Raechele Cochran Gathers, MD Bad dandruff is often caused by a common scalp condition called seborrheic dermatitis. Seborrheic dermatitis can cause greasy scaling on your scalp, itching and even hair loss. Often, it is treated with prescription steroid creams.
What’s Seborrheic Dermatitis?
Seborrheic dermatitis (often called seb derm) is like an extreme form of dandruff. In addition to causing flakes in your hair and scalp, it can cause scaling around your hairline, in your ears and even on your face—especially the eyebrows and creases of your nose.
Causes
Seborrheic dermatitis is caused by your body having a strong response to a common scalp yeast, called Malassezia furfur. This is why we often use antiyeast shampoos to treat the condition.
How Does Seborrheic Dermatitis Look?
If you have seborrheic dermatitis, your scalp may be scaly and/or red. If you peel back the scale, your scalp may look pink and inflamed. It might also burn and itch. You might also see scaling and discoloration around your edges.
Steroid Creams for Treatment
Prescription steroid creams work to calm down inflammation. They decrease the scaling, redness and itching of seborrheic dermatitis. If you have seborrheic dermatitis, your doctor may prescribe a steroid cream, ointment or oil. Usually used twice daily for a few weeks, they can be really helpful.
Since seborrheic dermatitis is caused by your body’s reaction to a common yeast, a popular and helpful treatment for this yeast is Nizoral® shampoo. Nizoral® comes as a prescription, but many people people find relief with the over-the-counter version too.
Other shampoos that can treat the itching and flaking of seborrheic dermatitis include those with active ingredients such as tar, zinc pyrithione, selenium sulfide, sulfur or salicylic acid. You can read more about seborrheic dermatitis here.
Steroid Injections
If there is a lot of inflammation associated with the seb derm in your scalp, your hair can begin to shed and fall out. Some doctors will treat this with steroid injections. Steroid injections can quickly improve stubborn scaling areas and help to stop the excessive shedding of your hair. You can read more about them and see a video of them being done here.
Do I Have Seborrheic Dermatitis?
If you think that your bad dandruff may be caused by seborrheic dermatitis, or even something else, you should always see a dermatologist to evaluate your situation. Remember, things like psoriasis and even ringworm can look like dandruff and seborrheic dermatitis. A board certified dermatologist should evaluate you first. You can find one here.
