Facial dandruff (seborrheic dermatitis)
Why do I have dandruff on my face?
Dandruff isn’t just a scalp problem – the same rash can appear on the face. Facial dandruff causes red, scaly patches behind or inside the ears, in the eyebrows, around the nostrils, or in the beard area for men. In more severe cases, it can also show up on the chest.
It often gets worse in winter or with stress. Some people are more bothered by visible flakes, while others notice redness and itching. In babies, this condition is called Cradle Cap.
How do I fix facial dandruff?
The main treatment for facial dandruff is a medicated shampoo. Each active ingredient works differently, so if one doesn’t help, try another. Higher price doesn’t mean better results. For years, I used store-brand Head & Shoulders, but recently found CeraVe’s dandruff shampoo works well as both a gentle face wash and an effective dandruff treatment.
Shampoos with Active Ingredients:
Zinc pyrithione:
CeraVe shampoo (1%) and conditioner (0.5%)
Head and Shoulders (1%)
Vanicream (2%, for sensitive skin)
Amazon brand (1%)
Selenium sulfide: Selsun Blue
Salicylic acid: T/Sal
Coal Tar (0.5%): DHS or Amazon brand
NOTE: Coal tar shampoos often have a strong smell, but they work well for dandruff. To get rid of the odor, use a conditioner after shampooing.
Ketoconazole: Nizoral
How do you use dandruff shampoo correctly?
Most people don’t use dandruff shampoo the right way. Just rubbing it on and rinsing quickly won’t help.
To clear facial dandruff (do this DAILY for 1 week):
Wet your face in the sink
Massage the dandruff shampoo into the skin on your face
Leave the shampoo on for 30 minutes, then rinse off.
Cover face with CeraVe moisturizing cream before bed.
To keep facial dandruff away (at least 1-2 times/week):
Wet your face at the start of your shower or bath.
Apply dandruff shampoo directly to the red or flaky spots.
NOTE: All dandruff shampoos can burn the eyes. To avoid this, apply the shampoo to your eyebrows like a lotion 10 minutes before showering, then rinse off in the shower.
Leave the shampoo on for 5–10 minutes (longer is better) so it has time to work.
Rinse off at the end of your shower. Use a gentle cleanser afterward if needed.
How long do I have to use dandruff shampoo?
Facial dandruff is an ongoing problem that usually needs long-term use of medicated dandruff shampoo to keep under control.
While waiting for the shampoo to improve the redness, Clinique’s Redness Solutions base is excellent for covering visible redness.
What do I do for my facial dandruff if the steps above aren’t working?
If facial dandruff isn’t improving with the steps above, try these options:
Apply a thin layer of hydrocortisone 1% cream to the red or flaky spots twice daily for up to 2 weeks.
Warning: Overuse of topical steroids can cause skin thinning, stretch marks, and easy bruising/bleeding.
Use an antifungal cream (miconazole or clotrimazole) twice daily after your shower and before bed to the flaky or red spots on your face.
A couple of times a week, apply dandruff shampoo as a face mask: massage it onto damp skin, leave on for up to 60 minutes, then rinse off in the sink.
If your shampoo stops working, switch to a different active ingredient for 2–3 weeks. Often, your original shampoo will start working again after the break.
What if my facial dandruff isn’t getting better?
Most people improve with the steps above, but sometimes another condition (like contact allergy or psoriasis) can cause similar facial rashes. If over-the-counter treatments don’t help, prescription creams may be needed. 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.
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