Facial dandruff (seborrheic dermatitis)
Why do I have dandruff on my face?
Scalp dandruff is very common (one-third of people) - see my page on Scalp Dandruff. The same rash that causes dandruff on the head can happen on the face too. It is usually more annoying on the face because it is more visible. Facial dandruff is red, scaly spots behind or inside the ears, in the eyebrows or nostrils, or the beard area in men. In severe cases, it shows up in the middle of the chest.
It is worse in the winter and with stress. Sometimes visible flakes are more annoying than redness. It can be itchy. In babies, dandruff is called cradle cap - see my page on Cradle Cap.
How do I fix Facial dandruff?
The main treatment for facial dandruff is a medicated shampoo. Each active ingredient is different. If one doesn’t work, try a different active ingredient. Remember higher price ≠ better results. I use the store-brand version of Head and Shoulders myself.
Shampoos with Active Ingredients:
Zinc pyrithione:
Head and Shoulders (1%)
Free & Clear (2%, for sensitive skin)
Amazon brand (1%)
Selenium sulfide: Selsun Blue
Salicylic acid: T/Sal
Coal Tar (0.5% or 1%): DHS
NOTE: Coal tar stinks but is a great active ingredient. Use a gentle cleanser to remove the tar smell.
Ketoconazole: Nizoral
How do you use dandruff shampoo correctly?
Most people don’t use dandruff shampoo right, especially on the face. If you follow the directions on the bottle, you probably won’t see any results.
To clear it (every day for a week):
Apply dandruff shampoo like a lotion to the dry or red spots on your face.
Leave it on for 30 minutes.
Rinse off the dandruff shampoo. You can use a gentle facial cleanser if needed.
To keep it clear (at least 1-2 times/week):
Wet your face first thing in the shower or bath.
Apply dandruff shampoo to the dry or red spots on your face.
NOTE: ALL dandruff shampoos burn the eyes. To avoid burning, put the shampoo on the eyebrows like a lotion 10 minutes before your shower, then rinse off in the shower.
LEAVE ON FOR 5-10 MINUTES (LONGER IS BETTER)! The active ingredient needs TIME to soak into your skin to work.
Rinse off the dandruff shampoo at the end of the shower. Use a gentle facial cleanser if needed.
How long do I have to use dandruff shampoo?
Facial dandruff is a chronic issue. It usually requires long-term use of a medicated dandruff shampoo, but you can usually drop down to using it only once or twice a week.
While waiting for the shampoo to work, use Clinique’s Redness Solutions base to cover any redness. It works very well.
What do I do for my Facial dandruff if the steps above aren’t working?
Here are a couple of additional tips that you can try:
Apply a thin layer of hydrocortisone 1% cream twice daily to the flaky or red spots on your face for up to 2 weeks.
WARNING: Overuse of topical steroids like hydrocortisone can cause skin thinning, stretch marks, and easy bleeding or bruising.
After your shower and right before bed (twice daily), apply a thin layer of miconazole cream or clotrimazole cream to the flaky or red spots on your face.
A couple of times a week, wet your face, then massage the medicated shampoo into your face like a face mask. Leave it on for 60 minutes while you eat breakfast or scroll through social media, then rinse off in the shower.
Sometimes a dandruff shampoo may stop working. If you switch to a different active ingredient for a few weeks, usually your original shampoo will start working again.
What if my facial dandruff isn’t getting better?
The steps above help most people clear their facial dandruff. Sometimes people have a contact allergy, psoriasis, or another condition that causes an itchy facial rash. If over-the-counter products are not working, stronger prescription topical steroids can clear your facial dandruff. Look for a board-certified dermatologist in your area. If you are in or near Utah, see one of my excellent colleagues at the University of Utah or me virtually with Honeydew.
DISCLAIMER
The statements expressed and content of this website are not intended to be a substitute for professional medical advice. Readers should seek their own professional counsel for any medical condition or before starting or altering any treatment, exercise, or dietary plan. Please see our full disclaimer here.