Explore with celebrity hairstylist Kristan Serafino on hair solutions that are appropriate and attractive for those suffering from scalp eczema. Kristan received formal training at Toni & Guy and has styled many Hollywood A-List male celebrities.
This was originally a 3-week series, combined into one post. The information written by Marcie Mom on scalp eczema has been vetted by Dr Vermén Verallo-Rowell, the founder of VMV Hypoallergenics.
What is Scalp Eczema?
Eczema is a term for any skin change characterized by edema: at the dermis, then upwards to the epidermis, forming vesicles, and bullae, becoming thus at the clinical – a wet oozing and then crusting mess. Seborrheic dermatitis is one of the causes of eczema on the scalp (others are allergic or irritant contact or photocontact dermatitis, or secondary to trauma or presence of lice).
Dandruff, Symptoms and Yeast
In its mild form, scalp eczema may result in dandruff which is loose skin flakes; in more serious cases, scalp eczema may lead to red, inflamed, itchy, scaly or weepy scalp with yellowish greasy flakes. Scalp eczema is often associated with allergic reaction to malassezia furfur, a form of yeast that is commonly found on areas with more sebaceous glands as it requires fats to grow. It is estimated that about 1 in 4 adults carry the yeast on their skin or hair, mostly without a problem. However, individuals with seborrhoeic dermatitis have somehow become ‘sensitive’ to this yeast.
In seborrheic dermatitis, the yeast proliferate more from many reasons – decreased immunity, presence of too much sweat.
Seborrhoeic dermatitis can also extend to other areas with more sebaceous glands such as the face, ear canal, armpits and flexural areas.
What Triggers Scalp Eczema
Like eczema, scalp dermatitis can be triggered by sweat, weather, stress or irritants found in shampoo, hair dyes and other hair products. A common substance in hair dyes, namely paraphenylenediamine (PPD) used for permanent coloring, can cause severe allergic reactions for those who are hypersensitive to it. A patch test (in small amount) ought to be performed before using the hair dye. PPD used in black henna tattoo has also been cited to cause allergic reaction and has been banned in some countries for direct skin application. For someone with sensitive skin/scalp, it is prudent to also avoid the top allergens such as fragrance, preservatives, parabens, propylene glycol, lanolin and colorant (ranked by Dr Vermén Verallo-Rowell in this post).
Paraphenylenediamine (PPD) used for permanent coloring, can cause severe allergic reactions for those who are hypersensitive to it
Hairstylist Challenge – For people with eczema or moms with eczema child (like me!) who can’t or choose not to color our hair, what can be done to our hair so that it won’t look too one (color) – dimensional?
A conversation on how to achieve dimension in your hair does not always begin and end with hair color or dyes. This should be welcome news to women predisposed to certain scalp disorders, therefore unable to use hair dyes. A common substance in most permanent dyes is para-phenylenediamine (PPD), which is known to trigger eczema outbreaks. It can take only small traces of PPD absorbed through your scalp to cause inflammation. Therefore, women who have sensitive skin or eczema should refrain from using hair dyes or coloring.
So how do you achieve dimension when using dye is not an option?
Let’s start by examining how hair color achieves dimension. A head of hair with a single color is considered flat or lacking dimension. Dimension is a function of the range of tones in the hair commonly referred to as highlights and lowlights. This range of tones creates the appearance of movement throughout the hair.
So what is the substitute for color tones?
The answer; LAYERS! Visually, layers create movement, dimension and even volume. It also creates real texture to otherwise plain and flat style. The placement of layers should not be something entered into blindly. Don’t simply proclaim to your stylist, “I want layers!” Layers should be placed strategically to flatter and enhance you best facial features. The pre-cutting consultation with your stylist needs to include a candid discussion on your features, which will better define your options. Eyes, forehead, cheekbones, jaw line, neck are all facial aspects to consider. Of course the length of your hair is also a factor. A rule-of-thumb is the shorter the hair the less layers, and avoid too much layering in the back of longer hair or risk bringing back the mullet. Remember, a great layered haircut is almost invisible until you move… then it comes to life.
Layers should be placed strategically to flatter and enhance you best facial features.
Here is an example of the proper match between features and hair length; women with a long neck, but short thin hair look stunning with a short bob where the bottom of the hair at the back is layered to reveal an elegant neck line, and women with a full face and thick medium length hair find layers starting in the front of the head and textured to curve in toward the face flattering since it gives the illusion of a thinner face.
Most important, when trying to achieve dimension in your hair you need to avoid blunt cut styles because they leave too much weight on the hair causing it to lie flat and lifeless.
Who gets Scalp Eczema?
Scalp Eczema in Children and Men
Sebum secretion is controlled by the hormone, androgen, which can be higher in (i) infant and (ii) adult males. Androgen increases at puberty and causes sebum production to increase, peaking at about 20 year old.
For children, scalp eczema is also known as cradle cap, which is greasy, yellow and crusty. It is difficult to scrape off and emollient or coconut oil can be applied to soften the crust prior to combing it off before bath. Cradle cap can also develop above eyebrows and inside the ears, for more information read this post.
While children won’t know that they are having a bad hair day, scalp eczema can be an issue for teenagers. During the teenage years, there is higher sebum production coupled with sweating through sports, thus providing an environment for the yeast to grow. It is even trickier if sweat is also a trigger for the eczema; while the amount of sweat produced for long or short hair is the same, short hair could at least reduce the amount of sweat trapped. Heat may also be a trigger.
Hairstylist Challenge – We’ll ask Kristan for some short hair cuts and styles!
I recommend any number of beautiful short hairstyles for women with scalp eczema because of the ease of maintenance, cooling effect, and reduced itching. I truly believe a short hairstyle is the most provocative style a woman can wear, but it takes a woman with confidence to rock it. But if you embrace a short hairstyle it can boost your confidence, make you look younger, and reduce the amount of time you spend on hair care.
I truly believe a short hairstyle is the most provocative style a woman can wear, but it takes a woman with confidence to rock it.
Before you rush off to the salon you may want to consider the condition of the scalp. On those days when the scalp eczema flares up resulting in weepy patches or irritated scabs, you want to be particularly cautious of infection. While beauty salons are governed by strict heath codes, you have to consider that brushes, combs and scissors may not have been thoroughly sterilized between uses. Just to be on the safe side; you do not want to expose an irritated scalp condition to a possible infectious environment.
On those days when the scalp eczema flares up resulting in weepy patches or irritated scabs, you want to be particularly cautious of infection.
If you have not tried short hairstyles in the past then I don’t want you to think for a moment that your choice is a life sentence of boredom. A good short hair cut has all the right proportions and includes all the basic elements of balance, line and movement…just like longer hairstyles. A short hair cut is manageable and the hair will look great in its natural form even before styling.
I am a big proponent of change and encourage my clients to experiment and have fun as their basic cut grows out. Even if you have short hair! Twist, pull, pin, tie and add accessories to tweak your hairstyle regularly to achieve a feminine look one day, sassy the next, then sexy for those special nights. You will be surprised what a subtle difference can make in the way you look, and even your attitude.
Change can include introducing styling products into your routine such as gel, spray or mousse, but always test a product on a small area of the scalp before using. The ingredients and formulization of hair care products vary and you want to be certain all products agree with your skin condition. Most hair care companies will provide free samples for testing. Just as with your shampoo and conditioner, choosing the correct styling product is a process of elimination and experimenting with different hair products.
Now go out there and make the world sit up and take notice of your new short hair cut!
Scalp Eczema Treatment
Medicated Shampoo, Topical Treatment and Antibiotics
Scalp eczema, like eczema on other parts of our skin, requires treatment. Treatment varies, depending on the severity of the seborrheic dermatitis. In mild case where there’s only dandruff, medicated anti-dandruff shampoo can be used. These shampoos typically contain one of these ingredients, such as zinc pyrithione, selenium sulfide, salicylic acid, ketoconazole or piroctone olamine.
Shampoo for Scalp Eczema
For shampoo containing coal tar, light-colored hair may be discolored and the scalp be sensitive to strong sunlight, thus more vulnerable to sunburn. These ingredients generally have anti-fungal, anti-inflammatory or sebum-suppressive properties but it’s still best to consult a doctor before using as the type and frequency of shampoo may differ for each individual. One point to note when shampooing is that the water should not be hot, as that will strip moisture from the skin. For babies, shampoo can be what is already used on the body or virgin coconut oil which has anti-viral properties.
Treatment for Scalp Eczema
For more severe cases of scalp eczema, steroid cream or ointment may need to be prescribed. For the scalp, it may be easier to have it in lotion form for ease of application and it is also common for very mild steroid lotion to be prescribed for babies. Should the scalp be weepy or oozing fluids, it would usually warrant an antibiotics to control the inflammation and prevent infection.
Hairstylist Challenge – What are the ways to blow dry hair without hot air that may strip away moisture? Or, hairstyles easy to maintain, shampoo and apply topical lotions without having to blow dry?
When styling your hair it is important to avoid disturbing topical treatments such as medicated shampoos and lotions. The biggest culprits can be the excessive heat from blow dryers or styling products, which can partially or completely counteract the active ingredients in medicated topicals.
So what’s a woman to do? Simple… find a hairstyle that:
1) Does not disturb the topical during preparation and maintenance
2) Allows for easy, quick styling in the morning
3) Looks stylish and chic
I don’t mean to be flippant but I also don’t want anyone to think there is no solution. Before we discuss haircuts and hairstyles, let’s begin at the beginning. Regardless of the cut & style we need to dry the hair without disturbing the topical. Unfortunately I don’t have any special tips or tricks-of-trade for drying hair so let me describe what may be the obvious:
1) After showering blot your hair by squeezing and holding small sections into a microfiber towel
2) Comb out damp hair using a wide-tooth comb
3) Repeat step #1
4) Give the air access to more surface of your hair by flipping your head upside-down every few minutes
5) Run your fingers through your hair and shake your hair every few minutes.
Unless you are among the very, very few with unlimited time to prepare in the morning, then at this point you have damp hair. While damp hair may not be the optimum situation, you have done a good job preserving the integrity of the medicated topical on your hair and scalp. This is a good time to share a Red Carpet tip – to achieve a considerable volume boost, first make a deep side part then flip your hair to the opposite side. When the hair has air dried comb it back and voila…instant volume!
Below are a few of my favorite air-dry hairstyles that begin with damp hair:
Sexy Waves – Achieve sexy waves by braiding sections of damp hair and allowing it to air dry completely. When you release the braids you have breezy, been-to-the-beach waves.
Tight Bun – While the hair is damp, gather and coil it into a bun by twisting it around itself. You can place the bun high, at the nape of the neck, or to the side for a change.
Undone Bun – This cool, windswept chignon can be worn on all occasions!