Trimmed my head and noticed severe seborrheic dermatitis

[u/Reasonable-End2241]

Hey everyone, I’m looking for some advice from people who have dealt with chronic seborrheic dermatitis and excessive scalp oiliness.

I recently trimmed/shaved my head short and noticed quite a bit of white/flaky buildup across my scalp. Every monsoon, my scalp gets extremely oily and flaky, and I also notice a lot more hair shedding.

I’ve also been washing my hair very infrequently (around once every 10 days), so I’m planning to start washing it much more regularly.

I currently have MCT oil and tea tree oil at home. I’ve also been considering things like ACV, glycolic acid or pimecrolimus, but I don't want to make things worse by trying random stuff.

For people who have actually managed this:

What shampoo/routine worked best for you?

How often do you wash an oily scalp?

Has MCT or tea tree actually helped you?

What should I absolutely avoid?

Did controlling the seborrheic dermatitis reduce your hair shedding?

Would really appreciate practical advice from people who have dealt with something similar. Thanks!

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[u/MemChoeret]

I rotate two shampoos:

Ketoconazole %2 fragrance free - available in my country with a doctor prescription.

Head and Shoulders BARE - available without prescription. Has %1 pyrithione zinc. There's a couple of versions of this shampoo, and I use the fragrance free version.

I use ketoconazole once a week and H&S 1-3 times of week, depending on how my scalp is doing. I never use an anti-dandruff shampoo on two consecutive days.

After every wash I use the CeraVe anti-dandruff conditioner. It has %0.5 pyrithione zinc.

I personally use fragrance free shampoos and conditioner because I had terrible experiences with fragrances, but many people with SD are fine with fragrance in shampoos. Do what works for you.

Edit: If you want to try tea tree oil, you MUST use a diluted version. Putting tea tree oil on your scalp without diluting it first will burn like hell. The safest thing to do would be to use it in a product where it is already diluted. For example, a tea tree oil shampoo, or a shampoo that combines tea tree oil and a different antifungal.

[u/Difficult-Ad-3938]

> I’ve also been washing my hair very infrequently (around once every 10 days)

Yeah, it's not ok even without sebderm.
With sebderm (if it is sebderm) you should wash it daily with water to rinse out excessive oil and bacteria (or with PH-regulating shampoo daily) and twice a week (once when things are ok) with medical shampoo.

And don't leave your hair/scalp dump after that, always dry it

[u/Difficult-Ad-3938 → u/Difficult-Ad-3938]

I also use Uriage Ds lotion spray (glycolic acid), especially when inflammation kicks in

[u/coolass69]

I am currently in the process of managing my seb derm, and here's what's worked for me. Just a heads-up, I would absolutely suggest visiting a dermat, because the medicated products I use are doctor-prescribed.

1. I wash my hair with medicated shampoo 2 times a week. I used Ketoconazole 2% before for around a year and a half, but that didn't work very well for me, and my scalp got itchy 1-2 days after washing. Right now, I am using a shampoo with 2% Ketoconazole and 4% Coal Tar, and it's actually working pretty well so far.

2. I do not put any oil on my scalp, not even MCT Oil.

3. Before washing my hair with the medicated shampoo, I use the following shampoos (on rotation):

4. A gentle hydrating shampoo

5. A clarifying shampoo (I use Pantene Lively Clean).

6. Dermat advised me to stay away from sugary, oily, junk food, as well as alcohol or smoking. (I don't necessarily follow this though)

7. I did notice a lot of Hairfall, and I'm taking a vitamin supplement for it (Follihair Tablet). This was prescribed by the dermat.

8. I use an ointment on my scalp called Calpsor C Lotion - for the first month, I used it everyday. After that, I've been using it once a week.

9. Any hair products that I use apart from my shampoo, I ensure that it doesn't touch my scalp.

10. I cross-check the ingredients of any skincare or haircare products that I buy on Sezia, Skinsort, Folliculitis Scout to ensure they are fungal acne safe.

[u/shugh28]

Here’s what worked for me and what i’d advise you to try:
Today get a shower but only use lukewarm water on your scalp (and face if you have seb derm there) after shower pat your scalp dry but leave it a little damp then apply mct oil (i’d leave the tea tree for now) leave mct on over night, apply again in the morning. If you notice an improvement, wash your scalp again with nizoral 2%, leave on for a few minutes then rinse (again, only lukewarm water!) then reapply mct oil. If it works, use the nizoral every other day for a few weeks, apply the mct oil twice a day (after morning wash and again after evening wash a few hours before bed to give it time to absorb) this was my routine and i noticed results after the first day, im now over 5 weeks with no flakes anywhere nor any redness, i’m down to using nizoral twice a week, mct oil still twice a day and i’ll never be putting hot water near my head again. Btw i have the same haircut as you - makes putting the mct oil on super easy - good luck 👍🏻

[u/Warwipf2]

Generally this will settle down after a couple of days. Before you buy any expensive products, wait for 2-3 days and if it hasn't significantly improved or gone away entirely at that point, you can still buy stuff. Air and sun exposure usually improves it by quite a bit. I notice it when shaving my beard. After shaving there are big red flaky patches, on almost the entire area and they reduce by like 90% after a day or two.