Simple Tricks To Control Facial and Scalp Dandruff
By cynthia bailey md on March 20, 2011
Dandruff is really common and it doesn’t just affect your scalp. Do you know that the ‘dry’ skin in your eyebrows or around your nose could actually be facial dandruff, not really dry skin?
I see a lot of patients with dandruff. Doctors and scientists don’t know what causes dandruff and we don’t know how to cure it, but we have figured out some pretty effective ways to control it.
Dandruff, actually called seborrheic dermatitis can happen any time in life. In infants it’s called cradle cap, in adolescence it’s a pink skin color in the crease of the nose, and in people of any age it may just be an occasionally itchy scalp with a fine ‘dry’ scale. Seborrheic dermatitis is so common that almost everyone will have it at some point in their life. It’s one of the most common skin problems that I find during a skin exam.
You’ve undoubtedly seen seborrheic dermatitis it on yourself or someone you know. Common ways that dandruff shows up:
- 'Cradle cap' in babies
- Red, greasy, scaly skin in the nose cease or between the eyebrows
- ‘Dry’ and itchy scalp
- ‘Dry’, red, scaly skin in the T-zone of the face
- Red, crusty skin on and behind the ears
- Flaking of the eyebrows
- Crusty scale and itching of the eyelashes (blepharitis), especially in the morning when you wake up
- Greasy, slightly inflamed, scaly skin on the chest and upper back
Seborrheic dermatitis can even be accompanied by tender, itchy pimples on the scalp, around the hair line and on the neck, chest and upper back.
Doctors and scientists don’t know what causes seborrheic dermatitis, or why it sometimes flares up. We know that it’s more likely to be a problem in the winter or when a person is under stress. People with central nervous system problems like Parkinson’s are more likely to have it, and for them, the seborrhea is more likely to be severe and harder to control.
We also know that in pores of skin with seborrheic dermatitis there's a greater amount of a yeast organism that’s normally found in everyone’s pores above the waist. It’s unclear if this yeast germ is causing the dandruff or just there because of it. Aside from these correlations and observations, dandruff remains a mystery.
Treatment of dandruff is fairly simple and typically involves the use of over the counter, medicated products. For scalp dandruff, I tell my patients to start by using a dandruff shampoo and see if that helps. If not, then they need to pick 3 different types of dandruff shampoo medicines and rotate the products each time they wash their scalp/hair. The medicine ingredients in dandruff shampoo’s include:
- Pyrithione Zinc
- Selenium Sulfide
- Salicylic Acid
Tea tree oil is a natural ingredients that may work for dandruff, but it's technically not a 'medicine'.
I instruct my dandruff patients to use their medicated shampoo as their second lathering when washing their hair. They are to apply the medicated shampoo to the scalp,leave it on for a few minutes, and then rinse and finish with their conditioner or other hair products.
Simply rotating the use of 3 different dandruff shampoo medicines will solve the problem for the majority of people with itchy scalp dandruff. If not, it’s time for the more inconvenient treatments and/or prescription products and I describe some of those in more detail on my blog at DrBaileySkinCare.com.
Facial dandruff is also really common and it's also one of the most common reasons for sensitive facial skin. It’s the worst in the eyebrows and mid-brow forehead, down the sides of the nose and onto the chin. The dandruff may show up as just a dry scale or there may be a pink color too. Harsh soaps aggravate it, making the skin feel taught, irritated, and even more scaly. Likewise, anti-aging or acne products contain ingredients that may sting and irritate facial areas with dandruff. People usually try to fix the scale and irritation by using a lot of moisturizers, but it doesn't help because this is a rash, not dry skin.
The key to controlling facial dandruff is the use of cleansers that control that yeast organism and my favorite are either pyrithione zinc soaps or prescription sulfa antibiotic cleansers (if not allergic). All skin care products need to be gentle and non-irritating until the skin has healed plus a few weeks. Until the dandruff is controlled and the skin has had a chance to really heal, it will remain vulnerable to irritation by harsh products or harsh climactic conditions.
The other surprising places commonly affected by dandruff are the ears and the eyelids. Most of the time, the crusty stuff in the curves of the ears and behind the ears, and the intense itch down in the ear canals can all be blamed on dandruff. The same is true of the crusty red skin along the lash line. There are more great skin care tricks to control these problems too. They're on my blog.
Dandruff is annoying and it's not exactly a glamorous topic, but it's common. Simple tweaks to your skin care and hair care can control the problem in most cases. When that doesn’t work there are some nice prescription treatments too.