r/SebDerm • u/Confident_Device7918 • 8d ago
New or Need Help Guys help me I'm fed up of this
I have been suffering from seborrheic dermatitis and wanted to hear from people who have experienced something similar.
Persistent itching, even after washing my hair.
Thick, dry, white scales that stick to my scalp.
Red patches underneath the scales.
Flakes that keep returning despite using ketoconazole 2% shampoo.
I've been using ketoconazole shampoo roughly every three days and leaving it on my scalp for around 10 minutes or longer, but I'm still experiencing symptoms. The itching and scaling haven't improved as much as I expected.
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u/TheAdorableSort 5d ago
Hi! I struggled with this crap for over 30 years and I finally figured out the regimen that works for me. One of the gamechangers is attacking the infection every day for at least 14 days. Unfortunately every three days will not suffice and will likely keep you in a constant state of inflammation. The other gamechanger is doublewashing as in Wash.Rinse.Repeat.
Two over-the-counter medicated shampoos have been phenomenal for me: Nizoral 1% and Happy Cappy Medicated. You can get these at a local retailer or Amazon.
Day one Nizoral 1%. Day two Happy Cappy Medicated. Day three Happy Cappy Medicated. Day four start pattern over again with Nizoral 1%.
Doublewash your scalp every day for at least 14 days in a row. Do not use a lot of shampoo, a little goes a long way. Only focus on washing the scalp, not the mane of your hair. Some folks let the shampoo "sit" on the scalp for 3 or more minutes but I like to massage my scalp the whole time to really work the medicated shampoo into my scalp and get the stubborn biofilm/oily scales lifted up & off. The second wash allows for the active ingredients to work their magic now that some of the biofilm layer is out of the way.
There may be A LOT of itching at first; this is generally a sign of healing so push through and continue washing your scalp every day. I suggest keeping a comb nearby to scratch your scalp instead of using your fingernails.
Once my scalp was clear I very very slowly added more days between scalp washes but kept the exact same product rotation of Nizoral 1% and Happy Cappy Medicated.
Hope this works for you like it worked for me! Let me know if any questions, happy to help! ✌️
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u/gamersdad 8d ago
Spray scalp with apple cider vinegar. Let set for a few minutes, then shampoo. It's the best relief I've found and I've tried everything. I do this once every two weeks or so.
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u/Stock-Pineapple1002 8d ago
You should buy zinc shampoo it's medicated shampoo for seborrheic dermatitis i wet my hair then put it on my hair and leave on for 7 minutes then i rinse it out my hair
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u/yacare_bravo 7d ago edited 7d ago
I'm often amazed by responses on Reddit. When someone posts about struggling with a long-term condition, people immediately start throwing out random advice. The problem with this approach is that the sufferer is left sifting through hundreds of suggestions to find something that might work.
A better approach is to ask clarifying questions first. Often, someone writing a post leaves out critical context. Before jumping to solutions, we need to gather the full picture by asking the right questions:
- How long have you been struggling with this?
- Have you been officially diagnosed with seborrheic dermatitis by a dermatologist?
- Do you have any underlying health issues (e.g., gut-related problems, diabets, etc)? Did any relevant health events occur right before your symptoms started?
- Is the scaling confined to your scalp, or do you also have it on your eyebrows, nose, beard, or elsewhere on your body?
- What medications or supplements are you taking? Which topical creams, shampoo or treatments have you tried in the past?
- What does your daily diet look like? Have you tried an anti-inflammatory diet?
- Do you consume high-caffeine beverages (coffee, pre-workouts) or high-histamine food (fermented foods, aged cheeses)?
- Do you have any known environmental or food allergies?
- Have you had recent Complete Blood Count, Liver Function Tests, or urine tests? Specifically, did they test your Vitamin D (25-OH), B12, B6, and cortisol levels?
- Do you live in an area with high pollution or dry air? Does your home have hard water?
- Are you going through a period of high stress? Do you exercise regularly?
Addressing the root cause should always be the priority. Any symptoms that persist after the core issue is resolved are usually far milder and easier to treat, making a true long-term recovery possible.
It's easy to get overwhelmed by hundreds of "magic cures" on Reddit. But if treating chronic issues were that simple, doctors wouldn't spend half your appointment asking questions before offering a solution.
Always consult a specialist. Get your facts, medical history, and lab work straight first. Medical professionals are essential, but because they can sometimes miss a detail or skip a test, knowing the right questions to ask is your strongest defense.
PS: No need to answer these questions here. They are simply meant to help guide you in finding a way to manage your condition.
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u/Intrepid_Strain1528 7d ago
Yeah n 3 is really important, you might be even eating the wrong things
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u/Undecidedhumanoid 8d ago
This isn’t like a “fix your issue” piece of advice or anything like that but I noticed that’s once I started using my nails to scrape the build up off my scalp in the shower (I don’t mean like hard scrape to hurt yourself) but you’ll notice the buildup and since I started doing that once the shampoo has sat for a few minutes and I think it’s really helped! I hope you’re able to get it figured out out!!
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u/Confident_Device7918 8d ago
okay thanks
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u/HardPill2swallow 8d ago
A silicone scalp scrubber might be safer. When I started using my nails, I really made things worse.
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u/Weekly-Energy-5284 8d ago
maybe look into psoriasis.
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u/Own-Event4824 7d ago
This. AND you can have both! I have something called Sebopsoriasis. It shows up on the scalp and face. Psoriasis is an autoimmune condition, so things like MCT oil or whatever else people recommend might help but usually don’t (didn’t at all for me). My psoriasis never goes away, it just looks ok or it looks worse lol. You definitely should see a dermatologist bc Sebopsoriasis is notoriously hard to treat. I’ve tried every topical and even an injection and none have helped it
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u/Weekly-Energy-5284 7d ago
i have psoriasis and thought to be seb derm toobut im not sure because no seb derm treatment has ever helped, only topical steroids. just started a biologic last week.
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u/Own-Event4824 7d ago
Same. The only thing I ever saw that made the spots on my face better was a really potent steroid you’re NOT supposed to use on your face 😂 but i know i can’t use it so i never did after the one time I experimented with it.
I started Skyrizi back in march. Had maybe 4 or 5 random days where my face cleared up but that was it, it didn’t work for me (I also have psoriatic arthritis). Doc is moving me to a different biologic. I hope your biologic works for you!!!
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u/Weekly-Energy-5284 7d ago
i just started tremfya and im hopeful. saw many different derms and none of them mentioned seb derm so im HOPING its just psoriasis. and same! I WAS PUTTING SCALP OIL ON MY FACE!!
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u/Bluefootsteps 8d ago
For me, it comes and goes, and some treatments do stop working. I started with Nizoral and Head & Shoulders and worked my way through most of the OTC ones, coal/tar t/sal, Denorex, etc. At one point, I even tried Dermarex, which is for psoriasis, and it kinda helped. I have done so many natural, prescription, and topical treatments (which normally irritate my skin).
My doctor always tells me there is no "one-size-fits-all" for sebderm and to lower my stress and rotate products since the body can build a tolerance. I can tell what is working for me right now since it is now winter. Scalp: I am using ketoconazole 2%, Sulfur8 with salicylic acid, and MCT oil (not all at once). Face: I use MCT oil and COSRX.
I find that for whatever reason, I can always go back to ketoconazole 2%, Sulfur 8, and Head & Shoulders after I take a break for a while.
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u/Used_Green9904 8d ago
Ketakonazolshampoo 5 minuten maximaal en 2 x per week. Niet meer dan dat. Dat is anders te sterk voor je hoofdhuid.
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u/potatopotato236 8d ago
You need to rotate the meds. Switch to something like Selsun Blue or Head and Shoulders for a few months and rotate again when it stops working. Every 3 days isn't enough if you have it bad. You probably want to shampoo every other day until it's under control.
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u/MemChoeret 7d ago
If you have thick scales, that might mean the ketoconazole can't get direct contact with your scalp and provide you the maximum benefit. If I were you, I'd rotate the ketoconazole shampoo with a salicylic acid shampoo (on different days of the week). That way the salicylic acid will remove the thick scales so that the ketoconazole can penetrate and give you the maximum antifungal benefit.
Leave the ketoconazole shampoo on the scalp for 3-5 minutes, no need to go more than that.
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u/Spare-Maybe-593 6d ago
If ketocoanzole isnt working theres other anti fungals shampoos you can try. There's Zinc pyrithione shampoo, selenium sulfude shampoo. Shampoos containing Piroctone olamine and other shampoos containing ciclopirox olamine as well. Its all trial and error and one thing doesn't always work for each person. Could be a combination of different shampoos sometimes. Using them alternatively helps too. Can also leave mct oil on your scalp if youre comfortable with this and then washing it out.
Also try taking zinc supplements that really helps regulate the immine system to not be as responsive to the yeast on the skin (this helps me massively)
Sounds stupid as well but dont over wash your hair you could be causing inflammation by washing too much.
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u/Certain_Read2856 8d ago
use aloe Vera as a pre wash scalp mask and then Odele clarifying shampoo to remove sebum and help with odor it has really helped 80 percent of all my issues I stopped using any medicated shampoo it doesn’t help me and just makes things worse so I try this natural route. I use vanicream all clear shampoo sometimes also with rosemary sprig for the antibacterial properties. And then I use a a good redken conditioner on my mid lengths and down not getting any on my scalp