Itchy scalp and other scalp issues.

I have been following your recommendations for several years and feel so lucky to have you as a trusted resource. My question concerns my husband. He complains that his scalp itches constantly and he does have dry patches and actinic keratosis that have been treated by his dermatologist. The dermatologist tells him to put lotion on his scalp. He is not completely bald so the idea of lotion in his hair is not very appealing. Is there a product--oil, exfoliant, or anything else that he could use on his scalp, even if it is just at night? This may be a more universal question of how the skin on our scalp differs from the skin on our face or body. Thank you so much, Ruth K

Our scalps have a LOT of oil glands, and those don’t go away completely when hair thins or men go bald.  The oils that are secreted change somewhat with what we eat, medications, supplements (including fish and plant oils) and exercise level.   These oils affect the scalp in many ways, including being the “food” that yeasts and bacteria “eat” which is normal.

Dandruff (seborrheic dermatitis) is due to one of the main yeasts (pityrosporum).  It can overgrow and cause “dandruff” or the flakey scalp problem.  Probiotics, especially the higher quality refrigerated ones, taken daily often help.

If you are bald or balding, try the same things below.   It may improve the itching.

Easy stuff to try for dandruff and flakey scalp:

  • Wash your hair frequently and use the pads of the fingers firmly to really unplug the oil glands.  Remember your scalp isn’t really dry!  It’s the yeast/oil causing the problem.  If you have seb derm, washing daily will almost always help.
  • Look for shampoos that contain selenium.  This yeast doesn’t like selenium.  Leave the shampoo on for 2 minutes after scrubbing above, and then rinse, and use conditioner if you need it.
  • Take a daily probiotic and avoid cheap carbs like sugar, soft drinks and white bread etc.
  • If your multivit doesn’t have selenium in it, consider taking a low dose, but check with your doctor first.
  • Yes!  You can use a little exfoliant on a bald scalp at night to help unplug.  Try a 5-10% glycolic serum.

Other things to think about:

  • This may NOT be seborrheic dermatitis, there are lots of things that can mimic it.
  • Could a new (or even tried and true) shampoo, conditioner or other hair care product be irritating the scalp.  Low level allergies can sometimes just cause scaling.
  • Could you have become allergic to your hair color product?
  • Could you have psoriasis which also likes the scalp, so the diagnosis is wrong and the treatment would be different.
  • Precancerous spots should be treated by your dermatologist like you’re doing!
See your doctor or dermatologist, if you get worse, or just don’t improve with these over the counter options!  🙂
Hope this helps,
Dr. B
Founder, SkinTour
Director, Madison Skin & Laser Center
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Dr. Brandith Irwin, MD

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Hi, I’m Dr. Irwin. I believe that consumers deserve a medically trained and unbiased skin care advocate.

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