Eczema can result in inflamed, dry, itchy skin. On the scalp, the skin may appear scaly and red or a lighter color than the surrounding skin. A person may also experience dandruff. Treatment involves topical antifungal products.
Eczema refers to a group of skin conditions that result in skin inflammation. Atopic dermatitis is the most common type of eczema and can affect the scalp. However, one of the main types of eczema that can affect the scalp is seborrheic dermatitis.
It appears in areas where the skin is most oily, such as the scalp, face, and upper back. When seborrheic dermatitis affects babies, it is known as cradle cap.
This article looks at risk factors for scalp eczema, how to prevent it, and what treatment involves.
Seborrheic dermatitis is a type of eczema that has
Doctors do not fully understand what causes seborrheic dermatitis, but a type of yeast that lives on the skin may play a role.
The yeast, called Malassezia, exists on everyone’s skin and may trigger an immune response in some people. This response leads to inflammation and itchiness.
Seborrheic dermatitis affects up to
Other types of eczema can also affect the scalp, including atopic eczema or contact dermatitis. A doctor, such as a dermatologist, can identify the type.
Certain factors can make people more prone to seborrheic dermatitis. These include:
- having oily skin
- being male
- living in a dry or cold environment
- having a condition that weakens the immune system, such as HIV
- having a neurological condition, such as Parkinson’s disease
- having certain mental health conditions, such as depression or an eating disorder
- taking certain medications, such as lithium, dopamine antagonists, or immunosuppressants
The following might trigger a flare-up of this type of eczema:
- stress
- lack of sleep
- sweating
- irritants
- dry skin
Both conditions cause itching and scaling that can be white-to-yellow. However, unlike dandruff, seborrheic dermatitis develops more on the scalp and causes inflammation.
Researchers think that dandruff and seborrheic dermatitis are part of the same disease process and that both have associations with the presence of Malassezia fungus on the scalp.
Scalp eczema causes patches of itchy, inflamed, dry skin. The patches may change in shape and size over time.
People with seborrheic dermatitis may also have:
- patches of waxy or oily skin
- skin that flakes off
- yellow or red discoloration in people with light skin tones
- skin that is darker or lighter than the surrounding area in people with deeper skin tones
The condition typically appears in areas with many oil-producing glands. A person with seborrheic dermatitis on their scalp may also have it in other areas that produce oil, such as the:
- nose
- eyelids
- eyebrows
- ear canal
- area behind the ears
- upper back
Even after the rash heals, any color changes may last.
The best approach depends on the type of eczema a person has.
Treatment for seborrheic dermatitis involves using topical products that reduce the growth of the yeast, calm inflammation, and remove the flakiness.
The first step involves skin care, and a dermatologist can describe how to keep the scalp clean and hydrated. Replacing harsh shampoos with gentle, pH-balanced ones, for example, may reduce irritation.
Next, the doctor may recommend an antifungal cream, spray, or scalp treatment. This
- zinc pyrithione
- salicylic acid
- selenium sulfide
- ketoconazole
- ciclopirox
- sulfacetamide
- coal tar
- sulfur
For more severe cases, a mild corticosteroid can calm the inflammation. A doctor may prescribe a topical corticosteroid, which goes on the skin, to treat an active flare-up that causes severe pain, itching, and flaking. However, corticosteroids are unsuitable for use over long periods.
A doctor may also prescribe a topical medication that suppresses the immune system. These products do not contain corticosteroids, and people can use them for longer periods. For very severe cases, doctors may prescribe an oral antifungal medication.
For babies with cradle cap, mineral oil can help loosen the flakes so they fall off with gentle washing. Usually, this is all that is necessary. The condition often improves on its own after a few months.
In adults, seborrheic dermatitis can come and go for long periods, requiring managing to reduce flare-ups.
Many prescription products for seborrheic dermatitis contain ingredients that people can purchase over the counter, such as:
- coal tar, which reduces itching
- sulfur, an antibacterial mineral
- salicylic acid, a compound that naturally occurs in plants and exfoliates flaky skin
Many over-the-counter scalp treatments contain these substances.
Learn more about natural remedies for seborrheic dermatitis.
There is no single test for scalp eczema. The yeasts that play a role in seborrheic dermatitis occur naturally on everyone’s scalp, so testing for these will not help.
Instead, a doctor performs a physical examination and takes the person’s medical history. They may diagnose eczema according to the symptoms alone or perform tests to rule out other possibilities, such as an allergic reaction.
The specific symptoms can also reveal the type of eczema.
If a doctor suspects a fungal infection, they may take a skin scraping and send it for analysis.
Since experts are
However, a person can reduce the risk of the condition flaring up by:
- avoiding contact with harsh soaps, chemicals, or solvents
- protecting the head in cold or dry weather
- using a humidifier to make indoor air less dry
- washing the scalp after exercise and other activities that cause sweating
- reducing and managing stress levels
- receiving treatment for any medical conditions that increase the risk of seborrheic dermatitis
If a medication may be contributing to scalp eczema, a doctor can advise on the next steps.
Below are answers to common questions about scalp eczema.
What is the root cause of scalp eczema?
Scientists are not entirely sure what the root cause of scalp eczema is. However, a yeast that lives on everyone’s skin, called Malassezia, may be involved.
How to get rid of eczema on the scalp?
Getting rid of scalp eczema depends on the type of eczema. Treating seborrheic dermatitis on the scalp involves using topical antifungal shampoos and ointments.
If the cause is atopic dermatitis, a person can follow a dermatologist’s advice regarding skin care routines, medications, and trigger management.
What is the difference between eczema and seborrheic dermatitis?
Eczema is a term referring to a group of skin conditions causing skin inflammation. Seborrheic dermatitis is a type of eczema that develops where there are many oil-producing glands, such as the scalp, nose, and upper back.
How long does scalp eczema last?
In infants, cradle cap resolves within a few months.
In adults, scalp eczema can resolve without treatment. However, some people have the condition for life and experience flare-ups. A dermatologist can help ease symptoms.
Seborrheic dermatitis is a type of eczema that tends to affect the scalp. Doctors believe it results from an immune system reaction to a type of yeast that naturally grows on the skin. Seborrheic dermatitis causes one or more patches of itchy, flaky skin, which may feel oily.
Treatment may involve topical creams, sprays, or shampoos containing antifungal and anti-inflammatory ingredients.
Because other types of eczema can also occur on the scalp, it is important to get a diagnosis. The doctor can also rule out other conditions that can cause an inflamed or flaky rash, such as psoriasis.