Oils you apply to the scalp need to be washed off after a limited amount of time or they work against you.
To deal with dry hair and medicated or frequent shampooing: Some people shampoo every day and this can help control flakes. If you need to do this, but it makes your hair feel dry, try applying some coconut oil, olive oil (other oils will work well too) to your dry hair just before shampooing. This will buffer the stripping effects of the shampoo on the natural oils on your hair. Or condition your hair before and after washing.
Sugar scrub: mix equal parts olive oil and sugar - it should be on the oily side, massage into dry scalp and leave on for at least 10 minutes, then shampoo out.
Chemical exfoliants like Salicylic acid are commonly included in dandruff shampoos. Salicylic acid can be just awful for your hair! An alternative is to use a product made for skin (in the U.S., Scalpicin regular strength contains Salicylic acid) and apply it only to the scalp. Some acne medications have Salicylic acid as the active ingredient and could be applied with a cotton ball to affected areas of the scalp to control flakes without drying the hair excessively. Salicylic acid is a beta hydroxy acid. It breaks down the bonds between dead skin cells to help them slough off and is not repelled by oils, so it can get down through the sebum to help free up scaling skin so that it will not provide a good home for bacteria and fungi.©Science-y Hair Blog 2013
Control Itch: Topical hydrocortisone creams (1%) or solutions are commonly used for skin inflammation (allergic rashes, bee and wasp stings, hives) and can be helpful for itchy scalps. Scalpicin Maximum Strength contains hydrocortisone and is easy to apply as a liquid. Creams are more tricky to apply, but also help moisturize. Look for a cream with as few ingredients as possible. Hydrocortisone decreases the skin's inflammatory response to help reduce your symptoms and relieve itching. ©Science-y Hair Blog 2013
- So if one tablespoon of olive oil weighs 14 grams, then you need 1.4 grams of tea tree oil per tablespoon oil, or just about 1/4 teaspoon tea tree oil per tablespoon of olive oil for a 10% solution. Or 1/8 teaspoon tea tree oil per tablespoon oil (14g) for a 5% solution.
- Another study of Seborrheic dermatitis used 5% tea tree oil in shampoo for 4 weeks with improvements in itchiness and greasiness, and some improvement in flaking. You can read the abstract here. 5% tea tree oil in a teaspoon of shampoo is a little more tricky because not all shampoos and conditioners are the same weight. If we guess that a tablespoon of your shampoo or conditioner weighs approximately 15g (the weight of a tablespoon of water), then you would also use about 1/8 teaspoon tea tree oil per tablespoon of shampoo or conditioner to have a 5% solution. In this case, 5% of 15 g (15 ml) is 0.75g (roughly 0.75 ml) of tea tree oil.
- The absolute best thing you can do is weigh this out if the measurements seem unclear. The math is really simple. If you're making up a tablespoon of tea tree oil mixture - that's about 15 grams (15 ml). So you start by adding 0.75 g tea tree oil, then add enough oil or shampoo or conditioner to total 15 g.
- Of if you were making 100g, you would use 5g tea tree oil, then add whatever else you are using until the total weight is 100g.
Commercial antifungal shampoos (Nizoral with the antifungal Ketoconazole is an example) address the fungi directly whereas zinc and selenium shampoos may alter the sebum in a way that is unfriendly to fungi. Coal tar shampoos are effective for some people, and work by softening scales and slowing bacterial growth. Coal tar can make skin especially sensitive to sunlight - an important thing to know if you choose such a shampoo. While these shampoos can help control the secondary fungal overgrowth and reduce itching and flaking, they do not change the fact that Seborrheic dermatitis can flare up again. Many of them are full of potentially irritating chemicals, so if your scalp is red and irritated, be extremely wary. Never dilute a medicated shampoo! You'll dilute the medicine.
Control friction irritants: Use a satin pillowcase - or a silk one. Some people can be allergic to the protein on the outer part of the silk fibers. In fact, medical-grade silk (used for stitching wounds) has this protein removed to avoid reactions, so be wary. Satin is made from either polyester or acetate and in very dry air, this can cause static which is mostly just annoying. Using a humidifier helps with this. A slippery pillowcase will let your hair slide around as you move rather than tugging at your scalp or "scouring" your scalp when your hair sticks to the pillow but your scalp moves (like every time you breathe). Line winter hats with slippery fabric, put satin ribbon on the hat band of summer hats. Avoid hairstyles which pull on your hair and scalp - only loose and low ponytails. Every tug of hair in irritated skin makes it more irritated!©Science-y Hair Blog 2013
Housekeeping: Wash your pillowcase weekly. If you have dust mite allergies or pet allergies or outdoor allergies and you keep your windows open, wash your sheets weekly and consider investing in an allergen-proof pillowcase (they have zippers), and possibly an allergen-proof mattress and box spring cover. When you wash your sheets and pillowcases, there are 2 ways to kill dust mites (otherwise you'll just have clean, live dust mites). You can wash the sheets in hot water - which may or may not be economical and be sure you read fabric care labels! Or you can add 35-40 drops of tea tree oil to the wash water. A dust-mite controlling laundry additive sold in the U.S. as De Mite uses tea tree oil and oil of wintergreen as active ingredients. Drying sheets in bright sunlight can also kill dust mites, but if you have outdoor allergies/hay fever, you will be very uncomfortable if you dry your sheets outdoors during allergy season. All this work pays off because it reduces your exposure to allergens and irritants. Even without hot water or tea tree oil, washing your sheets, pillowcases and blankets removes the dust mite allergens and the dead skin cells (yours) which are their food.©Science-y Hair Blog 2013
Some brands which offer fragrance-free shampoos and conditioners (I would dilute nearly ALL of these shampoos). Some will leave you with a squeaky-clean, tangly feeling. If well-diluted, that's just the effect of the shampoo, not necessarily hair damage. Some of the "mild" detergents are just weird like that. Using conditioner will restore your hair's nice feeling and detangle. I've linked to the shampoos, you can look around the websites for information about conditioners.
Cliniderm (Canadians, the gentle cleanser might be a fantastic shampoo)
Magick Botanicals (Oil free shampoo and conditioner)
Avalon Organics (Olive and Grapeseed)
Logona Free (ingredients can be found here)
Cure Care (conditioner only)
Unicure (shampoo and conditioner links at the bottom of the page)
Unscented bases: Another idea is to look for unscented shampoo (and conditioner) bases. You'll usually find these online. They are sold for the purpose of adding fragrances, colorings, and active ingredients - but you can buy them and use them as they come, or dilute them (I say that a lot, but it really works) either when you use them, or in a clean bottle with boiled and cooled, distilled water.
Disclaimer: None of this information is intended to cure skin disease. In fact, that's pretty hard to do, these remedies can treat the symptoms for healthy adults. If your scalp itch is so bad it distracts you from your activities, keeps you awake at night; if you have large areas covered with red patches, blisters or oozing places on your scalp, please see a doctor. Untreated, these lesions can become infected, hair loss can occur.