The scalp is a particularly sensitive area that can be affected by several types of eczema. We often tend not to differentiate between them. Generally speaking, in a chronic phase, eczema is always characterised by a dry, irritated scalp, systematically leading to an undesirable symptom: the appearance of dandruff. In an acute phase (eczema flare-up), the scalp becomes red (inflammation) and very painful.
As well as eczema, there are other reasons why the scalp can become dry, itchy and produce a lot of dandruff. The most common of these are psoriasis head lice or a fungal infection of the scalp. When faced with these symptoms, our first advice is to consult a specialist who will be able to identify the real causes of the symptoms and prescribe the appropriate treatments.
THE DIFFERENT TYPES OF ECZEMA AFFECTING THE SCALP : SYMPTOMS and CAUSES
Eczema is presented as an atopic disease (such as asthma or hay fever), i.e. caused by the body overreacting to certain environmental factors. Depending on the individual, these environmental factors may be stress, diet, the use of certain cosmetic products, pollution, etc. In short, it's clear that there is no scientific consensus on the true cause of this skin condition.
So over and above the causes that are most often unexplained, let's examine the following different forms of eczema.
The most common is seborrhoeic eczema or dermatitis. It can affect babies (commonly known as cradle cap), children and, of course, adults. In the case of seborrhoeic eczema, the skin takes on a red appearance, generates scales too quickly leading to the appearance of dandruff in varying numbers.
Seborrheic dermatitis is therefore a chronic inflammatory condition caused by the overproduction of sebum. Sebum is essentially made up of natural oils secreted by the sebaceous glands associated with each hair follicle. Note: seborrhoeic dermatitis is not contagious at all!
As seborrhoeic dermatitis is a condition directly linked to the sebaceous glands, it can also appear on other areas of the skin with a high concentration of sebaceous glands: the 'T' zone of the face (eyebrows, eyelids and sides of the nose), but also the armpits, upper back and genitals.
It should be noted that if not properly treated, seborrhoeic eczema can develop into a more serious form, such as an infection of the affected areas.
Other types of eczema : atopic eczema. Although less common than seborrhoeic eczema, it is still a fairly common condition. Atopic dermatitis often occurs in people suffering from asthma or seasonal allergies, even though its cause is still largely unknown.
It can appear at any age. The skin on the scalp becomes red, dry and often severely itchy. This itching can lead to infection if the scalp is scratched (which should be avoided), weakening the skin.
The third family of eczema is called allergic contact dermatitis. It develops when our body reacts to a particular substance to which, often unknowingly, we are allergic. Every day, we may come into contact with substances that could potentially cause allergic contact dermatitis. The most common ones for the scalp are :
- Shampoos, gels, sprays and other hair products
- Hair dyes
- Bathing caps and, more generally, products containing rubber.
Irritant contact dermatitis is a type of eczema that simply occurs when the surface of the skin is irritated by a substance that makes the skin dry, red and itchy. Shampoos, foams, hair gels or hairsprays, and the fragrances in these products can all cause irritant contact dermatitis.
There are other, admittedly rarer, forms of scalp disorders that produce the same symptoms as eczema.
We think of folliculitis (inflammation of the hair follicles), which causes flaking and itching, scabs and dandruff. Once again, it's important to consult a professional who can diagnose the problem and recommend the right treatment and care.
Finally, there is often a tendency not to differentiate between eczema and psoriasis. The symptoms of psoriasis are both quite different and very similar to those of eczema: in the case of psoriasis, the skin patches are well-defined and white in colour, whereas in the diagnosis of eczema, they are pink or even red in the acute phase, rather diffuse and bleed very easily when scratched. Sometimes, not to simplify matters, scalp eczema and psoriasis can occur together. Fortunately, this is quite rare.
HOW CAN SCALP ECZEMA BE TREATED EASILY?
Treatment for scalp eczema depends, of course, on the type of eczema diagnosed. It is therefore important to seek the advice of a specialist who will be able to guide you towards a particular type of treatment. However, there are two essential steps you can take to soothe your scalp and reduce or even get rid of the symptoms: moisturising your scalp and using a non-irritating shampoo.
Moisturise the scalp
In all cases, the first step is to ensure that the skin on the scalp is well moisturised. This is the basic treatment. Moisturising creams or spray oils can be applied to the scalp. To do this, it's important to apply them directly to the skin using a methodical approach, i.e. parting the hair part by part so that the moisturising creams are not absorbed by the hair but benefit the scalp directly. The use of oils is also sometimes recommended, coconut oil being the most popular. We have some reservations about the regular use of these oils, as they end up clogging the hair follicles, disrupting the metabolisms and ultimately increasing the symptoms.
To moisturise the scalp, we recommend applying these products in the evening, leaving them to work overnight before rinsing with shampoo in the morning. Just remember to protect your pillowcase!
From experience, Laits Clauderer soothe and deeply moisturise a scalp suffering from eczema. Results are very rapid (2 weeks in most cases): don't hesitate to ask for a diagnosis, which is the only way to recommend the right treatment.
Choosing the right shampoo
If you have scalp eczema, 'normal' shampoos are likely to irritate your scalp even more and make the itching worse. This is because shampoos contain detergents that are often harsh, and fragrances that are also considered to be potential precursors of irritation when they come into contact with the skin. So it's important that you find either a less irritating shampoo or cleansing cream, or simply use water with added bicarbonate of soda, possibly mixed with a fine oil. This is a 'grandmother's recipe' that allows you to wash your scalp thoroughly without damaging it.
A very important precaution, particularly in the case of an irritated scalp: the right steps to take for a gentle and successful shampoo are detailed in our article How to shampoo properly.
Finally, use a hairdryer set to diffuse cold air. Hot air significantly increases skin dryness and itching almost immediately.
What to do in the acute phase (flare-up) of eczema?
In the acute phase of scalp eczema, the treatment is the same, with no miracle solution. Always moisturise the scalp, not the hair, and massage (without rubbing) for a long time to allow the moisturising products to soak into the skin.
If the scalp is flaky and very irritated, dermatologists generally prescribe topical steroids (to be applied directly to the skin) combined with salicylic acid. In addition, if the scalp eczema is causing a local infection, then this topical treatment will be supplemented by specific medication such as oral antibiotic therapy.
In all cases, we recommend the essential prophylactic gesture, the basic treatment: moisturise and hydrate your scalp very regularly (twice a week). This optimal moisturising helps to avoid or considerably delay the onset of acute eczema.
Your questions :
What are the symptoms of scalp eczema?
Eczema is an inflammatory disease manifested by the appearance of red patches on the scalp, dandruff and itching. Eczema patches can become very painful if the itching is so bad that you can't stop scratching your scalp.
How can you tell the difference between scalp eczema and psoriasis?
Not easy for the untrained eye! The symptoms are very similar: dandruff, itching and flaking. In the case of eczema, the patches on the scalp will appear rosier and more clearly defined than in psoriasis. As eczema is linked to the sebaceous glands, it tends to spread to the T-zone of the face, whereas psoriasis tends to affect the joints (elbow, armpits, etc.).
How can scalp eczema be treated?
There are three essential steps you can take to reduce symptoms and space out attacks:
- moisturise the skin of the scalp deeply and regularly
- use very mild shampoos without detergents or perfumes
- do not massage or rub the scalp when shampooing
Jean-François Cabos is the creator of a unique hair care method based on the research he coordinated, which led to the publication of the book Hair, Roots of Life with Hélène Clauderer published by Robert Laffont (Collection "Réponses/ Santé").
