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Reversing Seborrheic Dermatitis and Hair Loss

This article examines the intricate relationship between seborrheic dermatitis and hair loss. Quite a bit of ground is covered, but I’ve tried my best to keep the writing organized.

In most cases, seborrheic dermatitis is the first of the two issues to emerge.

Starting with a small patch of skin, which gradually increases in size and severity. Once the seborrheic dermatitis is entrenched, the hair follicles suffer and hair loss issues begin to emerge.

Thus, to really understand your issues, you should evaluate this process from beginning to end (resolving seborrheic dermatitis first and then finding ways to stimulate hair growth).

This article is structured into four main sections:

  1. Most common culprit responsible for seborrheic dermatitis and hair loss
  2. Proven treatment approaches to dealing with seborrheic dermatitis
  3. Possible factors which may be fueling your hair loss
  4. Strategies to jump start hair growth

You can jump around using the table of contents below, but I highly recommend you read the content in order. And if you have any questions or suggestions that come up, you can always drop a comment in the comments sections at the end of this page.

Update 2018: If you believe that your hair loss and seborrheic issues are caused from within (stress, nutrition, infection, etc.), you may want to have a look at SkinSupport. It’s a new systemic program that I’ve been working on.

The Fungus Most Commonly Responsible for Seborrheic Dermatitis and Accompanying Hair Loss

Hair loss is a common side effect of seborrheic dermatitis. And this is especially true, if inflammation is allowed to spiral out of control and flaking occurs on a large portion of the skin surface. Yet, the link between seborrheic dermatitis and hair loss remains illusive.

Is seborrheic dermatitis directly responsible for the hair loss? Or are the underlying factors of seborrheic dermatitis causing the hair loss?

The majority of medical literature and online discussion typically concludes that the majority of seborrheic dermatitis cases are caused by the malassezia yeast. This yeast is considered lipophilic, meaning that it feeds off of fats (lipids). And this is where the problem begins.

Normal skin uses sebum (secreted from the hair follicles) to protect itself from the environment and retain moisture. A significant part of this sebum, is made up of lipids.

These exact lipids that our skin relies on for its protection, can be a prime food source for the malassezia. This makes the yeast extremely common and it’s even present on the skin of individuals not affected by seborrheic dermatitis issues.

The problem is, in some of us, this yeast triggers seborrheic dermatitis symptoms accompanied by significant hair loss.

For those of us effected, the yeast appears to disrupt the skins natural defense mechanism and invade the hair follicles (hair root from which the sebum is secreted) [1]. It is this invasion of the hair follicles, which is likely to be the root of the hair loss that your experiencing.

If you really want to understand the connection between malassezia and seborrheic dermatitis, considering reading the in-depth article discussing the possible causes of seborrheic dermatitis. This goes into much greater detail into the underlying mechanism of the condition, but is slightly outside the scope of this article.

Perhaps Your Issue is Not Malassezia

The majority of this article is focused on discussing hair loss that accompanies malassezia infestation. In some individuals, the issues may not actually be caused by malassezia, but another bacteria/yeast/micro-organism. In these cases, much discussion relating directly malassezia might not be applicable. Nevertheless, many points may still be relevant.

Fighting the Malassezia Yeast to Help Restore Normal Hair Growth

Based on the theory discussed above, the most direct way to reverse hair loss and improve hair growth would be to fight the malassezia yeast invading the hair follicle. This should restore follicle health and pave the way for normal hair growth.

This next section will discuss the most wide-spread methods that have been documented to be effective against the malassezia yeast. The first two methods will be the more researched ones, but rely on the usage of commercial anti-fungal agents. After these, focus will shift towards more natural methods that are popular across the internet (some of which do have medical research behind them as well).

Pyrithione Zinc Is One of the Most Popular Anti Malassezia Solutions

Pyrithione Zinc is one of the most popular anti-fungal agents used against the malassezia yeast. And the shampoo that contains it (Head & Shoulders), is actually one of the most popular shampoos in the world.

Regular usage has been shown to be effective at reducing malassezia colonies on the skin, restoring normal hair growth, and returning the skins ultrastructure to normal [2]. But it is rather difficult to find studies that actually examine it’s effect on hair growth in individuals experiencing strong malassezia infection, instead most studies on its effect on hair loss/growth are more general in nature.

A shampoo containing pyrithione zinc may help control malassezia and restore hair grwoth

Pyrithione Zinc and Hair Growth – Highlights from Medical Literature

Overall though, pyrithione zinc is one of the most documented anti-fungal agents shown to be effective against malassezia. And here are some interesting points gathered from various research papers:

  • Hair quality and overall performance on scaling and itching appears to be better for pyrithione zinc then ketoconazole [3]
  • Appears to normalize epithelial keratinization (formation of outer most layer of skin) and/or sebum production, resulting in improved scalp health [2]
  • Selenium sulfide appears to be superior to pyrithione zinc in reducing malassezia numbers [4]
  • Regular shampoo usage (2-3 times per week) may result in a decrease in hair shaft diameter (hair thickness), but a significant improvement in new hair growth was noted [5]

One study [6] that tried to examine the effects on hair growth concluded that the daily usage resulted in a significant overall increase in total visible hair counts. But the issue with this study is that individuals with seborrheic dermatitis, psoriasis and other scalp infections were specifically excluded. As a result, this study may not be a good representation of how significant results may be for those actually suffering from a malassezia infestation.

If you like additional details (safety, mechanism of action, etc) on pyrithione zinc usage, you can refer to the treating seborrheic dermatitis with zinc pyrithione article.

Ketoconazole (Nizoral) May Be Better for Hair Growth

Another popular anti-fungal agent for the treatment of seborrheic dermatitis is ketoconazole. Most medical literature seems to indicate that it is actually more effective then pyrithione zinc [7]. In addition to this, ketoconazole usage appears to be more popular among individuals trying to combat premature balding.

This would indicate that ketoconazole may be a better option for control of malassezia and restoration of hair growth then pyrithione zinc. However, one studies concluded that individuals testing both products actually preferred pyrithione zinc in overall effectiveness.

Similar to pyrithione zinc, ketoconazole has been reviewed in greater detail in a separate article: treating seborrheic dermatitis with ketoconazole.

Ketoconazole and Hair Growth – Highlights from Medical Literature

  • On average, individuals reported better results from pyrithione zinc as opposed to ketoconazole in terms of overall performance on hair health (hair-combing ease, smoothness, frizz, etc) [3]
  • In an experiment carried out on mice, it appeared to stimulate hair growth, and when it was integrated into a shampoo (opposed to a regular lotion/ointment) penetration was enhanced [8]
  • Using ketoconazole containing shampoo 2-3 times a week for 6 months had no change on hair density, but had the most drastic (a reduction of almost 20%) impact on hair shedding from all anti-dandruff shampoos tested [5]
  • Regular usage was shown to increase hair shaft thickness while also producing a small decrease in sebum output at the skin surface [5]

Raw Honey for Malassezia Control

In Arabic medicine, honey has long been used for treatment of fungal infections of the skin and modern medical literature has highlighted its antifungal activity against malassezia and broad antimicrobial properties [9]. This makes honey a prime candidate for an all natural approach to treating malassezia infection and allowing for a healthy scalp environment.

Honey treatments have been discussed previously on this website in significant length. This discussion can be found here: basics of treating seborrheic dermatitis with raw honey, but for now, let’s focus on it’s effects on hair growth.

Raw Honey and Hair Growth – Highlights from Medical Literature

Medical literature regarding any potential impact that honey may have on hair growth is fairly limited.

  • One paper mentioned that honey application on a dog had restored had restored hair growth on skin severally damaged from a house explosion (areas of skin without treatment did not have any hair growth) (source)
  • In one study of 20 patients with seborrheic dermatitis, regular treatment with honey resulted in subjective (self-reported) improvement in hair loss [10]
  • A patent filed back in 2000 suggests that a combination of honey, vinegar and water may aid in stimulation of new hair growth and prevent/minimize hair loss, but this was note the core of the patent (source)
Honey may be an inexpensive and simple way to stimulate hair growth

Raw Honey and Hair Growth – Online Search

If we don’t restrict our search to medical literature, the internet is full of blog posts and forum posts that discuss honeys potential in stimulating hair growth. These will not be discussed here as there doesn’t appear to be enough valuable discussion or user validation. However, the amount of discussion on this topic appears to further validate the idea of using raw honey to aid hair growth.

Using Natural Anti-Fungal Fatty Acids Against Malassezia

There are also several fatty acids found in nature which appear to have significant anti-fungal activity against a variety of fungi [11]. One of the most popular of these, is caprylic acid.

Caprylic acid triglycerides are often used as the emollient (oily) component of many skin care products. When it is used at an adequate concentration, it’s been shown to have broad antifungal activity against a variety of malassezia species [12].

If hair loss that accompanies seborrheic dermatitis can be reversed once a healthy scalp microflora is restored, one could argue that caprylic acid triglycerides may be beneficial in restoring normal hair growth. However, there does not appear to be any medical literature which evaluates it’s effectiveness in the area of hair growth stimulation.

My current skin care regimen actually utilizes an oil based formulation high in caprylic acid triglycerides, inspired by the Cetaphil Restoraderm products I was using before it. This approach worked so well for me and my facial issues, that the formula was then later released to the SkinDrone community.

In the long run, I think certain triglycerides hold tremendous potential for the topical management of seborrheic dermatitis. It’s an all natural approach and targets the exact component the seborrheic dermatitis that appears to be the most influential in it’s progression (the lipid/triglyceride component of our sebum).

Specific triglycerides may allow trageted supplementation of the scalp's own defense system

Other Anti-Fungal Solutions

Earlier, two of the most popular anti-fungal solutions were discussed (pyrithione zinc and ketocanozole). In addition to these, there is a significant amount of other anti-fungal solutions currently available. Some of these are prescription based, while others are sold over the counter.

These include:

  • Bifonazole
  • Miconazole
  • Fluconazole
  • Metronidazole
  • Ciclopirox
  • Terbinafine
  • Nystatin

And some which are not officially considered anti-fungal:

  • Selenfium Sulphide
  • Sulphur
  • Tar
  • Lithium Succinate
  • Benzyol Peroxide
  • Propylene Glycole

These agents are noted here for reference, however, we will not be discussing these here in much detail.

Tons of Other Not So Well Documented Methods

In addition to the items discussed above, there are tons of other potential methods of fighting the malassezia fungus. Some of these have a good amount of discussion online, but the research behind these is fairly limited:

Ways To Stimulate Hair Growth After Fungus Has Been Controlled

Once the scalp micrflora is brought back to a healthy state, hair growth should naturally restore to normal. If hair loss was significant, increasing the rate of restoration may be helpful.

This section will discuss some of the potential methods this can be achieved.

Improving Circulation to Improve Growth

As with the majority of bodily functions, improving blood and nutrient delivery should increase the rate of repair and cellular activity. Thus, increasing circulation on our scalp and improving nutrient delivery to our hair follicles should in theory increase the rate of growth.

L-Arginine

L-arginine is a non-essential amino acid (protein) that humans typically obtain from diet. Athletes often use it as supplement based on the idea that it can increase blood flow and improve the recovery rate of muscle tissue.

The area which is most interest to us, is the fact that nitric oxide is produced from l-arginine. And nitric oxide appears to have both anti-fungal potential [13] and the ability to mediate vasodilatation (widening of blood vessels) [14]. Thus, improving the availability of l-arginine at the skin surface may improve local nitric oxide production resulting in improved blood flow.

Many Hair Restoration Shampoos Contain L-Arginine

Luckily, finding products that contain l-arginine is not very difficult. Many of the shampoos and conditioners currently sold under various labels and aimed at hair restoration contain l-arginine. Some examples include:

Many popular shampoos that target hair repair contain arginine and may help with seborrheic dermatitis

The biggest issue is that products typically do not specify the relative amount of ingredients they contain. Plus, shampoos are quickly washed off. These factors, make it rather difficult to determine if a shampoo will really provide enough l-arginine to achieve any beneficial effects. Perhaps, a leave-on product that species the relative amount of l-arginine it contains, may be more beneficial.

The Andalou Formulation Has Changed – 2017
Andalou has recently decided to change the formulation of the Moisture Rich Shampoo mentioned above. The new formulation has been much more drying for me and have been scrambling to find a replacement. For now, have been mixing my own oil based formulation (originally designed) for the facial skin, to reduce the dryness.

Can a Scalp Massage Help Improve Hair Growth?

Something as simple as a scalp massage may also be beneficial for improving blood flow to the scalp. The it has many positives: it’s completely free, can be done as frequently as you like and it feels amazing.

The research in this area is fairy limited, but there are patents that describe using a head massage device to stimulate blood flow and improve hair growth. Here is the most relevant one:

And there was one case study published by Cameron University in which massage, relaxation and monetary reward resulted in improvement/reversal of overall hair loss [15].

Correcting Nutritional Deficiencies May Reverse Hair Loss and Improve Growth

Many believe nutrition plays a large role in determining the growth rate and quality of hair. The research on this subject is quite sparse and mainly outlines the fact that deficiency of some nutrients (not very common in the modern world) may lead to hair loss/thinning. Yet, this does not stop various blogs and forums across the internet making a large range of recommendations on which foods and supplements can improve hair growth.

This section will look at some of the more popular nutrients that relate to hair loss/growth and make corresponding recommendations.

Biotin and It’s Role in Hair Growth

Most of the claims that biotin can regrow hair are anecdotal (unproven). A biotin deficiency may be both genetic (individual’s genes) or acquired (dietary and lifestyle choices). The acquired form is very rare in adults and typically only occurs due to alcoholism, malabsorption, pregnancy [16], but can also be a result of unusual dietary choices.

The most frequent cause of acquired biotin deficiency in adults, is the consumption of raw egg. This comes from the fact that the egg white contains a protein called avidin. This unique protein can bind with biotin and prevent its absorption by our bodies. Luckily, cooking denatures avidin and in this state, it does not appear to bind (preventing it’s usage by our bodies) to biotin [17].

What Does Research Say About Biotin

Actual research on biotin supplementation and it’s effect on hair loss is quite sparse. A small study on 46 women showed no results [18], and no clinic trials exist showing is efficacy [19]. Yet, there has been some mention of its potential usage based on it’s positive effect on brittle nails [20]. But, this really is not enough to warrant it’s general recommendation.

Most research on this subject is mainly concerned with babies and small children. Chances of deficiency at this stage of life are greatest.

If the deficiency is genetic, it can be fatal during the first 6 weeks of life it and surviving infants have extensive dermatitis and severe alopecia (hair loss) [21]. If the genetic deficiency becomes pronounced after the first 3 months of life, some children may experience small (less then normal) amounts of hair growth, but some may not have any hair growth at all.

The acquired form is quite rare as biotin is present in a large variety of food and synthesized by bacteria within the gut itself.

Zinc and It’s Illusive Connection to Hair Loss

There are tons of articles on the internet which state that a zinc deficiency can cause hair loss. And that supplementation can improve hair growth. Yet, the medical literature on the subject shows mixed outcomes and results are never as clear cut as online articles may suggest.

One study, done in 1981, tested the effectiveness of zinc sulphate supplements on 46 hair loss patients and concluded that no improvement occurred [22]. However, a more recent study carried out in 2009 on patients diagnosed with alopecia areata (an auto-immune disease that causes balding in random patches) showed promising results [23].

There are a number of smaller medical case studies which do show some potential for zinc to reverse hair loss:

But case studies on single patients do not provide enough evidence to warrant any general recommendations.

Overall, it is likely best to ensure we obtain enough zinc by eating a well balanced diet. The best sources of zinc are seafood and meat. Plant sources such as seeds, beans, peas and lentils do provide some zinc. But, vegetarians are often recommended to supplement as their diets typically result in low zinc intakes.

Iron May Improve Hair Growth in Cases of Deficiency

Iron is one of the worlds most common nutritional deficiencies. And it can results in diminished intellectual performance and decrease resistance to infection (

source).

One of the earliest studies was carried out over 40 years ago (in 1963 to be exact). In this study scientists demonstrated that an iron deficiency could be the direct cause of of hair loss in women and correction therapy was used to reverse this hair loss [24]. This study sparked interest in using iron to reverse hair loss. However, larger more recent studies failed to show any direct connection between iron deficiency and hair loss:

Even though there does appear to be some cases in which iron may contribute to hair growth, there is not enough evidence to suggest universal screening for iron deficiency in hair loss patients [25].

The easiest way to avoid iron deficiency is through adequate dietary intake. And similar to zinc, animal sources of iron (such as various meats and seafood) appear to be preferable to plant sources and iron fortified foods [25].

Over Supplementation Can Actually Lead to Hair Loss

Sometimes less is more. Excessive amounts of certain vitamins and nutrients has actually been documented to result in hair loss.

The most established of these relates to excessive vitamin A intake [26]. However, some studies suggest too much of vitamin E, selenium [27] and/or folic acid [26] also have negative results. As a result, the best approach to prevent deficiency is likely through a balanced diet and not abusive supplementation.

However, it can sometimes be difficult to eat a completely clean diet (often recommended by various onliny websites and health movements). As a result, your left more stressed out then you should be.

After researching this topic in more detail, my opinion is that there are specific foods that, if included in your diet, can provide the majority of benefits without adding any stress. This includes simple foods such as apples, cabbage and carrots, but also specific dietary principles which are often overlooked (glycemic index, lipid balance).

You can find a summary of findings on this topic over at the first two modules of the SkinSupport program:

Emblem for Skin Support Part 1 - Establishing Fundamentals

Improving Digestion

There is delicate relationship between your digestive system and the state of your skin. By improving one, you provide the building blocks needed by the other.

Emblem for Skin Support Part 2 - Achieving Dietary Balance

Achieving Dietary Balance

Dietary choices should not be overly focused on single nutrients and components. Instead, balance must be achieved to provide the stability your immune systems need to thrive.

Additional Nutrition Related Findings

Other nutritional deficiencies that appear to cause hair loss and documented in medical literature, include:

  • L-lysine (an amino acid) [26]
  • Essential fatty acids [28]
  • Niacin [29]

However, the internet is also full of recommendations which are not based on science. These typically result from the recycling of information from potentially unreliable sources. If you conduct your own research, be vigilant and look for information backed by at-least some sort of research.

Summary of Nutrition for Hair Growth

Research appears on nutrition and its effect on hair growth typically examines how various deficiencies may cause hair loss. And correcting these deficiencies can reverse hair loss and return hair growth to normal. However, supplementation without medical testing may actually be counter productive.

Perhaps the best approach is to simply ensure your diet has a large variety of healthy food choices and is suitable for your unique lifestyle.

Most Popular Methods That Specifically Target Hair Growth

In addition to the items described above, there are tons of discussed treatments found across the internet which target hair loss/growth directly (irrespective of malassezia). The most popular of these, is drug by the name of minoxidil and an all natural oil derived from castor beans. These approaches are discussed next.

Minoxidil for Stimulating Hair Growth

Minoxidil is one of the most famous hair growth stimulates known today. It’s results are so pronounced that in the 80’s some doctors started prescribing it to balding patients before it was ever approved by the FDA for treatment of baldness.

Minoxidil appears to be a potent vasodilator [30] and it’s most likely mode of action is increasing local blood flow.

The biggest downfalls, is that results take time to be noticeable and that once treatment is stopped, hair loss often returns [31].

Today, minoxidil products are widely available and can be purchased without any prescription. Costco carries it’s own Kirkland version, Wal-Mart has it’s own Equate version, and Amazon has a ton of offerings from various companies. And the reviews for the majority of these minoxidil products are quite favorable, further affirming its effectiveness.

Minoxidil is a widely used drug to stimulate hair growth, but combination with an anti-fungal does not appear necessary
Minoxidil and Potential Side Effects

As with most drugs, minoxidil has it’s own set of potential side effects. The biggest one is that in some individuals, it may produce the opposite effect and result in temporary hair loss. Other side effects include potential skin irritation, unwanted hair growth in other parts of the body, and unwanted thickening and darkening of hair.

Minoxidil – Highlights from Medical Literature
  • A solution containing only 1% minoxidil was shown to be effective for hair regrowth, but a 5% solution was more effective [32]
  • When 5% foam was compared to a regular 2% solution, results were practically the same [33]
  • In some patients, minoxidil can cause atopic dermatitis and scaling of the scalp and potential exacerbation of seborrheic dermatitis. In patients tested, the cause was not the active minoxidil, but the other ingredients of the formulation such as propylene glycol. Switching to alternative minoxidil preparations appeared to resolve symptoms [34]
  • Combining minoxidil treatment together with zinc pyrithione treatment does not improve outcomes beyond the effects achieved with zinc pyrithione alone [35]

Castor Oil for Hair Growth

Many blogs and forums tout castor oil as being one of the most effective natural treatments for improving hair growth. And many individuals claim that it has been used for decades.

The active component is the ricinoleic acid which believed to increase topical blood circulation.

The issues is that medical literature on this subject is practically non-existent. The most relevant item I could find was a review article published in 1982 that summarized the various uses of castor oil [36]. It mentioned that the oil is used in Ethiopia to combat seborrhea and tinea (another fungal skin infection). And that an alcoholic solution has been recognized in Italy to have anti-seborrheic action and favor the growth of hair.

Adding Rosemary Essential Oil to Castor Oil

Many sources also suggest that adding rosemary essential oil will further improve castor oil’s effectiveness. But once again, research on this subject is very sparse and the closest item I managed to find was a patent aimed at stimulating hair growth which included a rosemary extract (source).

Caffeine to Stimulate Cellular Growth

Some researchers suggest that topical application of caffeine can improve barrier function [37], increase hair shaft diameter [38] and stimulate/promote new hair growth. And shampoos containing caffeine appear to be excellent an method for delivering it into the hair follicles (source).

One study showed that regular application of a caffeine containing preparation reduced the number of hairs extracted using a pull test by 8.14% after 2 months and by 15.33% after 4 months (source).

While another study concluded that caffeine led to a significant stimulation of hair follicle growth. However, at higher concentrations it may actually have a negative impact on results as it may cause over-stimulation, over consumption of energy reserves and exhaustion of proliferation capability [38].

Even though caffeine does appear to hold some value in stimulating hair growth, most studies suggest that further research is needed. Nevertheless , for individuals desperate to improve hair growth, it may be a valuable addition to your regimen.

The Connection Between Androgens, Seborrheic Dermatitis and Hair Loss

The hormones classified as androgens are some of the clearest regulators of human hair growth [39]. Because the appear in greater abundance in males, people refer to them as male hormones (as their production is greater in males). But in reality they are actually present in both genders.

Androgens are responsible for the gradual replacement of baby hair (vellus hair) by more thicker, longer and darker hairs during puberty. Yet, they appear to have the opposite effect on scalp hair, causing regression throughout the aging process. Some predisposed individuals are more susceptible to this regression and issues of male pattern baldness arise.

One interesting point, is that androgens are also responsible for activating sebaceous gland activity (during puberty) and regulating it throughout adulthood. Since sebaceous gland activity is closely related to seborrheic dermatitis progression, it is possible that androgens may actually play a crucial role in the in the progression of seborrheic dermatitis itself. And the following three facts further help illustrator this point:

  • The malassezia fungus feeds off of sebaceous gland secretions which is regulated by androgens [40]
  • Seborrheic dermatitis often appears after puberty and this is the time that androgens become active [41]
  • Males have more androgens and seborrheic dermatitis is more common in men than in women [42]

However, even though androgens do appear to be related to both premature hair loss and seborrheic dermatitis, the connection is not clear. Some studies and review papers on seborrheic dermatitis do suggest that androgens may play a role, but most agree that they are not the direct cause [].

Conclusion

First we examined the potential role that malassezia fungus may play in influencing hair loss. They key takeaway was that malassezia feed off of the oils secreted by our sebaceous glands (many of which are connected to hair follicles) . As a result, malassezia colonies may be more active around the hair follicles and negatively impact normal hair growth.

As a result, reducing the number of malassezia colonies may reverse hair loss and return hair growth back to normal. To achieve this reduction, a significant number of topical anti-fungals (pyrithione zinc, ketoconazole, raw honey, etc) are currently available. And finding one suitable for daily usage may be a necessity (if the skin is failing to naturally regulate it’s microbial environment).

List of Most Common Malassezia Treatments:

Sometimes individuals may experience a negative reaction to various products. This reaction might not be caused by the active ingredient, but something else contained in the formulation. Thus, it may be worthwhile to compare and evaluate all ingredients while finding a suitable solution and reduce the use of formulations containing known irritants.

In addition to this, it might beneficial to aid hair growth by stimulating the hair follicles by inducing vasodilation (improving blood flow). This could improve nutritional delivery and increase the rate of cellular growth/repair. Topical solutions such as the drug minoxidil and a natural oil from the castor bean may also be of value. However, perhaps simply resolving seborrheic dermatitis may be enough to return things back to normal.

Potential Ways to Improve Hair Growth:

  • L-arginine
  • Caffeine
  • Scalp Massage
  • Minoxidil
  • Castor Oil

But in order for any attempts at improving hair growth to be effective, we must ensure that we do not have any nutritional deficiencies which may be preventing progress. The most common of these appear to be iron, zinc, and the amino acid l-lysine.

Medical testing for deficiencies is likely the best approach as over supplementation can actually result in the opposite effect (hair loss). Eating a balanced diet which respects the specific principles important for healthy skin is probably the best bet for the majority of us.

Overall, I strongly believe that solving seborrheic dermatitis is most likely to resolve hair loss in the majority of cases. Nonetheless, improving the rate of hair recovery/growth with some of the suggestions discussed in this post is likely to speed up recovery.

Update 2018: A big part of me still believes that strengthening the overall immune system can have tremendous benefits for your hair and skin. If you think your issues are at-least partially caused from within (stress, nutrition, infection, etc.), you may find some useful information in the SkinSupport{.skin-support-bottom-link} program.

If you found any of this information on seborrheic dermatitis and hair loss/growth helpful, have any additional suggestions or simply want to share your experience, drop a comment below.

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References

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  33. Elise A Olsen, David Whiting, Wilma Bergfeld, Jeffrey Miller, Maria Hordinsky, Rita Wanser, Paul Zhang, Bruce Kohut "A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men." Journal of the American Academy of Dermatology 57.5 (2007): 767-74. PubMed
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in Seborrheic Dermatitis   28

About Michael Anders

After being affected by seborrheic dermatitis, I have made it my goal to gather and organize all the information that has helped me in my journey.

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28 Comments

  1. Lan
    Lan -

    Thank you so very much for your article! I have searched high and low for information pertaining to my outbreak and hair loss caused by a severe allergic reaction to tape-in real hair extensions. Stupidly, I persevered with the extensions thinking that the symptoms would go away. Consequently, 3 months later that approach ended up with me having two bald patches, under my hair, on each side of my head. In addition, the whole front of my body (under breasts, belly button and groin area followed suit! Good news is that it’s slowly dissipating using an array of different treatments including diet and natural/OTC creams. I’ll add some more of your suggestions to my routine.

    Thank you, your article was by far the best – you know your stuff!!! 🙂

  2. Maiah Lively
    Maiah Lively -

    Awesome article. So much helpful information

  3. Human Person
    Human Person -

    Hi there, love this content!! Thank you.

    I saw that your reference of #6 actually says ” In addition, KTZ and PTO increased the mean hair shaft thickness while discretely decreasing the sebum output at the skin surface.”…meaning that the mean hair shaft thickness increased, rather than decreased as mentioned here:

    “Regular shampoo usage (2-3 times per week) may result in a decrease in hair shaft diameter (hair thickness)”

    I only mention this because no one with hair loss wants a decrease in hair shaft diameter! I was scared to use the dandruff shampoo.

    • Michael Anders
      Michael Anders -

      Dear Human,

      Thank you for pointing this out.

      From a quick review, the paper referenced did mention that KTZ (Ketoconazole) and PTO (Piroctone olamine) increased hair shaft diameter.

      However, ZPT (zinc pyrithione) usage resulted in decreased hair shaft diameter. Here is the relatavent part of the paper:

      > The efect on the mean hair shaft diameter was contrasted between the three groups of volunteers (KTZ: 5.4%, PTO: 7.7%, ZPT: -2.2%).

      Accordingly, in the artice, the decreased hair shaft diameter was specifically in relation to zinc pyrithione usage.

      On a side-note, thank you for the kind feedback regarding the writing. Hopefully with time, more discoveries lay ahead and a more clear understanding of the condition emerges.

      Please let me know if you spot anything else.

  4. Kelsey
    Kelsey -

    Michael, I have read all of your research and firstly, want to thank you. I would be lost without you. I’m a 26 year old female who went a year with no diagnosis and being told by everyone I was being over dramatic/paranoid about the my hair loss that I started having. My dermatologist wouldn’t even look at my scalp without doing a scalp biopsy… so I started doing my own research… went to see my regular physician for blood test and asked her if she could look at my scalp and she immediately said “oh this is definitely seborrheic dermatitis!”… (which I knew but didn’t want to be true…) With that being said.. I’m doing everything possible and I just cannot seem to get rid of this on my scalp… I have lost so much hair that I’m embarrassed to go out in public. Is there anyway you can email me and I can show you everything I have tried? I have spent 1000s of dollars in this past 8 months.. I appreciate tremendously everything you do for all of us suffering with SD.
    -kels

  5. Kelly Carruthers
    Kelly Carruthers -

    Hello,

    Thank you for providing all this information. It’s the fist time I found something explaining the relationship between hair loss and Seborrheic Dermatitis that makes sense. I am trying to figure out why my 12 year daughter is having hair loss. Her lab results have not shown any nutrition issues or thyroid problems. Our dermatologist is suggesting Rogaine but has not be able to give a clear reason why this is happening. I keep thinking that there is something going on and it occurred to me that she has had a history of dandruff and last winter had a red scaling spot on her scalp that the doctor said was eczema but I keep thinking how do they know it’s not ring worm or might be fungi related. The doctor prescribed Clobetasol Propionate for the eczema spot and that makes in go away but it has been reoccurring after a week or 2.

    My daughter washes her hair at night and often goes to bed with wet hair and I am wondering if that is contributing to the problem.

    After reading your article and I amthinking of trying the Nizoral shampoo.

    Thanks again!

    ~Kelly

  6. Will Moore
    Will Moore -

    I’ve had SD on my face and hair for a couple of years now. I have totally cured it on my face from one inexpensive moisturizer called child’s farm. It’s basically a miricle cream as far as I’m concerned, there is also a child’s farm shampoo and this has reduced the flakes in my hair significantly…if you’re suffering from SD, I’d urge everyone to look it up and see the benefits it has…it’s nothing short of amazing, it also cures other skin problems like eczema & psoriasis.

    • anna.del3
      anna.del3 -

      Hi Will, are you still using Childs Farm? I am interested in getting. Thanks Anna

  7. Linda Kilpatrick
    Linda Kilpatrick -

    I just got diagnosed today as having SD after years of being told by a former GP that it is psoriasis, therefore not getting the correct treatment. I am so pleased that I have stumbled across this article as it explains what I need to know so thanks.

  8. Arun
    Arun -

    I am suffering from seborrhoeic dermatitis … and i have excessive hair loss .. i am 23 yrs old male … is it possible for hair regrowth in this condition .. ?

  9. Amer
    Amer -

    The best advise i can give is to use Selson blue. Just 2 weeks after using it, IT WAS ALMOST PERFECT!!

    I have had Seborrheic Dermatitis for at least 10 years. I have used 2 medicated shampoos before for treating it, other than the usual Head and Shoulders shampoo.

    Try it and look at the benefit for yourselves.

  10. Randall
    Randall -

    I came down with SD when I turned 19. I got a perm and immediately was affected with SD in the front of my hairline. No dandruff or SD treatments (from Dr or shampoo) worked. I was told it was permanent and I’d just have to learn to live with it. Head and Shoulders worked better than anything else but it failed to stop the progression of SD. It spread to my eyebrows and face. By the time I turned 20 I had shaved my hair and eyebrows off in a last ditch effort to save them. My eyebrows grew back. My hair was too far gone. The hair loss was permanent. I’ve had SD for 25 years now. I’ve learned to control it by keeping excessive oil wiped off my scalp and face with a rag and using head and shoulders anywhere a flare up gets really bad. Unfortunately I am bald and it’s never coming back. This disease is awful. The greassines, the scaling, the insane itching and the hair loss have been traumatic for a teenager to go through. As an adult I just get on with my life and deal with it. I’m a fighter. I always adapt to anything. Still, there isn’t a day I don’t wish this evil away. I feel for all of you that are struggling with this. We’re the group that science forgot. Not important enough to cure but just important enough to discover lifelong treatments instead.

  11. Marie
    Marie -

    Here’s a shampoo worth trying: Aveda’s Scalp Benefits. For 2 years, I had pretty bad seborrheic dermatitis, and tried all the different things the dermatologist told me about. At best, they just kept it somewhat in check; some things seemed to do almost nothing. A hairdresser tried the Aveda shampoo; it worked, and for the last 6+ years, I’ve used it every time I seemed to have a small outbreak. I also used it on my face & ears. It may not work if you have a really severe case, but if it’s milder, try it. Aveda stores will usually give you samples (bring a small container with you so they can’t use not having a container as an excuse).

  12. Marie
    Marie -

    Thanks for all the information; it’s very useful and appreciated.

    One little note (I’m mentioning this because you make the mistake many times): if you cannot replace “its” with “it is”, then it is spelled without the apostrophe. “It’s” means “it is”. “Its” is possessive.

    Biotin and It’s Role in Hair Growth
    In the aboe example, there should be no apostrophe; “its” is possessive, referring to “biotin’s role in hair growth.

    • Samantha kidston
      Samantha kidston -

      You’ve got to be kidding me, I’ve been battling scalp and baldness problems for months now, this is the most helpful info I’ve found, and you are correcting spelling??? Get a grip!

      • Kels
        Kels -

        Did you ever find anything to help with your symptoms? I am still searching. -kels

    • Marie
      Marie -

      Maybe spell ‘above’ correctly to be taken serious as an expert in grammatical and or spelling errors!

    • Linda Kilpatrick
      Linda Kilpatrick -

      I cannot believe your attack on the author because of grammar. The subject matter is far more important than a few grammatical errors so please get over yourself and stop making a fool of yourself or is it the attention that you seek

  13. Dr preeti
    Dr preeti -

    Hi , this is preeti. I have been suffering from severe hair loss since the last 10 years . It started with some features of seborrheic dermatitis..With excessive flaking etc . Now also flaking is still there ..May be because I’m using minoxidil ..But I have lost almost 90% of my hair .. have episodes of pityriasis versicolor as
    well ..Almost every 2nd year..
    Do you have any research results with my profile?? It would of really great help ..Thank you

    • Gulrukh Jaffar
      Gulrukh Jaffar -

      I have been suffering from soherbic dermatitis since puberty and have lost my 90% hair.I have made a shampoo with 5% sulphur and 5% Camphor and it seems to be working

  14. MA
    MA -

    Sorry for typos, I meant hairloss.

  15. MA
    MA -

    It just sucks how ambiguous all literature concerning link between SD and hair loss is. I mean, why doubt the link when almost everyone having SD also develop hairless – moderate to severe. Instead of sending a patient to 1000 different types of doctors who would anyway conclude they cant confirm the REAL reason of hairless, one should rather focus on fighting SD if it’s clear that the hairless started from the point of contracting SD.

  16. Black US XY
    Black US XY -

    Good site Michael, i love how you delved so deep into all of this information to build this haven for us, people in need, looking out for answers.
    I have no doubt you are one of the greatest contributors in the scientific field to the understanding of Seborrheic Dermatitis.

    About hair loss, i don’t have it in my hair, though some years ago (i have SD for about 10/11/12 years) i noticed a bit of thinning in my lower frontal hair line, above the sideburn area. But i do not even care about this, because it is not “proper hairloss”, i do have though this strange thinning of my body and facial hair, i noticed first my mustache growing slower, after that i noticed it vanishing and thinning in some areas, now i have this uneven, patchy, not complete beard.

    The doctor said it was Alopecia Areata (she made no lab tests), but i don’t think so, because of the pattern, i don’t have circular areas or whatsoever anywhere over my body, just a diffuse thin hair. This hair loss never responded to minoxidil, neither to diet change, never went away, never relocated the area (like in alopecia suffers), haven’t responded to a bit o steroids i applied near my sideburns, nothing seemed to help, i never found anything about this, seems like i’m the only in the world with this strange (very likely not, but the information is scarce), strange, strange beard/body hair loss/thinning.

    About the DS, i have quit 1 month ago the usage of topical steroids, Clobetasol Propionate (ultra potent class), and cleaned my diet even futher (something i’ve been doing for many years), it’s too early to tell, but it seems like i’m getting better, and i will do no other thing than look for my diet/exercise in 2017, after that if i don’t have a remission, i will look for supplements, 2018, and if it doesn’t work, i can try something locally over my face, 2019. That way i can understand better how everything works, easy to say i will do this, hard to follow through this, i hope that i have the strength, and come back to tell (if i remember and follow my word) what i find.

    • Black US
      Black US -

      Oh shit! Still here struggling (though i fucked up my diet in late 2017 and now i am slowly returning back), got to take the supplements route now, i will start with ZINC and VItamin C serum.

  17. Matthew
    Matthew -

    I was diagnosed with Seborrheic dermatitis but I was treating it with daily washing for years without using antidandruff shampoos. This kept flakes away but didnt solve the problem. My hair thinned a lot. I had an episode of extreme stress last year which led to increased symptoms and eventual diagnosis of seborrheic dermatitis. Learning now that it may have contributed to my thinning and shedding, is the hair lost over the years reversible too or just the recent hair loss that occured just before using antidandruff shampoo? Also, is it safe to use Nizoral and other shampoos and conditioners or is mixing unsafe (either the same day or on in-between treatment days)? Thank you for the help. I appreciate this so much.

    • CC
      CC -

      My doctors recommended I use various medicated shampoos after the zinc pyrithione shampoo I had been using for years seemed to stop being effective. I now alternate between four different medicated shampoo types each time I wash my hair. I think the best treatment is to wash your hair with a medicated shampoo at least 4-5 times a week for moderate SD or daily for severe SD. I also think working on managing/lowering stress is key to helping control SD and its potential causes.

  18. Steve
    Steve -

    Great article, Michael! Your research is always top notch.

    Any specific findings or insights on eyebrow hair?

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  1. Guide to Treating Dandruff in Eyebrows - SkinDrone

    […] One of the biggest benefits of pyrithione zinc for many of it’s users is the fact that it may also help restore hair growth (source). And this fact, has been discussed in greater detail in a previous post: Reversing Seborrheic Dermatitis and Hair Loss. […]