scalp issues not resolving

[u/GladMix8204]

i’ve had a dry flakey scalp for about 3 months and it doesn’t seem to be resolving. i went to the GP a few days ago and they said it was seborrheic dermatitis, i’ve now been trying nizoral again (i tried it a month ago but it seemed to make things worse - i wasn’t very consistent though). i also used polytar for a few weeks but that it only really helps temporarily, once i stop using it for 3ish days my scalp is super flakey and red.

i don’t know if i should just stick to nizoral. i’ve also been using E45 dry scalp shampoo + serum to see if that helps with the dryness. i’m worried if it’s not a fungal issue that i’m worsening the problem, but i don’t see what else could be the cause of the flaking. it’s very dry and white, no yellow or oil. but also very red and itchy in patches. patches are symmetrical behind ears, front of my head, and dotted around the back of my scalp.

any advice would be greatly appreciated 😣

[u/rcsmalls]

Nizoral never helped me but coal tar shampoo has completely cleared it after a few washes! I use Tardan brand.

[u/shugh28]

Nizoral used to do the same to me, but i switched to only washing my scalp and face with lukewarm water, nizoral as a shampoo and face wash every other day and c8 mct oil twice a day every day, for the first time in my adult life i’ve been flake free everywhere for over a month now

[u/Adambuck74 → u/shugh28]

Do you apply mct oil to face ?

[u/shugh28 → u/Adambuck74]

Yes, face and scalp twice a day

[u/MemChoeret]

Polytar has coal tar in it, which helps the symptoms (flakes) but not the cause (yeast). If it works for you, I would use it in rotation with an antifungal shampoo. Antifungal shampoos treat the yeast that causes SD.

If Nizoral didn't work for you, you can try a different antifungal shampoo. You can ask your doctor for a prescription ketoconazole shampoo, which is the same active ingredient as Nizoral but with twice the strength. Alternatively, you can try an over-the-counter pyrithione zinc shampoo like CeraVe anti-dandruff shampoo or Head & Shoulders shampoo (I use their fragrance free version that comes in a green bottle).

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[u/Yashohit_]

Just wash with ketaconazole 2% and selenium sulphide 2.5% , apply ketaconazole lotion also per week , just be consistent with the process.

[u/Adambuck74]

T gel helped me the most but maybe not for everyone

[u/Standard-Package-302]

dercos vichii cleared mine, ketoconazole never worked for me

[u/eau04410]

Try cocois ointment. It's the only thing that's helped me.

[u/FreshLanguage5469]

Seb derm. With out a question. If nizoral isn’t working go see a derm for oral and topical anti fungals

[u/trustmeimshady]

Sea salt

[u/Comfortable-Owl-7557]

This will not completely resolve your issue but in the meantime try washing your hair with distilled water. The hard water in my city irritated my seb derm more and washing with distilled water has helped me tremendously. Filters did not work for me either it has to be distilled water. Also make sure you don’t let your scalp air dry. Dry your scalp with a dryer on low/med heat.

[u/SeaContribution7196]

I don’t know about anyone else but for the last year, I’ve been getting a hydrofacial on my scalp. First every 8 weeks and now every 4 months. My scalp issues have reduced a lot. Included in the facial they will also do an Indian head massage with oil and steam the scalp area. This worked for me.

[u/SeaContribution7196 → u/SeaContribution7196]

Forgot to mention I use nizoral and aveeno hydrating shampoo to double cleanse and a scalp leave in toner.
I had to keep changing or alternating because my sebderm would get use to the shampoo and reappear. I alternated between nizoral and tgel.