Nizoral or Head and Shoulders?

Seborrheic Dermatitis, or Seb derm for short, can cause dry itchy, red and scaly skin. It can be found together with rosacea making it even harder to treat. Use this forum to get help with your SD.

Nizoral or Head and Shoulders?

Postby pulp » Sat May 09, 2009 3:58 pm


Like many lucky ones on here, Ive been diagnosed as having both Rosacea and Seb Derm. The seb derm is mainly in my scalp and eyebrows.
Actually the eyebrows is a new thing. They've always been quite dry but recently they've been "attacked".
Thats the only way I can put it. I had very bad seb derm in my scalp and it resulted in a lot of hair loss there. Then the seb derm went away for a bit. Now it's back and its going for my eyebrows. In the morning they're caked with flakes and now the hair there is starting to come out too. Its all very depressing. I can just about handle going bald, but I'd quite like to hang on to my eyebrows:)

But anyway the question I wanted to ask was:

There are lots of different treatments for Seb Derm: Ketocanazole (Nizoral), Zin Pyrinthione (H&S), Coal Tar (T-Gel) and also Selenium Sulphide. Can you rotate them ? Can you say, use Nizoral one day and then H&S 2 days later etc? I've seen the advised in some places?

Secondly when you shampoo you hair with these products can you then use them on your face too? And if so - which are the best ones (considering the Rosacia also)

Also Ive seen it mentioned that you should leave these shampoos on your hair for up to 10 minutes (but at least 5)
Is this really necessary? I've tried doing that twice and it caused the skin on my forehead to peel terribly. Then I had to slather it with moisturiser to ease the flaking.

Can someone advise me on the best way to use these shampoos? And which is probably the safest and best to use on my face out of Nizoral and H&S.

Thanks very much!!


ps - anyone else have any experience of this "moving" seb derm? It's really strange that it should suddenly go mega on my eyebrows when previously they werent such a problem, dont ya think?
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Re: Nizoral or Head and Shoulders?

Postby David Pascoe » Wed May 13, 2009 6:04 am

Hi there and welcome,

You have very specific questions that I don't think I can answer as I haven't had that many battles with SD myself, sorry.

If your rosacea is flaring or your skin is reactive then I would keep these shampoos away from your facial skin. If you do want to experiment then take it slow and perhaps don't be too experimental to start with.

I have used Nizoral Cream in the past for SD in my eyebrows and really bad dandruff along my hairline. This helped a lot. I felt that the cream was a better option than lathering the Nizoral Shampoo on my eyebrows - mostly because it would rub in and stick better than foaming shampoo. I was also concerned that the shampoos would be too harsh for the skin - they are not formulated to be gentle to facial skin.

I still have dandruff, so use `Neutrogena T-Gel Daily Control 2 In 1 Dandruff Shampoo Plus Conditioner' every day as my shampoo. If I stop I'll get flakes withing a couple of days. This stuff really hurts if it gets in your eyes, so I keep it well away from my face. It works great as a dandruff shampoo. At around the same time I discovered this my eyebrow and hairline SD went away too. This shampoo contains 1% pyrithione zinc.

So I reckon starting with a ketoconazole based cream is a good way to start. Tinea cream is one possible option if you can't get Nizoral Cream without a prescription.

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Re: Nizoral or Head and Shoulders?

Postby CrabbyCathy » Wed May 13, 2009 7:53 am

I'm sorry I haven't answered at all, but I don't have seb derm. Did you browse the seb derm thread here on the forum? I remember there being a suggestion as to washing the face with the shampoo.
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Re: Nizoral or Head and Shoulders?

Postby Mike T » Fri Jul 23, 2010 8:06 am

I'm in the exact same situation as yourself except mine started in my eyebrows then my head.

The hairloss is the most upsetting and the longer you leave it the worse it gets.

We face a difficult battle of finding an effective antifungal which is tolerated by our Rosacea. Unfotunatley I have found that to use a strong enough antifungal long enough to clear the seb derm usually gives me a reaction.

Latley I have been using a salycic acid/coal tar compounded cream and a zinc pyrithione compunded cream. These have worked the best for my skin. I still need to be carefully how long inleave them on though.

I did numerous blood tests and took many pills to stop the hairloss but it kept comming. It seemed to slow down when I controlled the seb derm but then came straight back. The thing about hairs is that they can only grow back a certain amount of times.

My biggest mistake through this time was not to stick to a strict shedule to control the seb derm. I would miss days, I would only treat my hair sometimes and not my eyebrows/face visa versatile and now I know that this is why I never got better.

You must treat all the seb derm on your head and face, if you only treat one it will come back.
You must use the treatments am/pm every day in the short term. If you miss one application the hard work will be undone and the seb derm will muiltply again.
You may experience worsening of symptoms in the first few days, just use a moisturiser afterwards.
You can't be too soft on your eyebrows. You need to rub them with some vigour when applying the antifungal. If you loose some hair it is badluck, that hair was bound to come out.

It has taken me 2 years to figure out the above. My biggest problem was starting treatment and then not sticking with it. This has led to some permanent hairloss in my eyebrows, which rogaine seems to be helping.

I leave the zinc pyrithione on for 20 mins and the salycic acid for 1 hr. I alternate them sporadically. If you can tolerate nizoral it is very good, a few mins of it should do. My applications are strictly EVERY 12 hrs.

ofcourse everyone has differing severities of seb derm and you can adjust any of the above paramaters to suit.

Anyone struggling with seb derm and hairloss is welcome to leave me a message here or privatley. It is a difficult symptom of the condition which is not acknowledged, particularily by dermatologists.


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