Have you ever noticed unpleasant odors coming from your scalp? If you have seborrheic dermatitis, the excess oil production and buildup of dead skin cells may lead to itching, dandruff flakes, and sometimes smells that emanate from your scalp. These symptoms can significantly affect your quality of life, sometimes making you feel self-conscious in social situations.

Areas affected by seborrheic dermatitis may smell rancid, musky, or sour. The odors tend to get stronger when other symptoms are also flaring up.

Getting control of your seborrheic dermatitis should reduce your overall symptoms, including smelly scalp or body odors. If that doesn’t help, you can consider other factors that may be contributing to the problem.

Managing Skin Infections

Scalp skin is sensitive and prone to infections when you have seborrheic dermatitis. While massaging and brushing your scalp regularly are healthy ways to manage this skin condition, they can also lead to infections if you overdo it and break the skin. Also, it can be hard to resist the urge to scratch itchy skin, but scratching can damage the skin barrier and expose your scalp to germs in your fingernails and the environment.

Sometimes, odor is a sign of infection. People with seborrheic dermatitis may be vulnerable to bacterial staph infections and fungal yeast infections. Signs of a scalp infection include:

• Low-grade fever
• Pus-filled cysts or pimples
• Severe itchiness
• Swollen lymph nodes in the neck
• Temporary hair loss
• Tender areas that may be warm to the touch

Your doctor can run tests to determine what’s causing the infection. It’s important to investigate the problem so it can be treated with the right topical medication. Bacterial infections respond to antibiotics, but yeast infections require antifungal medications. Your dermatologist can help determine what type of infection you have and prescribe the appropriate treatment to keep it from worsening or spreading.

Smells From Topical Treatment

Some scalp treatments for seborrheic dermatitis have an odor of their own that can linger after you apply them. For example, selenium sulfide shampoo can leave behind a smell on the scalp. Many varieties of medicated shampoos that can work well for seborrheic dermatitis may contain sulfur, salicylic acid, pine tar, coal tar, zinc, or ketoconazole (an antifungal medicine). You need to let the shampoo sit on your head for at least five minutes to give the active — and potentially smelly — ingredients a chance to work.

If you don’t like how your scalp smells after using a particular type of shampoo, or you don’t feel like it’s helping with your skin condition, you may need to switch to a different product. Members of MySebDermTeam have said that changing shampoos every few weeks brings better results.

“I have been rotating six shampoos, and I figured Jason’s tea tree shampoo was going to be the winner,” one member said. “It turns out that so far, Dermoia eczema and psoriasis shampoo is. It has manuka honey, aloe vera, colloidal oatmeal, vitamin B3, zinc, and salicylic acid. My seborrheic dermatitis has not vanished, but it has diminished somewhat, as has the itching.”

Discuss your shampoo choices with your dermatologist to ensure that you’re choosing products with the potential to improve your condition rather than worsen it. It might be tempting to use essential oils or fragrances to try to mask the smell, but these can trigger seborrheic dermatitis. Instead, opt for hair products that are approved by your dermatologist and free of potential irritants, like perfumes and alcohol.

Treatment From the Inside Out

Shampoos and scalp treatments might seem to be the best way to manage symptoms on the scalp. However, topical products aren’t always effective for severe cases of seborrheic dermatitis.

Doctors usually start by treating seborrheic dermatitis with antifungal or antiinflammatory ointments. A newer option, roflumilast (Zoryve) foam, was approved by the U.S. Food and Drug Administration (FDA) in 2023 to treat seborrheic dermatitis. The once-daily, steroid-free treatment is a phosphodiesterase 4 inhibitor that works on the immune system to help reduce inflammation.

If your symptoms don’t respond to topical treatment, your doctor may consider systemic drugs that help treat the disease from within. A course of antifungal or antibiotic medications or steroids may be prescribed to be taken by mouth to clear up a flare or an infection.

You can also discuss newer medications that help target specific pathways of the immune system with your doctor to see if they may be a good choice for long-term control of seborrheic dermatitis or any coexisting conditions.

Other Contributing Factors

Hair care products and environmental pollution can also attach to the hair and scalp, leading to unpleasant smells that are unrelated to seborrheic dermatitis. In addition, certain foods in your diet may contribute to body and scalp odor. Other medical conditions, like psoriasis and hormonal changes, are also common causes of scalp smells.

Smells haven’t been discussed much on MySebDermTeam, but some members have noticed that wearing hats seems to worsen their scalp symptoms, increasing sweat, flakes, and potentially odors.

“I was trying to avoid washing my hair every single day, so I covered up with a beanie over the weekend and noticed I had significantly more flakes than if I just wash daily, blow-dry immediately, and let my scalp ‘breathe.’ I’ll be disappointed if it’s true, because some days it feels easier to just hide under a hat or beanie,” shared one member.

“Hats can make your scalp sweat, which increases the oil production. I’d recommend a dry shampoo without toxic chemicals on nonwash days. Find one that won’t cause buildup, so your scalp can breathe still!” suggested another.

You may have theories about why your scalp smells, or the reason may seem like a total mystery. Either way, discuss your concerns with your health care provider. They can offer medical advice to manage a smelly scalp. Don’t worry that you’ll be judged at the doctor’s office. Even if you find scalp smells embarrassing, your dermatology provider is your confidential support system to help you find a solution.

Talk With Others Who Understand

MySebDermTeam is the social network for people with seborrheic dermatitis and their loved ones. On MySebDermTeam, more than 9,000 members come together to ask questions, give advice, and share their tips with others who understand life with seborrheic dermatitis.

Have you tried any home remedies, hair products, or medicated shampoos to treat body odors related to your skin condition? Do you have any tips for maintaining a healthy scalp and healthy hair? Share your thoughts in the comments below, or start a conversation by posting on your Activities page.