5 Habits To Avoid If You’re Dealing With Seborrheic Dermatitis

When you’re dealing with any scalp issue, whether it’s product build-up or itchiness that occurs out of nowhere, treating it can involve a lot of trial and error. And there’s even more error when you have seborrheic dermatitis, a scalp reaction that can be hard to pinpoint—mostly because it can be mistaken for dry scalp and inflammatory conditions like psoriasis. So, for starters, unless you sort out the case of mistaken identity, you might be doing all the wrong things to treat it. And to make matters even more complicated: Even once you figure out you’re dealing with seborrheic dermatitis, the path to relief is rarely a straight line. You might have to test out different ingredients to get your symptoms under control, or level up to prescription-strength stuff. So it’s easy to mess up when you’re just trying to make your scalp happy.

The good news is that understanding seborrheic dermatitis and what causes it can help guide you. Seborrheic dermatitis is “an inflammatory reaction to a yeast called Malassezia that lives on everyone's skin,” says Michael Tassavor, M.D., a board-certified dermatologist in New York City. “In people who are susceptible, the yeast's byproducts — it breaks down skin oil into irritating fatty acids — trigger redness, flaking, and itch in the oiliest areas, like the scalp, eyebrows, beside the nose, and ears.” That’s not totally different from other scalp concerns that cause flaking. So it can be more helpful to think of them as a spectrum of conditions versus separate, individual diseases, says Tassavor. You have dandruff — flaking with minimal inflammation — on one end. And at the other, more severe end is psoriasis, with thick, silvery, or sharply outlined plaques. “Seborrheic dermatitis, in the middle of the spectrum, has thinner, greasier, yellowish scales with soft borders,” he says.

It’s also helpful to remember that seborrheic dermatitis can’t be cured. “It’s a chronic, recurring condition,” says Sejal Shah, M.D., a board-certified dermatologist in New York, NY. So the treatment should focus on managing your symptoms and controlling your flares — not eliminating it forever. Here’s what to avoid when you’re on a mission to get a clear, comfortable scalp.

Don’t: Keep Moisturizing

When you see flakes, you might think the issue is dryness — understandably. But “seborrheic dermatitis isn’t simply a case of having a dry scalp,” says Shah. “Reaching for moisturizing products, particularly oils, may seem like the logical solution, but these products aren’t necessarily helpful and may even worsen the condition for some people.”

That’s because, like a domino effect, the yeast that causes seborrheic dermatitis feeds on these oils, producing byproducts that, in turn, make the condition worse, according to Tassavor. So oils like olive and coconut should be a no-go — since they are, essentially, giving that yeast a nice buffet. Moreover, “heavy, occlusive styling products and pomades at the scalp and hairline can trap oil against the skin,” he says. Again, this only fuels the seborrheic dermatitis.

Don’t: Scrub or Pick Your Flakes

If you can feel the build-up or scaliness on your scalp, you might be tempted to get ahead of the flakes and pick them off. It might feel productive, like you’re clearing your scalp, “but it does the opposite, injuring the barrier and driving more inflammation,” says Tassavor.

Whipping out a scrub or scalp toner isn’t a better way to get rid of flakes, either, because seborrheic dermatitis isn’t a hygiene problem. “People see flakes and assume their skin is dry and dirty, so they moisturize with oils and scrub harder — the two things most likely to make it worse,” says Tassavor. “It has nothing to do with being unclean.” Everyone has this yeast on their scalp, but only some people are sensitive to its byproducts.

Don’t: Go to Extremes

To wash your hair or not to wash your hair — it can be a big question when you have flakes. If you’re tempted to start washing your hair less and give your scalp a break, that’s not always the best approach. “When the scalp feels dry, washing less frequently may seem like a good way to preserve its natural oils,” says Shah. “However, with seborrheic dermatitis, infrequent washing can allow oil and product buildup to accumulate on the scalp, potentially worsening symptoms.”

But on the flip side, it’s also not a great idea to suds up with all kinds of shampoos every day, which may only trigger more inflammation. Ultimately, there’s no right frequency for everyone. Rather, seborrheic dermatitis thrives with moderation — think regular, gentle, medicated washing, says Tassavor.

Don’t: Phone in Your Treatment

If your dermatologist has recommended a medicated shampoo or topical treatment — which are often the first options for seborrheic dermatitis — treat it like any other medication. That starts with following the directions, which usually involve leaving it on the scalp longer than your average shampoo. If you rinse it out after a few seconds, you’ll miss out on its benefits. “It's a treatment, not a shampoo — lather and leave it on for about five minutes so the antifungal can actually work, then rinse,” says Tassavor. Treat it like a hair mask: apply it, then wash your face or shave your legs before you rinse it out.

Also, make sure you actually work it into the roots and scalp instead of lathering it through the lengths of your hair. “Because seborrheic dermatitis affects the scalp, the medication needs to reach the affected skin to work effectively,” says Shah. Focusing on the midlengths and ends of your hair will only waste the product — and also keep you from getting relief as quickly.

Don’t: Expect Instant Results

Finally, don’t give up before your treatment has had a chance to work. “The goal is control: an antifungal to keep the yeast down, something to calm inflammation, and then a maintenance routine so it doesn’t come straight back,” says Tassavor. “Give a proper routine two to four weeks of consistent use before judging it.”

You can always start with an over-the-counter antifungal shampoo. If, after a few weeks, you don’t see improvement in your symptoms, or if you’re not sure whether you’re even dealing with seborrheic dermatitis in the first place, make an appointment with a dermatologist. “A dermatologist can confirm the diagnosis, rule out other conditions that may cause similar symptoms, and recommend an appropriate treatment plan to help manage the condition and prevent recurrent flares,” says Shah.

Also, see a derm if the plaques are thick or spreading, if they appear on places besides your scalp and face, or if they’re accompanied by hair loss, pain, or weeping skin. “Those are reasons it may not be simple seborrheic dermatitis, or may need prescription treatment,” says Tassavor. They can give you the best guidance on how to treat it right — so you can put an end to the flakes once and for all.

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