Eczema is a common skin condition that causes discomfort for many people.
Eczema is a common skin condition that causes discomfort for many people. As the name suggests, scalp eczema is a form of eczema that develops on your scalp. It can lead to dandruff and uncomfortable itching in people of all ages, from infants to adults.
Although there isn’t a cure for scalp eczema, many people can keep it under control and live comfortably with the right care. This condition is often manageable with home remedies, over-the-counter (OTC) shampoos and creams, or prescription medications.
This article covers everything you need to know about scalp eczema, including common symptoms, ways to treat it, and prevention tips.
Eczema is a group of conditions with similar symptoms known as dermatitis. The lifetime prevalence of eczema is about 15–30 percent in children and about 2–10 percent in adults.
Eczema isn’t contagious, meaning you can’t catch it or pass it on to another person.
Scalp eczema is often caused by a skin condition called seborrheic dermatitis. This condition is usually associated with an inflammation reaction triggered by Malassezia yeast. This yeast is found on most people’s skin without causing problems, so other factors, such as genetics, seem to make some people more susceptible to this inflammatory reaction.
Seborrheic dermatitis commonly develops in areas that contain many oil glands — in addition to your scalp, this includes your face, back, and skin folds.
Dandruff is considered the mildest form of seborrheic dermatitis and is estimated to affect about 50 percent of people worldwide. It isn’t serious but can be a source of embarrassment for some people and may cause uncomfortable symptoms such as itchiness or soreness.
Seborrheic dermatitis commonly develops on babies’ scalps. When it occurs in infants, it’s often called “cradle cap.” Cradle cap usually goes away on its own within a few months.
Other types of eczema that can develop on your scalp include:
Atopic eczema. Atopic dermatitis is a form of eczema that often begins in childhood and causes red, inflamed, and irritated areas of skin. It can develop on the scalp or other parts of the body, such as the hands, neck, elbows, and knees.
Allergic contact dermatitis. Allergic contact dermatitis occurs when a substance you’re allergic to triggers an autoimmune reaction that causes redness and inflammation. Affected areas appear dry, cracked, or blistered.
Irritant contact dermatitis. Irritant contact dermatitis is when a foreign substance irritates your skin but doesn’t trigger an allergic reaction. Some soaps and shampoos can potentially trigger irritant contact dermatitis.
Scalp eczema can cause symptoms that range from mild dandruff to severe scalp inflammation and hair loss.
People with dandruff may develop signs and symptoms such as:
Flakes of skin that are yellowish-white to brown, depending on your skin tone. These flakes may stay on your scalp or fall onto your shoulders and clothes.
Scalp itchiness that ranges from mild to intense
Frequent urge to scratch your scalp
Scalp redness
Sore areas from frequent scratching
Bleeding, pus, or redness if an infection develops from scratching
If you have more severe seborrheic dermatitis, you may develop an inflamed rash that appears pink or red on light skin tones or pink to purple on darker skin tones. You may also develop a rash on other parts of your body, such as your face, around your eyebrows, eyelids, or ears.
Hair loss isn’t common in people with seborrheic dermatitis, but it may occur for some people due to excess scratching and inflammation of the scalp that damages hair follicles.
The exact cause of scalp eczema isn’t fully understood, but a few factors are believed to contribute to the condition.
Factors thought to contribute to the development of seborrheic dermatitis include:
Disruption of your skin’s natural microbiota
An impaired immune reaction to Malassezia yeast
Overactive oil glands
Disruption of skin neurotransmitters
Abnormal shedding of skin cells
Genetic factors
Eating a diet filled with inflammatory foods might also contribute to symptoms of scalp eczema and other inflammatory conditions. Examples of inflammatory foods include:
Refined carbohydrates like white bread
Sugary foods and drinks
Highly processed foods like chips
Vegetable oils and oily foods
Scalp eczema can also develop due to allergic reactions or sensitivities to certain products you apply to your scalp, such as shampoos, conditioners, hairsprays, and more.
Some factors increase the risk of developing scalp eczema. Understanding these risk factors can help you take steps to prevent or manage your condition.
Risk factors for seborrheic dermatitis include:
Being in early childhood or later adulthood
Male sex
Chronic stress
Washing your hair Infrequently or too frequently
Exposure to low humidity and low temperatures
Having a condition that weakens your immune system, such as cancer, an organ transplant, or HIV/AIDS
Having neurological and psychiatric diseases like:
Parkinson's disease
Stroke
Alzheimer’s disease
Major depression
Autonomic nervous system dysfunction
Some medications, such as dopamine antagonists, immunosuppressants, photochemotherapy, and lithium
Doctors can often diagnose scalp eczema by looking at your scalp.
If you suspect you have scalp eczema, it’s a good idea to consult a healthcare professional like a dermatologist. They can diagnose the condition by examining your scalp, ordering tests, and asking about your symptoms.
In most cases, a physical examination is enough to diagnose scalp eczema. However, in some cases, the doctor may take a blood sample or a small skin sample called a biopsy to rule out skin conditions such as psoriasis or a fungal infection called tinea capitis (ringworm).
If your doctor suspects you have contact dermatitis, they may perform a patch test. During this test:
You’ll have thin metal or flexible plastic chambers placed in strips on your skin, usually on your arm. Each contains a small amount of an allergen or a substance that may trigger an allergic reaction.
Your doctor will cover the strips with tape and record the location of each allergen.
The tape will be left in place for about two days. During this time, you won’t be able to get your arm wet.
After two days, your doctor will remove the strips and check if any allergens triggered a reaction.
Mild scalp eczema or dandruff can often be effectively treated with over-the-counter (OTC) shampoos, ointments, or creams. In some cases, home remedies can help.
More severe cases might need prescription products to help reduce scalp inflammation.
Many people with mild or moderate symptoms can successfully treat scalp eczema with dandruff shampoos or other products. Some home remedies may also help reduce your symptoms.
Many anti-dandruff shampoos can help reduce scalp eczema and dandruff symptoms like flaking skin and irritation.
The American Academy of Dermatology Association recommends the following active ingredients as some of the most common and effective ingredients in anti-dandruff shampoos.
Pyrithione zinc and salicylic acid. Shampoos containing pyrithione zinc and salicylic acid, such as our dandruff detox shampoo, can potentially help reduce itchiness and irritation on your scalp. Salicylic acid helps reduce flaking, while pyrithione zinc helps reduce yeast growth. A 2018 study found that herbal zinc pyrithione shampoo combined with scalp lotion improved seborrheic dermatitis symptoms in a group of 50 people.
Ketoconazole. Ketoconazole can potentially reduce yeast growth on your scalp and reduce associated inflammation and dandruff. It’s most often sold in 2% concentrations.
Sulfur. Sulfur has antifungal qualities and can potentially help break down flaking skin. It’s found in many skincare products that treat dandruff and conditions like scabies or acne.
Coal tar. Coal tar can potentially help reduce flaking skin on your scalp. It’s used to treat many skin conditions, including eczema, psoriasis, seborrheic dermatitis, and dandruff. One drawback is it can make your skin more sensitive to UV light and more prone to burning.
Selenium sulfide (Selenium disulfide). Selenium sulfide can potentially slow the growth of yeast on your scalp. A 2023 study published in the European Journal of Dermatology found that the Selenium disulfide shampoo applied two to three times per week effectively reduced dandruff and seborrheic dermatitis in 1,407 adults.
If OTC shampoos aren’t effective, your doctor may recommend prescription shampoos. Prescription shampoos may contain higher amounts of active ingredients than OTC products. They might also contain antifungal ingredients such as ciclopirox.
When using anti-dandruff shampoos, or any other treatment option for that matter, it’s important to follow the instructions on the bottle. Most medicated shampoos recommend leaving the product on for several minutes before you rinse it out so it has more time to act on your scalp.
Some home remedies, including the following, might help decrease symptoms of scalp eczema, especially when combined with shampoos.
Tea tree oil is an essential oil derived from the leaves of a tree native to Australia. Some research suggests that it may help reduce fungal growth on the scalp.
Applying coconut oil to your scalp may help improve its microbiome and reduce yeast growth that contributes to dandruff.
Aloe vera is another commonly available product that may help reduce yeast growth on your skin and scalp.
Apple cider vinegar may also reduce yeast growth on your skin. You can try mixing it with water and leaving it on your scalp for about 15 minutes.
Moisturizers can help soothe and hydrate your skin, which reduces itching and flaking. For people with scalp eczema, moisturizing is essential to keep the scalp comfortable and prevent cracks or sores.
If home remedies and anti-dandruff shampoos aren’t enough to treat your seborrheic dermatitis, your doctor may also recommend topical corticosteroids or calcineurin inhibitors to reduce inflammation. These medications are only available with a prescription.
Your doctor may also prescribe antifungal creams or ointment to help reduce the growth of yeast on your scalp if they think it may be contributing to your symptoms.
In severe cases, a doctor may prescribe oral medications, such as antifungal pills or oral steroids. These treatments are usually reserved for people who are severely immunosuppressed and don’t respond to other treatments.
Treatment for atopic dermatitis includes:
Using moisturizers or lubricants two to three times a day to reduce itching. Petroleum jelly is a commonly recommended moisturizer. It’s important to look for products free of alcohol, scents, dyes, and parabens since these may irritate your skin.
Antihistamines, which may help reduce severe itching
Prescription topical steroids for up to three months
Avoiding anything that worsens your symptoms, such as harsh shampoos or hair products
If you have contact dermatitis, treatment involves avoiding whatever hair or skin care product caused your symptoms.
While scalp eczema can’t always be prevented, there are some steps you can take to reduce the risk of eczema flare-ups and keep your symptoms under control.
The following may help prevent scalp eczema or help you improve your symptoms.
Maintain good scalp hygiene. Washing your hair regularly can help remove excess oil and prevent the buildup of yeast and dead skin cells. However, it’s important not to over-wash, as this can dry out your scalp and worsen symptoms. The optimal frequency to wash your hair depends on factors such as your hair’s natural tendency to get oily.
Use gentle hair care products. Avoid hair care products with harsh chemicals, such as fragrances, which can irritate the scalp. Instead, try using a product specifically designed for people with dandruff.
Managing stress. Stress can increase your risk of many conditions, including scalp eczema. Finding ways to reduce stress in your life may help improve your symptoms.
Avoiding triggers. You may find that using certain hair care products causes your symptoms to flare up. Avoiding your triggers may help you avoid scalp irritation and dryness.
Moisturizing your scalp. Keeping the scalp hydrated can help reduce dryness and itching. You can use a gentle moisturizer or oil on your scalp, but be careful not to use anything too heavy that might clog your pores.
Talking to a dermatologist. A dermatologist can help you identify your hair and skin type and help recommend products that may work best for you. For example, somebody with dry skin might do best with products designed to moisturize the scalp.
Eating a healthy diet. A healthy diet filled with fresh foods like fruits, vegetables, lean proteins, and whole grains may help reduce inflammation throughout your body.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.
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