If You're Dealing With A Flaky Scalp, Your Haircare Routine Needs An Update

If you have seborrheic dermatitis, a skin condition that causes redness, intense itching, and flakes on your scalp, you need a special hair routine to reduce those symptoms. As Benjamin Ungar, M.D., director of the Rosacea & Seborrheic Dermatitis Clinic and assistant professor in the department of dermatology at the Icahn School of Medicine at Mount Sinai, explains, seborrheic dermatitis can be caused by different things, such as an impaired skin barrier, immune dysregulation, and the overgrowth of the yeast that naturally lives on scalps called Malassezia. And there are different ways to treat it, depending on how severe your condition is.

But before you ask your doctor for the strong stuff, consider making a few product swaps and changes to your styling routine to see if they help stop the itch and flakes from falling off your scalp.

Avoid Irritating Ingredients

The key with your hair routine is to soothe, not add more irritation. That means avoiding ingredients that may worsen your seborrheic dermatitis, including harsh alcohols, strong fragrances, irritating exfoliants, and essential oils. Ungar says these ingredients can irritate the skin, disrupt the skin barrier, or, in the case of some oils, provide fatty acids that contribute to the growth of Malassezia yeast.

New York City-based board-certified dermatologist Hadley King, M.D., adds that you’ll want to be cautious with heavy oils, scalp oil, exfoliating scalp treatments, thick occlusive styling products, or strong clarifying products, as they may create an environment where Malassezia yeast can thrive. Exfoliating and clarifying products, King adds, can disrupt the skin barrier and increase irritation. With these products, it’s all about balance. “The goal should be to maintain a healthy scalp environment without stripping or irritating the skin,” she says.

Look for Anti-Fungal and Anti-Inflammatory Ingredients

For seborrheic dermatitis, Ungar recommends over-the-counter products with ingredients such as ketoconazole, zinc pyrithione, and selenium sulfide, which have antifungal properties that can reduce Malassezia overgrowth and keep symptoms in check.

King agrees and adds that these ingredients also have anti-inflammatory properties and can help control itchiness. Other ingredients to consider include salicylic acid, which Ungar says can help exfoliate the flakes, and niacinamide and ceramides, which are known to reduce redness and support your skin barrier. King adds that coal tar can help suppress fungus, decrease inflammation, and may reduce sebum production.

Several ingredients can be helpful. “We cannot cure seborrheic dermatitis, but we can manage it,” she says.

Use Warm Water, Not Hot

In general, we should not use hot water to cleanse our skin, no matter how good a hot shower can feel. This is especially important for anyone with seborrheic dermatitis, as Ungar explains that high heat strips your skin of its natural oils and compromises your skin barrier. “This can increase irritation, dryness, redness, and flaking, which may worsen seborrheic dermatitis symptoms and contribute to flares,” he says.

Hot water may also temporarily increase blood flow to the skin, which may intensify redness. “Lukewarm water is much gentler and helps preserve the scalp’s natural moisture balance,” King says.

Pat Hair Dry Gently

Yes, how you dry your hair matters — especially if you have seborrheic dermatitis. Ungar recommends drying your hair and scalp as gently as possible, as excessive rubbing can irritate the skin. It can also disrupt your skin barrier and worsen seborrheic dermatitis symptoms, including redness, itching, and flaking, he says.

King recommends gently patting the hair and scalp with a soft microfiber towel. If you’re blow-drying your hair, she says to use a low or moderate heat setting and avoid directing very hot air directly onto the scalp.

Avoid Heavy Styling

Hairstyles that cause tension and friction can irritate the scalp, while heavy styling products can cause buildup. Ungar advises against doing these things regularly to help prevent your scalp from flaking. “Leaving sweat, oil, and product residue on the scalp for prolonged periods may also contribute to discomfort,” adds King.

You’ll also want to avoid any scratching, picking, or aggressively trying to remove flakes, she says, as it can cause additional inflammation and potentially lead to a secondary infection.

Wash Hair Regularly

It’s important you don’t avoid washing your hair out of fear that shampooing will dry out your scalp. “Regular cleansing is actually important for removing excess sebum, dead skin cells, and product buildup,” King says. So wash on.

Be Consistent

Above all, consistency with your scalp-care routine is crucial. King recommends regularly cleansing with the medicated shampoo of your choice for best results — just be sure to check the instructions on the bottle. “Allow medicated shampoos to sit on the scalp for the recommended contact time, rather than immediately rinsing them off,” she says. When using conditioner, focus on hydrating the mid-lengths and ends of the hair rather than applying it to the scalp, so you don’t further irritate the skin or cause more issues.

When to See a Doctor:

If these tweaks to your routine don’t control the flakes, King says it may be time to see a dermatologist who can prescribe something stronger, like topical cortisone or another prescription medication. “Someone should see a dermatologist if their symptoms are persistent, worsening, or not responding to consistent use of the over-the-counter medicated shampoos,” she says. “They should also seek evaluation if they experience significant redness, inflammation, intense itching, painful lesions, crusting, or hair loss.”

Or if you have any questions, it’s always best to see a professional rather than self-diagnose. “Anyone with suspicion that they might have seborrheic dermatitis should see a dermatologist,” Ungar adds. “There may be prescription medications that can help achieve excellent control of symptoms. And because seborrheic dermatitis is a chronic condition that can sometimes worsen if untreated, ongoing evaluation and care is generally a good idea.”

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