Eczema often affects the scalp, causing significant distress, discomfort, and embarrassment. Flaking, itching, and hair loss can leave sufferers frustrated and self-conscious. Fortunately, there are treatments. Unfortunately, applying them to an area covered by hair isn’t always so straightforward. How can you ensure that you’re applying the product correctly?
Different types of eczema affect the scalp in different ways and require different treatment plans. We’ll look at the types of eczema that commonly affect the scalp, discuss their treatments, and share best practices for applying medication.
How Eczema Affects the Scalp
There are a few different types of eczema that affect the scalp. Symptoms can include dryness, itching, and scaling. Redness and other discoloration–either darkening or lightening of the skin–indicates inflammation. The affected skin can become crusty and ooze. Combing and brushing the hair sometimes results in inadvertent scratches, which can result in bleeding and scabbing of affected skin. .
Types of eczema that affect the scalp
Dandruff produced by seborrheic dermatitis may look like small, white flakes; it can also look like large sheets of dry, scaly skin similar to that seen on babies with cradle cap–in fact, cradle cap is a form of seborrheic dermatitis.
Affected skin may be red and scaly on light-colored skin; on darker skin tones, darkening or lightening of the skin might be seen instead. Lesions can take a shape similar to the petals of a flower, a phenomenon called petaloid seborrheic dermatitis.
This kind of eczema can also cause rashes and flaking around the eyebrows and eyelids; the sides of the nose is another area that is sometimes affected.
Treatment may include topical antifungal gels, creams, lotions, foams or shampoos; medications are sometimes alternated.
Anti-inflammatory creams or lotions are usually prescribed, too; these include hydrocortisone fluocinolone, clobetasol, and desonide. The latter two are very strong steroids, prescribed to rein in very stubborn or severe cases.
Calcineurin inhibitors such as tacrolimus or pimecrolimus are sometimes effective treatments, also. They are sometimes alternated with steroid creams to reduce the risk of steroid-related side effects.
If topical treatments don’t work, your doctor may prescribe oral antifungal medication. Seborrhoeic dermatitis can become infected, so it’s important to treat it promptly.
Atopic dermatitis is caused by a combination of immune overreactivity, compromised skin barrier, and an out-of-balance skin microbiome (your microbiome consists of several different microbes; when it’s out of balance, unhealthy numbers of bacteria and fungi can grow).
Atopic dermatitis can be triggered by extreme cold, excessive shampooing, or environmental irritants such as pollen. Topical steroid creams and calcineurin inhibitors are the usual treatments.
Atopic dermatitis is often unbearably itchy, and scratching can aggravate symptoms and cause infection. For this reason, it’s best to get flares under control as quickly as possible.
Contact dermatitis symptoms are similar to those of atopic dermatitis; the difference is that symptoms improve soon after the irritant is removed. Treatment usually consists of topical steroid creams.
Applying Cream to Scalp
Regardless of the type of eczema, it’s important to treat the skin–not the hair. This can be challenging, especially if your hair is very thick or highly textured. It’s still possible, though, with forethought and thoroughness.
Below is a method for applying medication to the scalp. If your doctor advises you differently, follow their advice instead:
Make a part down the middle of your scalp. From the front of your scalp to the back, apply your medication to the skin in the part, making sure that you are releasing a consistent amount of cream.
Make a part to the left of the middle part, another to the right, about two inches down from the first part. Once again, apply the cream down the skin of the part from the front to the back. Maintain steady pressure on the bottle or dropper to ensure that the product is dispensing evenly.
- Just above your ears on both sides, part your hair once more. Using the same technique as before, apply medication down the skin of the part.
As an alternative, you could part your hair ahead of time, using duck-bill clips to hold the parts in place before you begin.
Foams are sometimes prescribed instead of creams. The application process is much the same, except that the foam will be poured out from a bottle cap instead of dispensed from a dropper. Don’t try to apply foam with your hands; it’s designed to dissolve when it comes into contact with the skin. If you need help getting it out of the cap onto your scalp, you might want to use something to help you scoop the medicine out as you go. Otherwise, use the very tips of your fingers to quickly rake the foam onto the scalp.
Important: Do not apply scalp medication to eczema on your face, eyebrows, or eyelids without your doctor’s approval! These areas often need lower potency steroids or different treatments altogether.
Managing Eczema on the Scalp
To get the best results from your treatments, support them with some good self-care practices.
Avoid triggers. This includes hair care products, allergens, and soaps that aggravate your eczema
Treating eczema on the scalp can be more involved, but it is doable. Follow your doctor’s guidelines precisely, and take care to get your treatments onto the skin where they belong–not the hair. Watch out for irritating hair care products, and don’t overstyle your hair during flares.
Be aware that eczema isn’t the only condition that can cause itching and dryness. Fungal infections (like ringworm) and psoriasis can also cause these symptoms, but they require different treatments. Ask your doctor if you’re not sure!
Prescription treatments are powerful and effective. However, some symptoms may linger during treatment. SmartLotionⓇ eczema cream is a great tool for addressing these refractory symptoms. It’s formulated with three different prebiotics to balance the microbiome of the skin, which makes it harder for microbial organisms like Malassezia yeasts to overpopulate the skin.
It’s also an effective treatment for inflammation, thanks to the small amount of hydrocortisone it uses. At .75% hydrocortisone, this low-potency preparation will not cause topical steroid withdrawal or atrophy. It gives eczema sufferers a greater level of control over their symptoms, and under a doctor’s guidance, it can often be used in concert with other treatments.