Let me be clear: I am obviously not a doctor. I don’t even play one on TV. I am, however, a very good Google-er of random symptoms in search of a self-diagnosis. Real doctors are always impressed by the amount of knowledge I possess about diseases which I most definitely do not have. So when I started having these randomly greasy, itchy, flaky patches of skin on my scalp, I didn’t bother going to the dermatologist -- I just cracked open my computer and consulted the Diseases and Conditions tab at Mayo Clinic.org that I have open at all times.
I quickly ruled out psoriasis or eczema, in part because the flaky, scabby areas were concentrated only on my scalp, (and even then just in two tiny spots at the base of my neck) but also because I had never before exhibited any flaky skin symptoms. That left me with only one diagnosis: seborrheic dermatitis. It's a non-contagious, often recurring skin infection -- kind of a turbo-charged version of regular old dandruff. Hello? Is this thing on? Are you still with me?
Seborrheic dermatitis (seb-o-REE-ik der-muh-TI-tis) is a common skin disorder that mainly affects your scalp, causing scaly, itchy, red skin and stubborn dandruff.
Seborrheic dermatitis can also affect your face, upper chest, back and other areas of your body that have many oil (sebaceous) glands.
Common signs and symptoms of seborrheic dermatitis include:
• Inflammation (redness) of the skin
• Patchy scaling or thick crusts on your scalp
• Yellow or white flakes (dandruff) on your scalp or your hair, eyebrows, beard or mustache
• Red, greasy skin covered with flaky white or yellow scales on other areas of your body, including your chest, armpits, the area where your thigh meets your abdomen (groin) or the male scrotum
• Itching or soreness
Doctors don't actually know the root cause of seborrheic dermatitis -- but a fungus called Malassezia, a normal microscopic life form that grows in your skin's oily secretions may play a role in flareups. (BRB, throwing up at the idea that some random fungus is just casually living on my person like it's NBD.) Winter weather, stress, fatigue and certain neurological conditions can also cause a bout of seborrheic dermatitis.
Even though my flaky spots were small -- only two of them, each the size of a dime, they were crazy annoying and itchy. My hairdresser took a picture of them for me so I could see exactly what was going on, as they were at the back of my head -- but I'm not going to ruin your lunch by sharing them with you now! (There's a totally non-gross picture right here if you are curious.)
For starters, I used Neutrogena's T-Sal shampoo on the affected areas, and it helped a lot. T-Sal is formulated with 3% salicylic acid, which has been shown to be effective at breaking down the bonds between skin cells to help remove dead tissue. I use it only on the affected parts of my scalp and still slather my fancy-pants shampoo on the length of my hair.
While the T-Sal helped, it didn't completely solve the problem, so I kept turning over every rock in my life in an attempt to find the root cause of my scalp drama. After about a week, I realized that while I am an all-star obsessive hair washer, it would seem that I am not a very talented (or skilled) hair rinser. The area at the back of my neck (where my hair is thickest) is hard to rinse completely, and I often overlook it, which results in a mild shampoo and conditioner buildup -- the perfect kind of moist environment that Malassezia loves to thrive in. In short, I think I'm kind of a piglet?
The simple act of parting my hair in the back after washing and making sure I rinse all the shampoo and conditioner away has made a world of difference in my scalp health. It was instantly less flaky, crusty and itchy. But the thing that has really kicked my seborrheic dermatitis' ass is this little $5.00 hard rubber shampoo brush. It gets my scalp squeaky clean and works to break up any existing flakes pronto.
I use it to wash my hair (applying the shampoo directly to the brush) and it feels soooooo darn goooooood. I also use it during the rinsing phase on my problem spots to ensure I've gotten all the shampoo and conditioner off my scalp. As a result, my flakes are now totally gone -- and my scalp, which is a notorious grease pit, feels cleaner and squeakier than it has in years. Even if you don't have dandruff or dermatitis problems, it feels exactly like getting a scalp massage at the hair salon -- a total luxury for just five measly dollars.
While the (admittedly online) doctors say there is actually no way to prevent developing seborrheic dermatitis in the first place -- or of avoiding a recurrence of it once it's appeared -- I'm here to tell you that my triple threat routine of salicylic acid shampoo, proper rinsing and a $5.00 shampoo brush has completely banished my flaky, crusty, itchy scalp, at least for now. I've got my fingers crossed that it stays that way. This is Dr. Alison Freer, signing off.
Alison Freer is the author of 'How to Get Dressed: A Costume Designer's Secrets for Making Your Clothes Look, Fit, and Feel Amazing'.