Natural Dermatology: #1 Seborrheic Dermatitis, Dry Itchy Scalp, and Dandruff Tips

By Dr. Nicole Sundene

Naturopathic Dermatologist

Seborrheic Dermatitis, dandruff, itchy scalp, scalp eczema and psoriasis are so annoying they drive patients in droves to see me as a Naturopathic Doctor that specializes in Dermatology. This condition can become so severe it can even cause hair loss!

The good news is I have such a high success rate from treating these patients over the past fifteen years that we usually can get an itchy scalp problem better in just a few appointments. Often just one appointment is needed for my Seborrheic Dermatitis patients!

Nothing makes me happier than hitting a "Naturopathic Home Run," aka fixing a chronic annoying Dermatology problem in just one visit. Keep in mind that is generally the case with kids and teens, and that adults generally need multiple visits because their hormones are imbalanced and that is the #1 trigger for seborrheic Dermatitis.

Here is what my solution is to this frustrating skin condition:

1. Test hormones and nutrients to rule out conditions that cause dry and inflamed skin such as hypothyroidism, anemia, menopause, perimenopause, Hashimotos, Omega-3's, Zinc, and Vitamin A deficiency.
2. Identify and Eliminate Food Sensitivities with a Naturopathic Doctor approved Food Sensitivity Test.
3. Balance the microbiome and improve digestion. Yeast on the head generally means chronic yeast infections or yeast overgrowth in the digestive tract.
4. Increase hydration and electrolytes to the skin.
5. Apply the topical recipe below multiple times per day well past symptom resolution so the yeast does not grow back.

WHAT IS SEBORRHEIC DERMATITIS?

An itchy dry, flaky scalp is typically “Seborrheic Dermatitis”commonly referred to as dandruff in adults and “cradle cap” in babies. Most standard anti-fungal shampoos, topical steroids, and topical treatments such as selenium sulfide and pyrithione zinc typically only provide temporary relief because they are not addressing the ROOT CAUSE of their Seborrheic Dermatitis. This requires me to put on my detective cap to figure out what is actually wrong and why the body is sending this negative itchy message that something is not quite right.

The fact that the body is out of balance must be addressed or the shampoo will simply not be enough. Although I do agree these shampoos are helpful for reducing symptoms while the actual cause is treated, they frankly are not the “be all end all”.

First of all seborrheic dermatitis is an inflammatory condition of the scalp that can manifest in the form of mild dandruff to dense, greasy scaling of the scalp. Mild cases of dandruff will typically resolve with the addition of fish oil, biotin and b-complex, zinc, and selenium, however more severe cases of seborrheic dermatitis will require further investigation.

The reason for this is that in babies the condition typically remits after 6-8 months, but in adults the Seborrheic Dermatitis is almost always chronic and will just tend to relapse and remit while it worsens over time. So let’s get this figured out now, shall we?

This condition is commonly correlated with a yeast, Pityrosporum ovale, but that yeast is predominantly everywhere right? It is not some random infectious disease like Ebola, it is simply a common thing in our environment, which gets me thinking…why doesn’t EVERYONE that is exposed to P. ovale have Seborrheic Dermatitis? The reason for that is that not everyone is pre-disposed to being susceptible to such a problem. There is a high familial correlation with this disease. Typically our diet, genetics, environment, lifestyle, and stress levels all contribute to causing Seborrheic Dermatitis, and an illness just chooses to show up on the body somewhere to show us that we are out of balance. Especially with dermatology it is as if your body is screaming at you to pay attention to what is wrong with it when the embarrassing dermatology condition shows up on the face or scalp. We can no longer ignore it and cover it up with clothes. Whether we choose to listen to the message or ignore the message while suppressing it with shampoos and topicals or what not is up to us, but rarely to patients find permanent relief from topical treatments from Seborrheic Dermatitis very similar to my long acne rant about how we need to treat the underlying ROOT CAUSE.

So what is out of balance? Most likely digestion and stress.

When I have worked with patients with very refractory cases of seborrheic dermatitis in the past they have all had food sensitivity components, especially to wheat, dairy, and citrus that needed to be addressed. For whatever reason imbalances in our gut always show up on the skin first. I always know my dermatology patient is going to have a great outcome when they understand the problem on their outside is actually caused by a problem on their INSIDE. My guess surrounding this is that people are naturally pretty vain and will easily ignore a stomachache, but not a skin problem. The body is very wise when sending messages. Also since 70% of our immune systems surround our gut in the form of “Gut Associated Lymphatic Tissue” or GALT, any inflammatory condition will improve by simply going on a trial hypoallergenic diet for several weeks and then testing for food sensitivity once the condition has cleared.

Be sure to start a whole foods diet whenever possible free of your individualized food sensitivities until the Seborrheic Dermatitis improves. Of added interest, this problem is predominantly male which suggests a male hormone component or imbalance. Most hormones are easily brought back in to balance by improving sleep and cleaning up diet and stress.

I would recommend for anyone with an itchy skin problem to read my article on eczema, as in my mind they are all basically the same thing and tend to resolve by using similar traditional nature cure means. All my friends that are Dermatologist friends hate me for saying that but I have worked in both conventional Dermatology for eight years for three Dermatologists and Naturpathic Dermatology for over fourteen years so with twenty two combined years of experience in Dermatology I feel I am entitled to my own opinion.

Of course Seborrheic Dermatitis in adults has been shown with good research to improve specifically from taking zinc daily (start with 15-20mg, but you can bump it up to 50mg daily, yet I would not do this long term as it will throw your other minerals out of balance), as well as selenium (150-200mcg), biotin (10mg), Folic acid (10mg), and B12 (1000mcg), but we really need to address the cause of the inflammation, or most people will have to be on these supplements long term. Please check with me or your own Naturopathic Doctor before starting any new vitamins, herbs or supplements.

For mothers of infants with cradle cap that are breastfeeding you can ensure that you are not deficient in these vitamins and minerals by taking a high quality prenatal vitamin at the full dose (don’t take mega doses of ANYTHING when you are breastfeeding unless prescribed by your Naturopathic Doctor!!!). But ultimately I would investigate food allergies, as a food you are eating is most likely upsetting the baby. Do add cultured foods like yogurt in to your diet to improve your digestion.

Topically a 5% Tea Tree oil shampoo has been shown to be effective against Seborrheic Dermatitis, but I would make my own conditioner instead and let it sit on the scalp. My rationale for this is that shampoos are really drying and the scalp is already dry and irritated. We want the medicine to sit on the scalp long enough to kill yeast in Seborrheic Dermatitis. I would prepare a topical solution using aloe vera gel or borage oil and tea tree oil. Add about 20 drops of tea tree oil to a ten ounce bottle of aloe vera gel. Shake that up and apply it to your scalp daily for 15 minutes to treat the Seborrheic Dermatitis. Depending on your sensitivity, you can add more tea tree oil than that, however it should NOT ever feel like it is burning. Never apply any essential oils directly to your skin without diluting them in aloe or a carrier oil first as they are caustic and will burn you. If you ever experience burning, rinse it off immediately. Topically aloe vera gel and borage oil have also been shown to be soothing for this condition. For babies you can simply rub their head with olive oil and then comb all the flakes out. Please do not treat your baby for Seborrheic Dermatitis without the help of a skilled herbalist or Naturopathic Doctor such as myself. If you need my help simply pop over to appointment SCHEDULE page and I would be delighted to help you!

Remember that if you discover you have food allergies it is not the end of the world, you simply eliminate the food for a period of time while the immune system forgets about it (typically three months for those blood cells to die and forget the food allergy or intolerance), take probiotics daily to reseed healthy gut flora, adopt better stress management coping techniques, and then rotate the foods that were causing the inflammation back in moderately.

As a final note on Seborrheic Dermatitis I would like to add that you should NOT ever take any new supplements without checking with your Naturopathic Doctor first (preferably me) and be sure that you have the correct diagnosis before attempting any home remedies or self treatments for dermatology issues. Heaven forbid my advice ever does more harm than good. Please read my long acne rant about how nothing you put on your skin ever really fixes your skin until we get to the underlying ROOT CAUSE of the Dermatology and Hormone symptoms of Seborrheic Dermatitis.

Dr. Nicole Sundene, NMD

(480) 837-0900

Dr. Sundene is a Naturopathic Doctor in Scottsdale, Arizona, and is considered a Female Hormone Expert  in Women's Health and Bioidentical Hormones. She specializes in Holistic Women's Health for Menopause, Thyroid, Hashimotos, PMS, Perimenopause, Autoimmune, Postpartum, Chronic Fatigue, Depression, Anxiety, Food Allergies, Digestion, Dermatology , Acne, Psoriasis, Eczema and Adrenal Hormonal Conditions. In 1999 she began working for a Hormone Doctor prior to starting Naturopathic Medical School. With over 22 years of experience in both Prescription and Natural women's health and hormones she presents to women the best integrated health solutions for their Chronic Disease. She has been an Herbalist for over 27 years and enjoys teaching women how to use herbs to balance their hormones, nutrition and optimize their health. Dr. Sundene relies on blood testing for her hormone metrics. The hormone testing is covered per the patient's insurance plan and conducted at certain points in the woman's menstrual cycle. To learn more about Hormone Testing for Women Visit: Bioidentical Hormones. Follow Dr. Sundene on Instagram, Twitter and Facebook for more tips on Women's Health, Female Hormones and Naturopathy!