Question for scalp itch

[mamaherrera]

I don't think it's seborrheic D, but maybe I'm wrong. Yesterday was a wash day. While it was still damp I did an updo. After like six hours, I took it down, was getting ready for bed and I had this stubborn itch, you all know what I'm talking about. so I asked my daughter to take a look, she said I had lots of white flakes/like white pieces of skin and there were still small circular patches around my hairs, stuck to my scalp. Anyone who has had this know what it is?? I can't believe if it's like shed skin, why didn't it come off with my wash??? You'd think I'd be clean for at least a day?? Is it product?? I'm confused, and I know, many will say go to the doc. But the docs here are no good. They look at your scalp for a minute, they tell me, it's clean. So no, I'm trying to find out by other people's experiences, observations, and trial and error. So thanks for those are willing to share their knowledge with me.

[Panth]

Seborrheic dermatitis can look like that, but I'd expect the itching to be prolonged/recurrent. If it is SD (or any other relatively minor fungal-based problem) you can effectively treat it with 2% ketoconazole shampoo, which can be bought over the counter without prescription (at least in the UK, possibly you can only get 1% without prescription in the USA, but that should still work). Used exactly as per the instructions, it should clear things up.

In my experience, that's what a GP recommends anyway for all scaley/itchy scalp conditions - try 2% ketoconazole and if you still have a problem after you've used the whole bottle according to the instructions, come back and we'll try something different.

[lapushka]

try 2% ketoconazole and if you still have a problem after you've used the whole bottle according to the instructions, come back and we'll try something different.

I'd try the Nizoral as well, if I were you. Stick with it though, don't just try once and expect it all to go away. Use it at least a couple of times before drawing conclusions. You are supposed to smear it on your scalp (suds it up a little), leave it to soak for 5 minutes, then suds up (wash) and rinse.

[mamaherrera]

I will. Like you said, I tried it once, and then yesterday used my regular shampoo. And yes I need to leave it on longer. Now that my daughter scratched/removed those scales, today my scalp feels itchi-er/raw. . . . I guess I shouldn't have scratched!

[meteor]

I agree with Panth's and lapushka's recommendation, if it's SD.

Also, I wonder if it could be an allergy to something in your shampoo - the change from normal scalp to flaky/red happened pretty fast after a wash...
Are you using new products by any chance?
Also, it could be a reaction to damp-bunning and keeping hair wet for so long - if this is the first time you've tried damp-bunning... it doesn't work for everyone. My scalp always itches if I leave it wet for too long in an updo.

[mamaherrera]

very good point, I rarely never ever do damp bunning. But I still have to be honest, I have had scalp itchies and flakes before, so maybe one bothered the other condition.

[Panth]

I will. Like you said, I tried it once, and then yesterday used my regular shampoo. And yes I need to leave it on longer. Now that my daughter scratched/removed those scales, today my scalp feels itchi-er/raw. . . . I guess I shouldn't have scratched!

The Nizoral / 2% ketoconazole shampoo needs to be used exactly as directed. IIRC, that is: later shampoo into hair, making sure to get lather onto as much of scalp as possible; leave on for 5 minutes; rinse out; use any conditioner/leave-ins as usual; use shampoo every 2 days (using regular shampoo in between if you wash more often than that); once the scalp condition is gone, if it has a tendency to be recurrent, use the shampoo (with the 5 mins leave-on step) approx. once a month to maintain an infection-free scalp.

Definitely do not itch the scalp. It is quite possible to itch it completely raw without stopping the itching feeling (I've done that...). Not only does that not help the healing process, it leaves the scalp vulnerable to secondary infections which can further complicate things. If I really want to itch, I tend to firmly tap the area instead of itching - lets you do something with your hands without risking damage to the scalp.

[brickworld13]

Panth has some good tips about scratching. I've itched myself into raw sores without realizing it. It was horrible. Knocking on the offending spot with your knuckles will help or smacking it like they instruct with new tattoos. No nails or you will make it raw.

[mamaherrera]

So this is not the time to dilute the shampoo (nizoral) with water??? Or will it still be as effective?

[meteor]

So this is not the time to dilute the shampoo (nizoral) with water??? Or will it still be as effective?

I think medicated shampoos are not supposed to be diluted or it will reduce their effectiveness.

I think if you worry about drying out your hair in the process, you can cover the ends with a neutral conditioner or maybe mineral oil (since it's not supposed to affect SD, unlike many natural oils).

[Panth]

So this is not the time to dilute the shampoo (nizoral) with water??? Or will it still be as effective?

Definitely do not dilute the shampoo. As you rightly suspect, it'll make it less effective (as you're reducing the ketoconazole concentration).

In my experience, even though Nizoral and other similar formulations are SLS shampoos, they are fine to use just with a regular routine as you only use it for a bottle-worth and are focusing the shampoo on the scalp. If you are really concerned, there is an SLS-free brand of 2% ketoconazole shampoo that you can buy on the internet, but it's really expensive. As meteor says, you could do a CWC-type routine to try to protect your length if you were feeling super-paranoid. IMO, I'd not use any oil - the yeast eats oils (sebum is its natural food, but other oils applied to the scalp can exacerbate the infection by promoting growth). I'd personally prefer just to avoid all oils (except maybe for applications to the ends of the hair) at least until the infection is cleared up. I'd probably avoid putting oil anywhere near my scalp for a good while after, possibly permanently (depending on whether the SD has a tendency to recur or not).

[mamaherrera]

YOu know what and thinking of that, last week I put coconut oil on the scalp and after that, this got worse. So no oiling hair for people like us? I mean, do you all not oil your hair before washes, like pre-oiling, or just up to the ear like conditioner? And I Just saw on another post that someone said that they have "dry scalp" right out of the shower that causes flakes and gets worse throughout the week. How the heck do we determine if what we have is dry scalp or SD??? That's always been my thing.

[lapushka]

No oil on your scalp. Seriously. This is not something to mess about with, you know. And no diluting either. Yes a sulfate shampoo can be somewhat drying, but you could always try and condition twice. That's what happens with me, and I love it! (WCC see signature)

[hennalonghair]

Yes it sounds like you have SD. I've had this a few times in my life also.
All the info given here for the condition is good advise. The last thing you need is oil on your scalp. It will definitely worsen your condition. No damp bunning or braiding. Try to keep the scalp as dry as possible.
Do you brush your hair? My problem started when I stopped brushing my hair.
The problem cleared up when I started using a bbb again.
I also used some essential oils on my scalp which are antifungal like tea tree oil, neem oil, peppermint or a drop or two of oregano oil. There's many shampoos that have these EO's in them. Other things that work extremely well are:



Original listerine: pour a capful and dab areas with cotton balls or pads dipped in it
ACV works great on scalp. Full strength is needed. Use cotton ball method.
Pure lemon juice. Works well but can be very sticky and quite drying to hair.
And lastly diluted borax. Mix 2 tbsps with 1 litre of warm water and pour over scalp.
Many people think this is horrible on hair but it actually isn't.
You just need to dilute it properly. The pH means per hydrogen.

There's a shampoo called theraneem which is all natural that works great.
Anything with sulphur in it will work also but is really harsh on hair but like someone else mentioned condition your hair first from ears down , leave the conditioner in your hair while you are treating your scalp so that you save your hair.

I used to have this problem often in the past but haven't had it for years now. If you have thick hair then you have to let your hair breath. Sometimes having it up all the time can aggravate the condition . Using a good bbb works good also BUT you HAVE to make sure its cleaned daily. This IS contagious meaning if you don't wash your hair toys and tools you risk spreading it.

[Georgii]

Research into Tea Tree Oil? It is an unconventional route but it works wonders. I hear it also works wonders for scalp problems but you may want to research it to double check :)

[hennalonghair]

This was meant for this thread. Somehow I mixed up my threads.

My response is at the bottom

Sorry about that meteor
http://forums.longhaircommunity.com/showthread.php?t=126916

[Panth]

YOu know what and thinking of that, last week I put coconut oil on the scalp and after that, this got worse. So no oiling hair for people like us? I mean, do you all not oil your hair before washes, like pre-oiling, or just up to the ear like conditioner? And I Just saw on another post that someone said that they have "dry scalp" right out of the shower that causes flakes and gets worse throughout the week. How the heck do we determine if what we have is dry scalp or SD??? That's always been my thing.

Yup, if oil applications on the scalp made it worse then a yeast-based scalp problem is very likely to be the cause. As I said, the yeast lives off oils, so if you put oil on your scalp (and leave it on) then you are just adding fuel to the fire.

Personally, I just don't oil the scalp ever. However, it should be fine to either a) oil the length only (I'd probably go jawline-down or shoulders-down, as I suspect ears-down would still result in a good amount of oil getting onto the scalp at the nape) or b) if oiling the scalp, do not leave the oil on for any length of time (this removes the possibility of deep treatments - you could only do things like oil+scalp massage, then immediately wash your hair - it would also make coconut oil based treatments and other penetrating oil treatments fairly pointless, as they require a fairly long application time to be able to penetrate).

As for dry scalp (e.g. scalp eczema) vs. SD. Well, SD (in my experience) tends to be a more clumpy, waxy sort of "dandruff". Particularly in bad cases, it results in red, welt-like areas (patches, often not the whole scalp) that can be raised, inflamed-looking and may be associated with the scalp skin shedding in a way similar to cradle cap. In really bad cases you can get sort of "mushy" scalp that you can just itch and itch and ... you just keep itching it off and it's still mushy under there. Very gross. It's also often associated with elevated shedding.

The main test, though, is how it responds to treatment. Dry scalp (and especially scalp eczema) is treated by moisturising the scalp skin (with emollient creams, or with oils). SD is aggravated by using oil or creams with oils/fats in on the scalp. It is treated by using medically indicated antifungal shampoos (not just "anti-dandruff" shampoos like Head & Shoulders, but proper buy-at-a-chemists / on prescription stuff, e.g. Nizoral).

[Squiggy]

My goodness, you all are just describing my scalp! I've always just thought it was dry and itchy, but Panth's mention of cradle cap got me - I have some patches that look exactly like cradle cap (which is pretty nasty, let's be honest).

I had been using a shampoo with tea tree and peppermint oil in it, and my scalp was much happier. Then I switched, because I couldn't find it at the store and my scalp immediately flared up! I think I'll look for some Nizoral and see if I can get this under control. I know my scalp is always itchier and more uncomfortable in the colder months, which are just around the corner!

[meteor]

Just wanted to come back to this thread to say that if Nizoral doesn't work for you, you should probably see a dermatologist. A lot of the over-the-counter products are low-concentration, so they are great for mild cases, but if they doesn't clear it up, get a doctor to examine your scalp.
Apart from ketoconazole, you might want to look for shampoos with ciclopirox, selenium sulfide, zinc pyrithione, coal tar, salicylic acid - and they work differently... so it's best to get a doctor's opinion instead of wasting money trying out all the different shampoos out there.

Also, I need to caution you against using undiluted lemon juice and ACV. Lemon juice has ph of around 2 and ACV has ph of around 3... that's extremely acidic, and it's critical to keep your scalp's ph balanced throughout this. Dermatitis is "inflammation of skin", so you don't want to destabilize your skin further by messing up its ph too much. Undiluted lemon juice and vinegar is also extremely drying on hair if left on for too long.

More generally, put as little on your scalp as possible.

The key is to keep your scalp very clean and dry: clean of sebum and clean of oils rich in oleic acid (e.g. olive, almond, etc) that feed Malassezia fungus.

SD/"cradle cap" is not contagious, its a fungal/yeast problem.

If your hair is very dry and you are really scared of drying it out while washing with anti-fungal shampoo (which you'll need to do regularly for now), try to get conditioner of the same line: this way you'll know that the conditioner won't have some ingredients in it (natural oils/butters) that could be counter-productive for SD. If your hair is extremely dry and you feel like you really need to use oils on hair, switch to anti-fungal ones: neem oil, tea tree oil, etc. Mineral oil and silicones don't feed Malassezia fungus, so they might be useful for keeping hair moisturized while you are attacking SD with medicinal shampoos. Do avoid conditioners with oils rich in oleic acid - oils travel up and down hair shaft very easily.

Best of luck getting it under control! :D And happy growing! :D

Some information you might find useful:
http://www.mayoclinic.org/diseases-conditions/dandruff/basics/causes/con-20023690
http://www.patient.co.uk/health/seborrhoeic-dermatitis-leaflet
http://dermnetnz.org/dermatitis/seborrhoeic-dermatitis.html
http://www.nature.com/jidsp/journal/v10/n3/full/5640230a.html

[lapushka]

Just wanted to come back to this thread to say that if Nizoral doesn't work for you, you should probably see a dermatologist. A lot of the over-the-counter products are low-concentration, so they are great for mild cases, but if they doesn't clear it up, get a doctor to examine your scalp.
Apart from ketoconazole, you might want to look for shampoos with ciclopirox, selenium sulfide, zinc pyrithione, coal tar, salicylic acid - and they work differently... so it's best to get a doctor's opinion instead of wasting money trying out all the different shampoos out there.

Also, I need to caution you against using undiluted lemon juice and ACV. Lemon juice has ph of around 2 and ACV has ph of around 3... that's extremely acidic, and it's critical to keep your scalp's ph balanced throughout this. Dermatitis is "inflammation of skin", so you don't want to destabilize your skin further by messing up its ph too much. Undiluted lemon juice and vinegar is also extremely drying on hair if left on for too long.

More generally, put as little on your scalp as possible.

The key is to keep your scalp very clean and dry: clean of sebum and clean of oils rich in oleic acid (e.g. olive, almond, etc) that feed Malassezia fungus.

SD/"cradle cap" is not contagious, its a fungal/yeast problem.

If your hair is very dry and you are really scared of drying it out while washing with anti-fungal shampoo (which you'll need to do regularly for now), try to get conditioner of the same line: this way you'll know that the conditioner won't have some ingredients in it (natural oils/butters) that could be counter-productive for SD. If your hair is extremely dry and you feel like you really need to use oils on hair, switch to anti-fungal ones: neem oil, tea tree oil, etc. Mineral oil and silicones don't feed Malassezia fungus, so they might be useful for keeping hair moisturized while you are attacking SD with medicinal shampoos. Do avoid conditioners with oils rich in oleic acid - oils travel up and down hair shaft very easily.

Best of luck getting it under control! :D And happy growing! :D

Some information you might find useful:
http://www.mayoclinic.org/diseases-conditions/dandruff/basics/causes/con-20023690
http://www.patient.co.uk/health/seborrhoeic-dermatitis-leaflet
http://dermnetnz.org/dermatitis/seborrhoeic-dermatitis.html
http://www.nature.com/jidsp/journal/v10/n3/full/5640230a.html

Very nicely explained. Thanks meteor & Panth as well!

[Horrorpops]

This has been a problem for me too, but is due to a medication I am taking (accutane). My scalp is just super auper dry and I get the symptoms you list - mainly and itchjng then flaking of the scalp. I've found a scalp massage with a small amount of oil (coconut, olive or rice bran) has really reduced my flakiness, and my scalp jo longer itches.

Still agree with PPs on the SD treatments etc, but sometimes I think scalp can be dry and a bit of moisture can help. As always YMMV :)

Goodluck!!

[hennalonghair]

No contagious isn't the right word. Since its a fungal /yeast infection it can spread to other areas of the body.
The holistic approach isn't for everyone but it worked great for me.
I haven't had SD in almost 3 years now.

[meteor]

Horrorpops, I think the difficulty with itchies and dandruff is that they are only symptoms that can point to many very different conditions - from allergies to xerosis (dry scalp) to SD etc., and we can't diagnose it here... And for some of these conditions, oils can be very helpful while for other conditions - they can make it worse.

The problem is further complicated by the fact that oils rich in oleic acid often provide initial soothing relief in case of SD, but are ultimately counterproductive in case of SD.
So if you love oils on scalp but have some unidentified flaking/itchies from time to time, then I'd suggest at least sticking with anti-fungal oils (e.g. neem). And immediately getting a medicated shampoo or visiting a doctor if it flares up. :)

[hennalonghair]

Horrorpops, I think the difficulty with itchies and dandruff is that they are only symptoms that can point to many very different conditions - from allergies to xerosis (dry scalp) to SD etc., and we can't diagnose it here... And for some of these conditions, oils can be very helpful while for other conditions - they can make it worse.

The problem is further complicated by the fact that oils rich in oleic acid often provide initial soothing relief in case of SD, but are ultimately counterproductive in case of SD.
So if you love oils on scalp but have some unidentified flaking/itchies from time to time, then I'd suggest at least sticking with anti-fungal oils (e.g. neem). And immediately getting a medicated shampoo or visiting a doctor if it flares up. :)

EXACTLY! Great post. It can be a sign of an underlying illness.
Also its confusing to the average person because when most people think of dry itchy scalp they do often add things to it that make it worse. Plus there's about 5 different types of dandruff which just adds to the confusion.
SD is almost like dandruff on steroids. Someone described what it's like in this thread that was spot on. Little dry patches that when picked can become raw and sore and it itches.
I've had scalp issues for most of my life and I didn't figure out what it was until about 3 years ago.
At that time in my life I was devastated because I also lost a lot of hair through shedding so I honestly feel for anyone going through this.

Good luck mamaherrera !

[mamaherrera]

I have had issues too, I almost wonder if it is contagious because my daughter (11) has terrible dandruff/something, and my husband has used my combs to take off the "crap" off her scalp. so I washed my combs. But I find, that I always do oil in my henna (temple area) and oil massages on my temples/bangs and I rarely have issues there. It's mostly the back of my scalp and top of my head that get this issue, but maybe I will have to switch conditioners, because I use TREsemme (I LOVE IT) and it has avocado oil. ANyone have any good, moisturizing conditioners that you know of that don't have cones and don't have irritating stuff for SD?? Maybe it's because I've been trying to conditioner more my hair, to detangle (i've been doing much better at detangling) and so like someone said, the oils travel up and not out of my hair, thus they get to my scalp. Gosh, it's gonna be hard to find a conditioner that fits in those qualifications. Any known ones you all have in mind would help so much.


thanks to everyone for advice, I have been shedding more, but part of it because it's fall. Why does SD cause more shedding?? Is it from the scratching, or just the unhealthy scalp?? Mine sounds just like yours "hennalonghair" because they are little dry patches. Can you get neem oil at a store??? I do need an oil I can put into my henna mix, any suggestions for that too??? Man, this is such a bummer, but thanks!! Wish me luck getting through this. SO Nizoral twice a week, or every time I wash (which is three times a week). For you all that have SD, does that mean you have to wash more frequently or just use the right stuff??

[meteor]

mamaherrera, yes, one can definitely shed more due to SD, unfortunately. :( It usually happens when SD is at a pretty serious stage.

I can't make any conditioner recommendations because it's such an individual search - it depends on where you live, plus you need to find something that works specifically for your scalp. How about experimenting with catnip rinses or a couple drops of mineral oil on length as a way of replacing conditioner? Or you could look for very simple conditioner formulations, so you can rule out anything that may be causing a reaction. If anti-dandruff shampoo lines have matching conditioners, I'd try them first, because I would guess that they are less likely to contain ingredients that would make SD worse.

Neem oil can be found in Indian stores and in gardening stores. I find it excellent for problematic scalps/skin. It's not only anti-fungal, anti-bacterial but also very moisturizing, so you don't risk drying out your skin/hair, unlike with many other products. Unfortunately, it smells very, very strong - like burnt garlic or something.
Stuff like honey rinses / aloe vera rinses might give your scalp some nice relief, as well. They probably won't help with severe cases, but are quite effective against mild irritation.

[mamaherrera]

Any info on how to make a honey rinse?? I do have that. I also have aloe vera ,but do you mean like put it on as an after shower rinse and leave it on?? OR do you rinse it out?? as far as shampoo, well for anyone wanting to take the risk of recommending, I need a moisturizing one, no protein, but that would not have oils/butters in it. IN the past I've done ok with Tresemme naturals, because I only do up to the ears, but trying to detangle better and get farther up, I think has exacerbated the problem. but yeah, just a moisturizing conditioner with no oils.

[meteor]

For honey/aloe rinse, just dilute it in enough water to make it easy to apply, slather it on scalp and wash it off after a few minutes. Either before shampooing or after. :)

[hennalonghair]

I highly recommend neem as treatment also. It is less drying than peppermint, tea tree or oregano oil and is super soothing. It does have a bit of a funky smell but not too bad.
Here is a therapy shampoo and conditioner that works incredibly well. It would be beneficial to read some of the reviews on this. You'll find all kinds of people with SD who used this with great success. It's SUPER gentle and won't dry your hair out at all. You seem to lean towards more holistic haircare so I think you'll be really happy with it.*
http://www.amazon.com/gp/aw/d/B00020DY2O?pc_redir=1412265913&robot_redir=1

[mamaherrera]

I' have it actually. It's like two years old, don't know if it would still be good?? But at least it has a pair conditioner with it. THat I don't have. I might have to throw it and get fresh. Thanks, and I guess tea tree conditioner by Giovanni might be another one to pair with my nizoral for now. Do you use that shampoo now to keep SD warded off?

[hennalonghair]

It's probably still good and Giovanni makes great products.
Yes I use it about once a month plus every 2 weeks I add 2 drops of neem oil along with some peppermint oil into my henna paste when I do my roots and I always do an ACV rinse every time I clean my hair.
And yes I absolutely believe all of this helps.
I also never go to bed with wet hair, style hair when wet, and I brush and massage my scalp daily.
You'll clear it up I have no doubt.

[mamaherrera]

Thanks, I'll keep you informed of my trials and errors. I don't brush, not cuz I think it pulls hairs out but rather because I want to keep my curl formation. But I try and scalp massage when possible. Or I use a shower "scritch" comb when showering just to do like a little "scratching" when showering, but very light. And I hate styling wet hair too, my hair is just too fragile at that point. I don't think I can handle ACV rinses, just the smell will have me knocked out in the shower. But I will look for neem oil (indian stores, someone said) to my henna paste. Those oils don't need to be mixed in a carrier oil then, just straight as they come into the henna? How often do you wash?

[hennalonghair]

If you're going to ditch any part of your haircare routine it would be the Dove creamy cleanser. If you're susceptible to 'these' types of scalp issues then the last thing you want to use is something with a creamed cleanser.
When my scalp problems were the worst was when I switched to WEN creamed cleanser. I'm not saying these shampoos aren't good, I'm just saying they aren't suitable for people like us.
Oddly enough the other thread that I got confused with yours has a member with the same issues and she's using Dove shampoo. Yes it might just be a coincidence but I don't think so.

[hennalonghair]

I only wash my scalp with shampoo about every two weeks because I henna my hair every two weeks and don't wash it then because the conditioner on my length and henna pack on my roots I find enough there to gently cleanse. I might do I diluted shampoo rinse but at the most once a week. My hair doesn't get that dirty so it works for me. My hair is usually up during the day and/or braided.

[mamaherrera]

Just an observation: If I sweat, from exercise, those "areas" that itch, start to itch. As soon as they feel sweat on them: does that sound like SD or dry scalp? Still so undecisive!

[Panth]

Just an observation: If I sweat, from exercise, those "areas" that itch, start to itch. As soon as they feel sweat on them: does that sound like SD or dry scalp? Still so undecisive!

IMO, if it was an immediate itching sensation on scalp that wasn't already inflamed, then I'd think it's just "one of those things". Lots of people find the feeling of cooling sweat on any skin itchy - perhaps because it is salty?

Of course this, like all of my advice, is not that of a medical professional. Just a best guess from a somewhat obsessive amateur. ;)

[mamaherrera]

No thanks, I appreciate it. IT's just sharing observations and opinions. So if SD is kind of inflamed to begin with , anything that wets the area makes it worse?? But that doesn't mean I should wash after every sweaty exercise, right, because overwashing aggravates SD too?? It's such a fine line with this stuff.

[Panth]

No thanks, I appreciate it. IT's just sharing observations and opinions. So if SD is kind of inflamed to begin with , anything that wets the area makes it worse?? But that doesn't mean I should wash after every sweaty exercise, right, because overwashing aggravates SD too?? It's such a fine line with this stuff.

I think it's not wet per se that aggravates it, but leaving the scalp wet. That can aggravate it. If it is SD, leaving sweat in the hair / on the scalp is also a bad idea as the yeast (again) can feed off that too.

Basically, you want to dry your scalp area quickly after it is wet, via whatever method you like (leaving hair loose, or using a hairdryer, or sitting in the sun / in front of a warm fire ... whatever). You can leave the length wet/damp to dry naturally if you like.

[mamaherrera]

Now I wish I wouldn't have read that :D, because I just showered and didn't wash my hair, since tomorrow is my normal wash day. Obviously now that I'm actively trying to wittle my waist, I plan to sweat daily and I really don't want to have to wash my scalp daily. I hope it can handle a little sweat. At least for tonight!! But if I do continue to sweat daily, you do think it's best to wash daily then, shampoo I mean?? And should it be dandruff shampoo daily or no?? Thanks for helping me sort all these questions out, I do really want to get actively better with scalp health.

[lapushka]

I have had issues too, I almost wonder if it is contagious because my daughter (11) has terrible dandruff/something, and my husband has used my combs to take off the "crap" off her scalp. so I washed my combs. But I find, that I always do oil in my henna (temple area) and oil massages on my temples/bangs and I rarely have issues there. It's mostly the back of my scalp and top of my head that get this issue, but maybe I will have to switch conditioners, because I use TREsemme (I LOVE IT) and it has avocado oil. ANyone have any good, moisturizing conditioners that you know of that don't have cones and don't have irritating stuff for SD?? Maybe it's because I've been trying to conditioner more my hair, to detangle (i've been doing much better at detangling) and so like someone said, the oils travel up and not out of my hair, thus they get to my scalp. Gosh, it's gonna be hard to find a conditioner that fits in those qualifications. Any known ones you all have in mind would help so much.

SD doesn't have to occur over the entire scalp, it can be local flare-ups as well! So mind that.

[mamaherrera]

I gotcha there, I think I have certain little patches that are stubborn, but then if I do sweat daily, does that mean I need to do a WO only shampoo wash daily, leaving no sweat at all?? Just wondering for those of you who it and control it?

[lapushka]

I gotcha there, I think I have certain little patches that are stubborn, but then if I do sweat daily, does that mean I need to do a WO only shampoo wash daily, leaving no sweat at all?? Just wondering for those of you who it and control it?

Well, I'm disabled, so no working out (impossible) and that means no sweating. I don't sweat through my scalp, basically. I did however have SD in a small patch instead of over my entire head (as is usual) one time. I needed to bust out the Nizoral for that one, and yes my entire head got treated. It's hard to get at those tiny patches otherwise.

I'd not WO, but just leave it until you can wash fully. And maybe wash more often. Instead of twice a week, say every 2nd to 3rd day. I mean, as an example.

[mamaherrera]

gotcha, thanks for helping me try out something a little better for my scalp!! I appreciate it!

And let's say I wash every 2/3 day (I'm going to try and do it less the better since I henna weekly and don't want to add to the drying) but should every time be this Nizoral shampoo for like a month?

[lapushka]

gotcha, thanks for helping me try out something a little better for my scalp!! I appreciate it!

And let's say I wash every 2/3 day (I'm going to try and do it less the better since I henna weekly and don't want to add to the drying) but should every time be this Nizoral shampoo for like a month?

You need to use Nizoral twice a week (as per the instructions) and for about I'd say a month, yes. After that you need to see what the status is with your scalp. I can keep off the Nizoral by using a harsh cleanser once a week (but I can't go longer than that or it returns and I can't use sulfate free or a milder cleanser or it returns as well). Harsh cleansers really help keep it in check for me and so I can get away with washing weekly (instead of twice a week). But this is something I've learned, trial by error. I have struggled with SD for *years* now.

The first thing that goes, even after using the Nizoral once, is the itching, it gets better quickly. The scaling, takes time to vanish and usually requires the full length of the treatment.

[mamaherrera]

Hey thanks for that info about scaling/itch, so I can watch for those improvements. So if I do, per say a harsh cleanser (after I get cleared), but I need to wash more often because I exercise, I'll have to see if two of those times I could use a sulfate-free poo and then just once a week use the harsher cleanser, see if my scalp can handle that no?? Also, basically you can use any shampoo as long as it has the sulfates???

[lapushka]

Hey thanks for that info about scaling/itch, so I can watch for those improvements. So if I do, per say a harsh cleanser (after I get cleared), but I need to wash more often because I exercise, I'll have to see if two of those times I could use a sulfate-free poo and then just once a week use the harsher cleanser, see if my scalp can handle that no?? Also, basically you can use any shampoo as long as it has the sulfates???

I typically use Pantene or Herbal Essences, because those two have SLS *and* SLES in them. It helps, in my case. I have oily hair on top of it all, so it does help. They are the harshest of cleansers on the market.

You'll have to see what you can do to keep your scalp happy. And the moment it starts to go haywire, move the Nizoral back in. If you're early enough, might only need one or two treatments to get your scalp to that happy place again.

[mamaherrera]

thanks!! If I have any questions, I might bring this thread back to life. Now to Nizorall the heck out of my scalp!!



I typically use Pantene or Herbal Essences, because those two have SLS *and* SLES in them. It helps, in my case. I have oily hair on top of it all, so it does help. They are the harshest of cleansers on the market.

You'll have to see what you can do to keep your scalp happy. And the moment it starts to go haywire, move the Nizoral back in. If you're early enough, might only need one or two treatments to get your scalp to that happy place again.

[lapushka]

thanks!! If I have any questions, I might bring this thread back to life. Now to Nizorall the heck out of my scalp!!

Good luck! Hope it helps. :D

[Panth]

I see Lapushka answered stuff whilst I was away. :)

But yes, Nizoral or other ketoconazole shampoos must be used every two days, generally for one bottle worth (about a month ish?), and must be left on the scalp for 5 mins before rinsing. If you want to wash more often when doing your Nizoral treatment, use a regular non-medicated shampoo for the washes in between. If you want to wash less often, don't - the Nizoral needs to be used every 2 days to work properly.

Once you've got things under control, it starts to get into YMMV territory. You'll need to experiment. If you have chronic or recurrent SD, you'll need to be more careful and check what things trigger your scalp. If it was just a rare / one-off thing, you can be less careful. In general, these are the suggestions:
- minimise oil on the scalp (i.e. minimise oil treatments and/or oil-treat the length only and/or wash promptly (e.g. within hours, not days) after doing a treatment that gets oil on the scalp)
- don't stretch washes too long (as the build-up of sebum gives lots of food for those yeasties and can prompt their overgrowth, causing a bout of SD)
- wash sweat off the scalp promptly (again, sweat = yeast food)
- don't leave the scalp wet for too long, either after washing, after sweating, after being in the rain, etc.
- consider harsher cleansers (i.e. sulphates)

However, it's all very YMMV. Unlike Lapushka, I use sulphate-free (cocoamidopropyl betaine) shampoo (as, *sigh* SLS causes dry, eczematous-like dandruff on me on both scalp and forehead). I wash every 3-4 days, but that's as much because I'm blonde (making greasies look super-bad) as for SD prevention. I don't do scalp oil treatments at all (or, indeed, oil treatments in general) and I'm terribly sedentary so don't worry about sweating too much. Oh, and I air-dry my hair, often at night, so often have prolonged damp scalp. So, for me not that much preventative stuff is necessary. However, I now crack out the Nizoral at the first sign of the itchies - I've had an awful lot of hair loss in the last 3-4 years (from 3 and 7/8" circ to 2" circ :( ) and SD has definitely been part of the cause of that.

[lapushka]

However, it's all very YMMV. Unlike Lapushka, I use sulphate-free (cocoamidopropyl betaine) shampoo (as, *sigh* SLS causes dry, eczematous-like dandruff on me on both scalp and forehead). I wash every 3-4 days, but that's as much because I'm blonde (making greasies look super-bad) as for SD prevention. I don't do scalp oil treatments at all (or, indeed, oil treatments in general) and I'm terribly sedentary so don't worry about sweating too much. Oh, and I air-dry my hair, often at night, so often have prolonged damp scalp. So, for me not that much preventative stuff is necessary. However, I now crack out the Nizoral at the first sign of the itchies - I've had an awful lot of hair loss in the last 3-4 years (from 3 and 7/8" circ to 2" circ :( ) and SD has definitely been part of the cause of that.

YMMV indeed. I can't leave my scalp damp at all (roots need to get dry in at least a couple hours), and on my instruction leaflet from my Nizoral it says wash 2 times a week. This is a 2% bottle I have.

[Panth]

YMMV indeed. I can't leave my scalp damp at all (roots need to get dry in at least a couple hours), and on my instruction leaflet from my Nizoral it says wash 2 times a week. This is a 2% bottle I have.

Funny. Mine (from memory) said every two days. That was a 2% too. ^_^