Eczema does occur on the scalp, but other medical conditions happen much more frequently and many confuse those conditions for severe eczema. We will briefly touch on scaling conditions of the scalp. If eczema does occur in the scalp it is much more likely to happen in a young child rather than in a teenager or adult. In the first year after birth, the most commonly occurring condition is seborrheic dermatitis, commonly known as cradle cap. About half of infants can get some degree of flaking and scaling on the scalp and eyebrows and behind the ears. Some people refer to this dandruff. Calling seborrheic dermatitis “dandruff” is not wrong but cradle cap is a more intense version of flaking and scaling than what you would see with plain old dandruff. We discussed seborrheic dermatitis on the scalp in more detail in one of our other articles. Probably 1 in 3 adults have some degree of dandruff. Many folks think they just have a dry, itchy scalp, and are unaware that the flakes on their shoulders are caused by dandruff. Just like in infants, adults can get redness and flaking behind the ears and in the grooves between the nose and the cheeks. Eczema occurs far less on the scalp, people usually mistake eczema for seborrheic dermatitis. Eczema on an infant’s head will tend to happen more on the cheeks, but it can also edge up into the hairline and would be associated with redness and can have some overlying scale. As a child ages they can develop other flaking conditions isolated to only a few coin size spots on the scalp that frequently can cause hair loss. The cause of this is fungus--what would be considered “ringworm” if occurred elsewhere on the body. The fancy name for ringworm in the hair is tinea capitis. Much less common in children and adolescents than eczema, and tinea capitis, is psoriasis. This condition can happen in the hairline or in the scalp and tends to have a red base with overlying silver/white colored scale. How do you treat eczema on the scalp? Now that we know the most common cause of flaking and itching of the scalp in adults is actually dandruff we should direct you on what to do to manage these symptoms. Many people that have diagnosed eczema on their elbows, knees, wrists and ankles and can also have dandruff on their scalp. It’s common for people and parents dealing with eczema to use a daily moisturizing cream for eczema to keep back the harsh symptoms. The first line recommendation to manage the symptoms of dandruff and seborrheic dermatitis is to use an over-the-counter (OTC) medicated shampoo for dandruff and seborrheic dermatitis The most common ‘active ingredients” in these OTC shampoos are: pyrithione zinc, selenium sulfide, salicylic acid, ketoconazole and coal tar. For cradle cap, 70% of pediatricians suggest using an adult dandruff shampoo due to a lack of kid-friendly products. However, some of these adult shampoos active ingredients can be drying, some have pungent odors, many have added dyes and some we would not advise on an infant. We would stay away from coal tar and salicylic acid for infants. Ketoconazole can be drying to the skin and most common over the counter medicated shampoos have harsh lathering agents (sulfates) that can further enhance loss of skin moisture. For people with sensitive skin, or that have both eczema and dandruff, we advise using an over-the-counter (OTC) medicated shampoo for dandruff and seborrheic dermatitis that is free of fragrance, dye, sulfates, and without preservatives that can irritate broken skin (parabens). Some OTC medicated shampoos contain beneficial inactive ingredients like Licorice Root Extract or provitamin B5 that can help to soothe and smooth irritated skin. As mentioned, OTC shampoos can be drying, so we suggest using a daily eczema shampoo and body wash cleanser that also lacks harsh ingredients and has a pH that matches that of your skin. If you think you or your child may have psoriasis or a fungal infection you should get an evaluation by your doctor’s office. There are many conditions not associated with scaling that can happen in an adult. If whatever you are treating with an OTC shampoo after several weeks is not getting better, than you should also consult a physician. Dr. Eddie's Happy Cappy products for eczema and seborrheic dermatitis Our products do not contain added fragrance or dye. We do not use parabens or phthalates, and we have gentle surfactants that are sulfate-free. Our medicated and daily shampoo was designed for children of all ages and many adults have found this product to be a fantastic addition or replacement in their tool chest for dealing with dandruff or seborrheic dermatitis. Our shampoos are pH balanced to keep your skin's pH optimized. All of our products contain redness soothing Licorice Root Extract. Both shampoos also contain provitamin B5 to moisturize your skin and hair. Our Daily Shampoo and Body Wash is a great option for those days you are not using our medicated shampoo. It contains many other skin hydrating ingredients like hyaluronic acid, oatmeal, and aloe vera. All Happy Cappy products are vegan and cruelty-free. For your eczema needs we have our baby eczema cream that should be used twice daily to protect and restore the delicate skin barrier. Our irritant-free emollient is not greasy and contains Licorice Root Extract and glycerin to hydrate skin all day long.