Is seborrheic dermatitis itchy? Yes, and this is how I treat it.

Regardless of what some ‘experts’ say, seborrheic dermatitis (SD) is a skin condition that can be itchy, although not everyone who has SD will experience itchiness. The condition is more likely to be itchy if it is on the scalp, face, or chest.

If you have seborrheic dermatitis, you know how itchy and uncomfortable it can be, especially during the inflammed phase. Why does this happen? More importantly, how do we get rid of the itch?

Let’s take a deep dive:

Is seborrheic dermatitis itchy?

When you read about the characteristics of seborrrheic dermatitis, itch is often not mentioned. It’s odd because itch is most definitely part of a seborrheic dermatitis rash. In fact, when my face and neck starts itching, it’s a herald symptom that a red rash will be forming soon if I don’t nip the flare in the bud.

Plus, dandruff, which is thought to be a mild form of seborrheic dermatitis of the scalp, is often itchy. Annoyingly so.

However, not everyone experiences itching with their SD rash. For some, itch and burning is a non-issue.

Why is seborrheic dermatitis itchy?

The mechanism of itch in seborrheic dermatitis is complicated but to put simply, the sensation of itchiness can occur through a few different pathways:

• Seborrheic dermatitis causes inflammation and damage of the skin, leading to excitation of the sensory nerve fibers in the skin and itch.
• The local production of histamine and other inflammatory chemicals lead to redness, swelling, itch, and even pain
• Mechanical stimuli such as heat (taking a hot shower or bath) or rubbing at your rash can sensitize your nerve receptors further, causing more itch.

What happens when you scratch?

Itch (the scientific term is pruritus) can be defined as an unpleasant sensation that evokes the desire to scratch. And scratch we do. Even when we are asleep.

But scratching causes inflammation and friction, triggering the release of more histamine and other chemicals that cause itching. Your already inflammed SD rash will get itchier, and redder and may even weep.

You also damage the skin barrier further and in fact, cause microscopic tears in your skin. You’ll know you have tears when it stings even to wash your face with water.

If you’re unlucky,  these openings can be infiltrated by bacteria, leading to skin infections that cause scarring.

It’s hard, and almost impossible not to scratch when your rash is in the inflammed phase. But it will worsen your situation significantly. Try your best to stop yourself. And if not, at least keep your nails short and only scratch the itchiest parts.

Further reading: What Happens When Seborrheic Dermatitis Is left Untreated

How to reduce itch from seborrheic dermatitis

There is no one-size-fits-all answer to reducing itch. However, these 2 tips give you the best bang for your buck:

• Keep your skin moisturized so it’s not too dry or too oily. I apply a thin layer of Moogoo Scalp Cream regularly throughout the day. It contains loads of aloe vera which soothes and heals. I don’t slather on a large amount in one go because when I have a rash going, my skin doesn’t absorb product as well and that leads to a heavy, oily feeling on my face. (You may also be interested in my review of the best moisturizers for seborrheic dermatitis)

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• Apply an antifungal cream twice a day religiously. When you reduce the amount of Malassezia on your skin, it not only shortens your SD flare, but also reduces inflammation and itch quickly. Again, less is more. A thin layer will do.

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Other tips that may help:

• Keep your skin cool. You can apply a cool compress to your rash. Just make sure it’s not too cold as that can backfire.
• Wash your face immediately, pat it dry and re-moisturize when you get back from an exercise session so sweat doesn’t sit on the surface. (read: Can sweat make seborrheic dermatitis worse?)
• Avoid harsh soaps and skincare products that can irritate the skin. These may include retinols and exfoliants like salicylic acid. Avoid oils that encourage Malassezia growth.
• Apply a steroid cream. I’m not a fan of steroid creams and never will be. But if you find that the itch is too unbearable and need an instant fix, steroid creams help by suppressing local inflammation. Only use it sparingly and for the shortest time possible as it can cause other problems in the long run.

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• Some people take oral antihistamines. Theoretically it can help but I like using creams for local inflammation. Taking a systemic drug feels like getting the courts involved to resolve a family conflict.
• Capsaicin cream can desensitize your nerve receptors and reduce itch and burning. It’s sometimes recommended for itch associated with psoriasis or kidney failure. Try the cream on a small area first to make sure you’re not sensitive to it.

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• Use calming techniques. You know as well as I do that when you’re worked up or stress, the itch gets worse and feels more unbearable. Meditation, deep breathing and mindfulness techniques help calm both your mind and the itch.
• For SD of the rest of the body, wear breathable clothing made of fibers like linen or bamboo that will allow heat and sweat to dissipate. My current favorite bamboo clothing brand is BOODY:

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To wrap up

Seborrheic dermatitis can itchy like crazy. Fortunately, there are lots of things you can do to reduce its severity. And if must scratch, do so in moderation to prevent complications.