My scalp itches all the time!

June 21, 2009 11:27 AM

I have seborrhoeic dermatitis/dandruff and my scalp itches so much it is often painful. The dermatologist recommended OTC shampoos help, but only turn the problem from impossible to ignore to bad. Can you help?

seborrhoeic dermatitis runs in my family. The dermatologist who I saw said that I have it too, and that I should use T-gel and Nizoral. I do that, but if I miss a single day (and I like to go a day without shampooing my hair, or camping, etc) my head is itchy and painful all day.

Sometimes I wake up in the middle of the night because it itches so much. I don't itch, I know that would aggravate the problem, but gently massage to try to stop the sensation.

I've tried moisturizing my scalp by rubbing in tea tree oil or just plain olive oil- it gives temporary relief, but the angst comes back as soon as I don't shampoo every 24 hours. Is there anything I can do to alleviate these symptoms?

I can go back to the derm, or to another derm, but my insurance doesn't cover it so it is out of pocket and given that I just dropped $120 on my last visit, I'd prefer not to repeat the experience too soon.

posted by stewiethegreat to health & fitness (18 comments total)

I have mild itching on my scalp, not your condition, but here's what worked for me. I got some pomade, which is beewax fat---read up on bee fat or fat in general on Wikipedia, lanolin, sheep fat. Both of those are special fats that alleviate itching. I rub just a tiny bit of pomade into my scalp when it is very wet. Itchy goes bye bye. I hope it works for you. I like 360 style since it is $2.50 a tin.

Tea Tree I am allergic to, and it makes all the skin slough off of my body any where I use it. Just sayin.
posted by effluvia at 11:42 AM on June 21

How is your nutrition? Are you getting enough B vitamins? I've noticed that my sebhorrhea (which I have on my face as well as scalp) gets much worse if I'm eating poorly. Also, cut back on the sugar if you're eating a lot of it.

I would be careful with adding oil to the scalp. For me, this makes things worse. What DOES work for me is apple cider vinegar diluted with water. I pour it on and leave it on for awhile, then rinse out. Doesn't smell all that good, but it helps the itchiness.
posted by Knicke at 11:48 AM on June 21

i'm a big fan of max strength Scalpicin, 1% hydrocortisone liquid. i also get the wake up in the middle of the night crazy itch. i probably use it too much, but it works so much better than any other thing i've tried i don't care. Also, t-gel about once or twice a week. All the natural plant based remedies and soaps don't work since i'm allergic to most plants. Cetaphil instead of soap for my face and body. good luck.
posted by th3ph17 at 12:05 PM on June 21

Ketoconazole.
posted by WCityMike at 12:26 PM on June 21

This is so anecdotal that I'm hesitant to even mention it, but I think that my scalp is happier when I take 2 omega-3 fish oil capsules every day. It's an indirect thing, and may just be placebo, but at least it's good for you. (unless you have a clotting/bleeding disorder or otherwise take high doses of other anti-inflammatories, then check with your dr.)
posted by mercredi at 12:28 PM on June 21

This has worked really well for me. Not sure if something similar is available in the US, but Scalpicin is a corticosteroid too, so I'd second th3ph17. Also I only use a soap-free skin wash on my hair (one with tea-tree oil, to which I'm personally not allergic).
posted by le morte de bea arthur at 12:54 PM on June 21

A lot of people swear by vinegar to get rid of dandruff - a little googling turns up a lot of results, sio it might be worth a try. this page also mentions aloe vera gel, which might also be a good idea, it feels very good on irritated skin.
posted by 5_13_23_42_69_666 at 1:05 PM on June 21

Major sympathy; I don't have it as bad as you describe, but it's been a lifelong struggle. T-Gel works OK, but what I'm currently having good results with is going in the opposite direction: Baby Shampoo. An MD suggested it for the eye gunk I wake up with, saying that it, too, was sebhorrhea related. I can't use the T/Gel daily, but the Baby shampoo I can, plus I can wash my eyes and flaking, itching ears twice daily; makes a big difference.

The whole "maybe try NOT irritating/assaulting your flaking skin" idea strikes a chord, esp. after years of trying out ever-more-industrial-strength super-toxic-shampoos, to little avail.
posted by dpcoffin at 1:59 PM on June 21

You know what else is itchy and flakes a lot? Psoriasis.

I thought I had dandruff or dermatitis on my scalp, and I tried all the dandruff shampoos (including T-Gel and Nizoral), as well as lots of cortisone and antibiotic ointment, etc. They all helped kinda-sorta-a-little, but the crazy itching and flaking persisted. Then my doctor told me it was psoriasis and gave me psoriasis prescriptions. You might want to check into that if the treatments on offer for seborrheic dermatitis are not working as they should.

Not implying your doctor is wrong or an idiot, but it's just a thought.
posted by peggynature at 2:00 PM on June 21

I agree with the dietary recommendations in the link 5_13_23_42_69_666 provided above, but the cheapest and most effective folk remedy I've found has been to wash your hair with a shampoo that does not contain sodium laureth sulfate, followed by a full 5-30 minute (depending on severity of the dandruff) scalp soak in vinegar, and if you like, condition with a non-SLS containing conditioner like this.

Apple cider vinegar is much more expensive than plain white vinegar and ACV is also way stinkier -- it takes forever to air out of a room -- and since both are effective, I recommend the cheaper, less stinky plain white vinegar.

Some people even recommend drinking two teaspoons of ACV mixed in a glass of water every morning and evening to keep dandruff and yeast under control. I sure hope you find relief soon -- being woken up in the middle of the night by an itchy scalp sounds miserable. Good luck!
posted by LuckySeven~ at 2:21 PM on June 21

By the way, some recommend leaving the vinegar on your hair all day after you soak, but that really isn't necessary (unless you like smelling like an Olive Garden salad). Just rinse it out, condition, and style as usual. You'll notice right away that your hair is sqeaky clean and shiny -- thanks to the vinegar removing all of the old gunk from product buildup. You can add a drop or two of jojoba oil to your wet hair before styling it if your hair feels too dry.

Also, I don't think you should be using tea tree oil full strength like that, it's very strong and could cause your scalp to be even more irritated. Olive oil is good for many things, but it might clog your hair follicles, so you may want to ease up on that as well.
posted by LuckySeven~ at 2:49 PM on June 21

This may sound idiotic, but you know those handbrushes at the barber shop? THe ones that are a 3" disk of plastic bristles, with a loop on back to place over a finger? Try massaging your scalp with one of those every day with your shampoo. Might be psychosomatic, but it seems to help me.
posted by notsnot at 3:38 PM on June 21

I'd like to piggyback on this question and ask how people have treated their skin for this condition? My forehead and temples are red, inflamed and feel mildly bumpy and greasy. I've been using elidel once a day which seems to help with the flaking. Does anyone have any remedies return the skin to a more normal texture/color?
posted by rglass at 4:19 PM on June 21

For the past few months, I've been alternating weekly between Head & Shoulders (with selenium as the active ingredient) and Selsun Blue (with salicylic acid as the active ingredient). This, as well as a second wash with a tea tree oil shampoo, seems to have worked well for me.
posted by chengjih at 4:39 PM on June 21

The current thought on the cause of most dandruff is that it's a fungus that is found naturally on most people's scalp that's gotten out of control

http://www.sciencefriday.com/newsbriefs/read/153

When you use dandruff shampoos, most of them are killing off a lot of the fungus. The problem is when you use them too often and only the fungus that are resistant survive and reproduce. You now have a bunch of super fungus that can come back much more quickly than normal which I think is what's happening to you.

There are a lot of ways to kill fungus. Shampoos with sulfur or zinc pyrithione help kill fungus. Same with shampoos with natural oils like tea tree. Cinnamon oil is killer but so harsh it will shock the roots of your hair and make it fall out much more than normal. I think Peppermint works too but not as well as tea tree. Even anti-bacterial soap will kill off the fungus if you leave it on long enough (over 3 minutes). Vinegar is also a fungicide. The main thing is to switch it up so you never have one kind of resistant super fungus build up.

Try rotating shampoos that have fungicidal stuff in them, say tea tree oil for the first time. All the fungus sensitive to it dies but the more resistant fungus starts breeding. Shampoo the next day with one with zinc pyrithione which kills the tea tree oil resistant fungus. Then next time switch back to the tea tree oil shampoo to kill the zinc pyrithione resistant fungus. The trick is to rotate so you never have a bunch of super resistant fungus build up.

Anyway, this has really helped me. I went from having to use something every time I washed my hair to now just using something when it feels itchy. If it's as driving you as crazy as it sounds, I'd go all out and try the cinnamon oil a few times. Thinner hair wouldn't win out over being able to sleep without waking up from itching. You can buy a bottle of oil for around $5 at a health food store. I just pour some shampoo into my hand and carefully add one or two drops. Just don't use it two days in a row. I'd probably try to limit it to twice a week. Make sure to switch up what you use. Anything resistant to cinnamon oil would be hell to kill.
posted by stray thoughts at 4:38 AM on June 22

Background: I've had seborrheic dermatitis all my life too. The type where I could never wear my hair back (I'm a woman) because my scalp was caked in a thick layer of gunk, and I was way too embarrassed to risk showing it. (Yuck.) Using T-Gel helped cut down on the gunk to where it only covered part of my scalp, but like you, as soon as I went 24 hours without using it, the infernal itch returned. Nothing my doctor prescribed helped more than a month, and was too expensive to keep up for longer.

A few years ago, however, I was diagnosed with a gluten and casein intolerance. Once I stopped eating wheat and dairy, my scalp cleared up almost entirely -- almost. It was a very pleasant suprise. Do you possibly have a food allergy or intolerance?

For two years now my scalp has been entirely clear. The biggest change came when, as LuckySeven mentions, I started using shampoos without sulfates (sodium laureth sulfate being one of several that are often used). I didn't do it on purpose -- it was simply because I was in an organic store and found a delicious-smelling coconut shampoo that has, like, three ingredients. When my scalp cleared up a few weeks later and my stress levels hadn't changed, and I hadn't done anything else, I was overjoyed. I've continued to use similarly basic shampoos and my seborrhea has never returned.

I've had doctors mention the fungal aspect of it too. For info, jojoba oil has natural anti-fungal and anti-bacterial properties. As other commenters mentioned, you could try using a couple drops of it -- it doesn't take much. I use it (pure, single-ingredient jojoba oil) on my face and have beautiful skin now, whereas I had struggled with it all my life before.
posted by fraula at 5:14 AM on June 22

I suffered from seborrheic excema (behind my ears and so bad they'd bleed) from birth to my early 20s. I'd been to multiple specialists, you name it - I tried it. Nothing ever worked and I gave up.

Years later I went to the Doctor for an unrelated issue and asked him to take a look out of curiosity. He prescribed TOPICORT lotion. I used it as directed for just a few short months and it went away and never came back.

Yes, that's right I had it for 20+ years with no relief and a few months of Topicort made it disappear and never return.
posted by goml at 11:42 AM on June 22

WCityMike: "Ketoconazole."

That's Nizorol, which the OP mentioned already.
posted by radioamy at 7:07 PM on June 22