Sunday, May 27, 2018

My Problem-Scalp Line-Up

Greetings blog-readers! The blog has been quiet because while I have ideas for blog posts, they generally take more hours to carry out than I have to write them. This is not intended as medical advice and does not replace a consultation with a doctor. Use any and all treatments at your own discretion - or ask your doctor or pharmacist. Nor does it replace buying half a dozen dandruff shampoos and handing them off to a family member or friend when they don't work for you. Alas. I buy these products myself - this is not a sponsored post. Everything you see here should cost less than $25.

I have an entire page dedicated to itchy, flaky, bumpy scalp products because so many of us encounter those problems from time to time, or on a more or less constant basis.

What kind of scalp problem do I have? My skin falls into the "atopic dermatitis/eczema" category. Also "seborrheic dermatitis." I don't see those things as separate entities, there is overlap, even though eczema usually means dry skin and seborrheic dermatitis usually means oily skin. Atopic dermatitis means you have allergies, and part of your allergic reaction is your skin barrier breaks down when your skin is bombarded by allergens - things like mold spores, pollen, pet dander. But because allergies have an inflammatory component, some people's skin "learns" that inflammation reaction and will also become inflamed - dry, red, painful, peeling or flaking, raw - from exposure to wind or cold or heat or pressure (hat-wearing or headbands).

The "seborrheic dermatitis" component applies because scalps (and eyebrows, noses, cheeks, chins) can sometimes be more-oily. And sometimes the flaking and peeling of skin is a more-visible symptom in these areas. And oiliness - greasy hair. But for some people, that "oiliness" actually looks like thick, waxy, yellow flakes. Or it may feel like a waxy/powdery residue or "scalp build-up" that accumulates under your fingernails if you scratch your skin, or leaves that residue on your fingers if you rub it. Some people get "scalp acne" or bumps or cysts.

What do I use? The right treatment varies a lot from person to person. I have skin that reacts badly to a lot of products, and I have tried many dandruff treatments with very few "hits." This is what works for me, when it works and why it works.

Scalp massage: Before washing, or between washes if you go several days between washes. Nothing fancy, massage the scalp gently with the finger-pads (not the nails - if you have a very sensitive scalp, that can leave you with skin damage). Then I stroke my fingers over and through my hair - which spreads any oils over the hair and can help hair feel more-hydrated and flexible after washing.

*For people who have a waxy, thick build-up, a shampoo brush can do a great job loosening that up. Using very warm water helps to soften waxy oils (or a warm towel wrapped around the head), by bringing them closer to their melting point so they're easier to remove - but if heat makes your skin worse, just use water as warm as you can tolerate.

DHS Sal shampoo: For dry-weather peeling/flaking and humid-weather itching and bumpiness. This product contains Salicylic acid to act as an exfoliant to remove skin cells which need shedding. Those of us with problem scalps tend to need help with exfoliation because our skin is not functioning like healthy skin, and skin cells which should be shedding freely tend to stick together instead. That can provide a moist little environment for yeasts and bacteria - the ones that normally live on our scalps without causing a problem - to grow more than usual -causing itch and inflammation. FYI: Yeasts are a kind of fungus. Good exfoliation can help keep your microbial community in check.

I use this 1-2 times per week when my scalp is flaring up. I wash my hair frequently to remove allergens. This shampoo is fragrance-free and contains no conditioners - which are a problem for my skin. My hair is short, but if it were long, dry, highlighted, relaxed, dyed, heat-styled or damaged, I would want to condition it before washing as well as after to protect the hair from drying out. An oil pre-wash treatment would also protect hair from drying effects of shampoos such as this. This shampoo is meant to de-grease hair and scalp, but not all itchy and flaky scalps are especially greasy. Mine isn't. I usually wash after this with my favorite mild shampoo to make sure there will be nothing left behind to cause itch.

I can't buy this product locally, so I order it directly from Person and Covey - their shipping is quick and I'm certain to receive a product which has not been sitting in a warehouse for too long. As I write this, it costs $8.60 for a 4 oz. bottle. That skimpy little bottle lasts a long while unless more than one person is using it.

Hydrocortisone cream: For applying to itchy, peeling, red (inflamed) or flaky areas. Some people get flaking and peeling all over. My scalp will flake or peel in patches (usually) with itching. So I can spot-treat with hydrocortisone cream, which reduces inflammation and itching quickly.
Cortizone-10 is my favorite, but I'll buy a generic if the ingredients are the same. In other countries, this anti-itch medication will have different brands, but the active ingredient is Hydrocortisone 1%.

That which needs extra medicine: When hydrocortisone cream fails, in summer when it is humid, when I've been sweating, if there has been a dramatic weather change, I've been wearing a hat, etc., the yeasts on a sensitive scalp (and sometimes bacteria too) can get a little out of control and that means extra itching, inflammation - usually slightly different symptoms than during our more-dry, colder winters. Sometimes it seems to turn on an allergy response, if you're not outright allergic to molds/yeasts to begin with. In which case, your eyes might itch or get watery, you might feel tired or foggy-headed and your mind will drift to washing your scalp and it's really, really hard not to scratch. This is the muscle for really bad skin days.

Tinactin antifungal: This is what I use to spot-treat itchy areas when topical Hydrocortisone does not work. Designed for athlete's foot, a fungal skin disease - this cream works so quickly when I need it on my feet, I decided to try it in my itchy pool-ears and eyebrows and after a few applications, things are usually back to normal. Sometimes I need to use this in addition to hydrocortisone cream on an itchy/peeling spot. One could use any brand or athlete's foot treatment you like, this is the one that gets along with my skin and works very fast. I use it to spot-treat my scalp sometimes. It's a cream, and it comes in a small-ish tube, so obviously I'm not going to put this all over my scalp. The active ingredient is Tolnaftate.

Zinc, Ketoconazole and antifungal shampoo/conditioner or treatments: I like DHS zinc shampoo, but the fragrance is strong. If the itch of an itchy scalp is more than I can spot-treat, and Salicylic acid shampoo isn't getting the job done, it's time to try something anti-microbial.
Pyrithione zinc shampoos like this tend to work for lots of people by reducing yeasts on the scalp. There are Pyrithione zinc, Ketoconazole shampoos and Piroctone olamine shampoos and treatments in a list on this page. Those are also anti-yeast.
I use these "as needed" because I've been dealing with this for years and I know (mostly) how my scalp will respond - usually a few uses is enough for me if I'm using other treatments at the same time - which I do. Usually one needs to use a medicated shampoo for about 2 weeks, and then less often for maintenance after your scalp has cleared.

Antihistamines: For those of us with seasonal allergies, taking antihistamines regularly when you need them, assuming it's safe for you to take them, can help minimize the intensity of skin reactions.

There you have it - one person's strategy for dry-weather scalp problems, humid-weather scalp problems, and things in between.


  1. Thank you sooo very much for this article. It just so happens that I have this issue at the moment. My scalp flared up yesterday, and it happened so quickly over the course of one day. I think in this case, the cream would have been the best course of action

    1. Hello - Scalp flare-ups can happen crazy-fast! One minute you're fine and the next, you need mittens to keep from scratching. I hope things get under control soon. Best wishes - W

  2. I suffered for years on and off of scalp problems, mainly big ugly flakes, sometimes oily others dry, and a couple of times also on my face around my nose (but I accidentally got cured of the facial flaking by taking a liquid B-complex that I got from someone in my family who didn't use it). So, I believe that tendency can have roots in our diet, the lack of certain nutrients can leave our skin vulnerable to the attack of micro-organisms. Also, the use of harsh shampoos or hair dyes (probably my case) which strip the acid mantle of our skin is another important factor.

    But the very best thing that happened to me was to experiment with borax. Being very much into alternative forms of healing I participated in many health forums and in one of them someone mentioned borax as a way to pull flouride from our pineal gland. Not being a person who jumps at anything only on someone's word, I did some research and found that it has antifungal and even bactericidal properties. Some people mentioned the benefits of taking it internally or using it topically, one person claimed washing her body with a borax solution instead of soap cured her from allergies. Another mentioned that acne can be caused by demodex mites or other micro-organisms and that reminded me of how my skin got healed after I began using my father's Boraxo hand soap granules to exfoliate my skin when I was 14 or 15. So I decided to try a borax solution (1 tsp. of 20 Mule Team borax dissolved in 1 C. of boiling water then allowed to cool to a comfortable warmth) on my scalp and experienced immediate relief of the itching and after using it a couple more times the flaking stopped completely. Btw, I had previously succeeded in curing other bouts of dandruff/flaking with ACV (Apple Cider Vinegar) but that time it had failed me.

    So, ever since whenever I find a spot or two that start to flake after doing my color retouch I wash my scalp with the borax solution. Other times so I won't overuse borax I use a cheap conditioner to which I've added a bit of castor oil & tea tree or rosemary & peppermint oils and that is very helpful too. I also discovered that borax is a wonderful clarifier, it removes even light 'cone deposits from my hair but mainly polyquats and similar buildup; once I gently massage it on my hair the water turns milky and I know the coating on my hair is gone. Borax is alkaline (but not as much as baking soda) so after I rinse thoroughly I follow with a good moisturizing conditioner and my products work well again.


    I have probably saved myself hundreds of dollars in dermatologist visits and Rx with this simple method. The interesting thing is that about 9 years ago when I first suggested the use of borax on the hair it was met with strong opposition from people who believed it to be toxic, even after I provided the data sheet which proved that it was safe when used properly they would oppose me, but today one can do a search about borax hair wash and plenty of hits will come up. The quiet lurkers with a "self-guinea pig" inclination like me very obviously decided to take their chances and tried it, so I'm very pleased that although I had to take some flack back the in the end the truth prevailed. So, I encourage you to give it a chance as well, borax has many uses around the house, like for treating mold and neutralizing mycotoxins from clothes that may have been contaminated with mold/mildew, to kill ants, surface cleaning, etc., so the investment of approx. $4 for a box of 20 Mule Team pays off in many ways, for years now I've never let myself be out of it for long.

  3. I love borax so these two comments fascinate me. For the itchee owees and clarifying purposes. Can you all explain a little further how you use it? Is it instead of shampoo? Do you comb it through? How long would you leave on a follow up conditioner? Last time I used Taal by. Neutropenia, my hair got dried out and pouty.

  4. *sorry for double post*

    Thank you for the great article! As someone with incredibly sensitive skin, I find that most products cause scalp irritation. With that in mind and my goal of reducing as much waste as possible, I’m hoping to create my own products.

    Currently, I follow a modified version of the tightly curly method on my 4c Hair. I try to use rinse-out conditioners that have been formulated as both rinse outs and leave ins due to my sensitive skin. I currently use the Shea Moisture Raw Shea Butter Conditioner but it is not as moisturizing as I would like. What do you make of the following formulation? (newbie DIY-er)
    BTMS-50 - 6% (sole emulsifier)
    Optiphen - 1 %
    Oils/Butters: sunflower & shea - 10%
    Water Phase: mucilage of marshmallow root & slippery elm (50%) + distilled water (50%) - 83%

    Thank you for your input!

    1. Hello TreeTrunks - This looks like a really rich, thick, creamy formula. BTMS-50 is a great choice for a nice-feeling product and for good conditioning. I like the thickness of the products too - some hair needs clingy products, and BTMS produces a more clingy conditioner. One obvious thing that comes to mind is - does your hair already do well with these 2 oils? Something I think I would modify if I felt like I needed more slip in wet or dry hair would be to add some broccoli seed oil or jojoba oil to your oil/butter blend. Either has very nice slip in a conditioner and in dry hair.
      Be sure you are sterilizing everything that touches your herbal blend - I would probably take the extra precaution of re-heating it to boiling after straining out the herbs to be certain I'd killed bacteria and molds.
      Personally, I like some extra humectant in conditioners. Some people prefer not to use them, but my hair is bouncier and has more sheen if I use at about 0.5% panthenol (powder - 1% if liquid). That is a modest amount - I've used more and I didn't like it as well. Marshmallow and slippery elm have some humectant properties already, so it depends on how your hair is behaving. If you felt you needed a little more hydration - consider adding some panthenol or possibly a little glycerin if your hair likes that. Both of those are small-molecule humectants that can penetrate into the hair shaft for good hydration. Amino acids would be something else to consider to make the product more moisturizing. Those are small-molecule moisturizers. If the amount is kept quite low - 0.5% or 0.25%, you're unlikely to run into "protein side effects" if your hair has those. Good luck with you formulating! -W

  5. I struggle with this too! So many products irritate my scalp :( it will work wonders for my hair but my scalp will start to flake and itch. But what i do to help soothe it is mix equal parts apple cider vinegar,water and witch hazel then add a few drops of fractionated coconut oil and with some lavender and peppermint essential oils. Put this in the spray bottle shake and spray after conditioning onto scalp. The essential oils herp to Soothe and calm the irritating skin, the coconut oil helps to moisturize, the ACV balances the Ph of my scalp and the witch hazel works as an astringent and also has a calming effect on the skin

  6. Thank you so much for the info! I was a little worried about the water phase (using mucilage at all vs a tea infusion), so I am excited to start tinkering! And panthenol looks like a really great ingredient (even compared to glycerin). Do you think the percentage of btms-50 would be ok for a leave in? I’m having trouble finding the standard amount of BTMS in leave ins vs deep/rinse out conditioners. I absolutely love the richness & moisturizing qualities of rinse-out conditioners as leave ins, but the preservatives (like MI etc) in a lot of drugstore conditioners really irritate my scalp. I guess I can’t complain, since they are designed to be rinsed out haha.

    My hair does like shea butter and sunflower seed oil for the most part, although some oils tend to cause some breakage when being applied. I’ve never tried jojoba oil, so I’d be happy to look into. Honestly, it has seemed like nothing beats the slip of Mineral Oil - it causes no breakage when I’m applying it - even when my hair is desert dry. Unfortunately, it’s not the most sustainable ingredient around. Jojoba & Broccoli Oil seems like interesting alternatives.

    1. Hi Tree Trunks - I think 6% BTMS is okay for a leave-in if you want something thick and a little clingy. If you make it and find it's a little too rich - just add a dab to your palm, add a few drops of water, rub your palms together firmly and you have an instant "lighter" leave-in without making a new batch. If you want a more-dilute product, you can go down to about 4% BTMS before your product will want to separate on you. And you could potentially thicken it with 2-4% Cetyl alcohol, which adds some extra softness (either for the rinse-out or the leave-in).
      For really rich rinse-out conditioners, use about 8% BTMS (so thick!). And the same for a deep conditioner, but there too you might thicken with a little extra Cetyl alcohol, and add oils and a little butter to increase the uptake of conditioner and increase softening. For deep conditioners, you want some amino acids or penetrating humectants to get the most moisture into the hair.

      I guess you could have some interactions with mucilage if it were really, really strong, but I've made conditioner with that and did not have a problem.

      Mineral oil definitely isn't sustainable. Broccoli seed oil has that lovely slip, but not so much weight as mineral oil. Jojoba oil isn't very weighty either. Argan oil has some "weight" to it, so I wonder how a combination of argan oil and broccoli seed oil would work? You'd get the weight and slip from both.
      My experience in my own hair and working with other people's hair samples is that breakage from oils means one is applying a little too much of the oil, or using it too often - or that oil is not a good match. But even with oils that are a good match - too much of a good thing is not a good thing! Best wishes - W