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Why Does Your Scalp Hurt With Seborrheic Dermatitis? 5 Ways To Ease the Pain

Medically reviewed by Steven Devos, M.D., Ph.D.
Written by Joan Grossman
Posted on April 19, 2024

There’s no doubt that a painful scalp due to seborrheic dermatitis can take a toll on daily life. It’s a topic that many MySebDermTeam members have discussed.

“I have severe eczema on my scalp and on my ears,” a team member wrote. “On my scalp and also on my forehead and the sides of my nose. … It’s painful and it affects my life every day.”

Another member said, “I have a very bad flare on my scalp. Feels like all my hair will be falling out and the itch is tremendous. Yet if I touch it, the pain is unbearable. Another day in the life.”

“My scalp is burning and stinging and seeps brown liquid,” wrote a third member. “I have tried all things known over the counter, and I hope they will prescribe me something that will give me a break. I have not gone out and don’t even want to come out of my room. Seriously.”

Seborrheic dermatitis on the scalp can be itchy and painful. If your scalp hurts due to this condition, there are steps you can take to manage the pain and pinpoint the underlying cause.

What Causes of Scalp Pain With Seborrheic Dermatitis?

Seborrheic dermatitis is a skin condition that is a common type of eczema. It occurs in areas of the body that have oily skin due to a lot of sebaceous glands, which produce sebum (oil). The scalp is one of the areas most affected by seborrheic dermatitis.

In healthy skin, naturally occurring oil helps protect the skin and keep it moist. But in people with seborrheic dermatitis, affected areas of the skin and scalp become inflamed. Dermatology research shows that people with seborrheic dermatitis have increased amounts of Malassezia yeast — a fungus commonly found on the human body that generally doesn’t cause any issues. For people with seborrheic dermatitis, however, this overabundance of the fungus causes the immune system to overreact and attack healthy skin.

Scalp pain may be caused by inflammation from the condition itself. Symptoms on the scalp include:

  • A greasy rash that may be discolored (red or purple, depending on your skin tone)
  • A buildup of skin cells causing crusts or scaly patches
  • Flaking skin, such as dandruff
  • Scabbing
  • Itchy scalp, pain, a burning sensation, or stinging on the scalp
  • Scalp tenderness or scalp sensitivity

Scalp pain can also be caused by aggravating the condition. For instance, scratching an itchy scalp may cause sores that become painful or infected. Seborrheic dermatitis may also cause scalp pain if you have a bad reaction to a topical ointment, lotion, or shampoo.

There’s no known cure for seborrheic dermatitis, which is considered a chronic (ongoing) health condition. But symptoms can often be controlled with treatment options such as over-the-counter (OTC) and prescription medication, along with a home scalp and skin care regimen. It’s important to talk to your health care team about how symptoms such as a painful scalp are affecting you. If you’re dissatisfied with your treatment plan, you can ask your doctor about other treatment options.

Here are several ways to help manage scalp pain.

1. Avoid Scratching Your Scalp

When your scalp itches, resisting the urge to scratch can be difficult. But scratching can damage skin on the scalp.

“Scratching my scalp. I know I shouldn’t. A little sore,” a MySebDermTeam member shared.

Scratching seborrheic dermatitis on the scalp may cause some temporary relief from itching, but scratching can actually increase itching and cause the itch-scratch cycle — a debilitating cycle of relentless itching and scratching. Scratching can worsen inflammation, open scabs, cause sores to develop, and may lead to infection, all of which may be painful. Damage to your scalp from scratching can also harm hair follicles and cause hair loss.

2. Identify Hair Products That Irritate Your Scalp

Everyone’s seborrheic dermatitis is unique. While some cleansers, shampoos, or ointments may help relieve seborrheic dermatitis symptoms on the scalp for some people, they may exacerbate (worsen) symptoms in others and cause scalp irritation. Ask your health care provider or dermatologist how to safely test a new hair product on a small patch of sensitive scalp to see if you have an allergic reaction or unwanted side effects, such as stinging, burning, or other types of pain.

People with seborrheic dermatitis on the scalp should generally avoid hair care products that contain alcohol, as well as hair-styling products, such as gels and hairsprays. Other ingredients or products may also cause a bad reaction on your scalp.

One MySebDermTeam member said, “Trying to figure out if my new BeKynd hair cream is for me or against me. Used for the second time yesterday, I have not had itching. But, I do have some new scalp lumps/bumps that I’ve never had before and they kind of hurt if I fool with them. Hmmm.”

Another member wrote, “My scalp is inflamed. It feels warm to the touch and irritated. I’ve been using prescription shampoo. So, I’m wondering if my seborrheic dermatitis is getting worse or if the shampoo is irritating my scalp.”

The National Eczema Association has a product directory of medicated shampoos and other hair products that have beneficial ingredients for the scalp such as:

  • Salicylic acid
  • Selenium sulfide
  • Zinc pyrithione
  • Ketoconazole, an antifungal medication that fights the overproduction of Malassezia yeast

Products in the directory are also free of ingredients that are known to irritate the skin and scalp. Be sure to ask your doctor about dandruff shampoos or antifungal shampoos that may be appropriate for you.

3. Manage Stress

Seborrheic dermatitis triggers such as psychological or emotional stress can make scalp symptoms worse. “Does anyone have flare-ups when they are stressed?” a MySebDermTeam member asked. “My scalp has painful itching and I’ve been under a lot of stress.”

You can manage stress with self-care. Practices such as meditation, yoga, and mindfulness training have been shown to help relieve stress. Regular exercise not only boosts your mood and well-being but also helps reduce the risk of seborrheic dermatitis flare-ups.

If you need help managing mental health issues such as anxiety, depression, or insomnia, your doctor can provide a referral for mental health counseling.

4. Maintain Your Home Scalp Care Routine

Your health care team can advise you on home care for your scalp, including:

  • How to best shampoo your hair
  • How to properly apply OTC or prescription medications
  • How to safely remove scales

Taking regular care of your scalp helps keep it clean and healthy, reducing the risk of painful flare-ups. Home remedies such as aloe vera gel or tea tree oil may be effective for some people.

It’s also a good idea to avoid tight hairstyles, such as ponytails and braids, that may pull on your scalp, increasing the risk of traction alopecia, a type of hair loss caused by ongoing pulling of a person’s hair roots.

5. Work With Your Doctor To Meet Your Treatment Goals

If you’re struggling to manage a painful scalp with seborrheic dermatitis, communicate openly with your doctor about how the pain feels and how it affects your quality of life. You may want to discuss switching treatments. It’s important to let your doctor know what your treatment goals are to be sure that you are managing symptoms as well as possible.

Controlling symptoms such as itchiness and flaking can help reduce pain. It’s never a good idea to change your treatment plan without medical advice.

You May Have Another Scalp Condition

In some cases, scalp pain may be due to another condition such as scalp psoriasis, scalp folliculitis, or another medical condition. Your doctor may want to test you for other scalp problems if painful symptoms continue over time. Getting the right diagnosis is crucial to ensure your treatment plan is effective.

Talk With Others Who Understand

MySebDermTeam is the social network for people with seborrheic dermatitis and their loved ones. On MySebDermTeam, more than 10,000 members come together to ask questions, give advice, and share their stories with others who understand life with seborrheic dermatitis.

Have you had scalp pain with your seborrheic dermatitis? How do you manage scalp pain? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Posted on April 19, 2024

A MySebDermTeam Member

Does anybody know about selsum blue prescription? It’s for sunspots eczema dry scalp, and you can use it sometimes symptoms won’t come back for six months. That’s how it works for me and my son.

posted May 5
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Steven Devos, M.D., Ph.D. received his medical degree and completed residency training in dermatology at the University of Ghent, Belgium. Learn more about him here.
Joan Grossman is a freelance writer, filmmaker, and consultant based in Brooklyn, NY. Learn more about her here.

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