Problems with using dandruff shampoos for a facial cleanser

Cynthia Bailey, MD|February 21, 2011

Hi Dr Bailey I have seborrhea. It affects my face mostly. The eyebrows and sides of my nose.  I have tried everything. I am a male 39 yrs of age.  The itch is probably the worst part of it. My doctor told me to wash my face morning and night with nizoral shampoo and apply nizoral cream each time. I kept to this regime for 4 to 6 months but I could'nt bare the itch. I then came across a a facial wash call "thoroughly clean face wash".  It's a tea tree oil face wash made by Desert Essence. I just used it on it's cream because I felt the Nizoral cream was making the itch worse. I am very fearful of nizoral even tohough it made my skin look ok the itch persisited. This tea tree oil face wash has been quite good but if I overuse it my face becomes inflamed........must be the tea tree oil! I tried using this face wash with a buf puf as per your blog but again it was too irritatin and left my face inflamed. I have also bought the clarisonic and used it with this face wash but after   a while it flared up. I do like the clarisonic but I think I can not use this face wash with it.  I have read your tips and am going to try the regime you advise.  I am from Ireland and can not purchase the Noble Zinc soap. Would it be ok for me to use a small amount of head&shoulders shampoo on a warm facecloth and lather gently as you describe morning and night? The head&shoulders shampoo contacins zinc pyrithione that you say is very good for seborrhea.  Should I also use the nizoral cream with 1% hydrocortisone cream to see how that works or do you advise something else?  I really like your blog and am grateful to have found your website because your instructions seem clear and simple.  Any specific advice you may have for me would be very welcome. I thank you so much. Rgds Cathal Dear Cathal, I don't ever recommend that my patients use shampoos to wash their faces because the inactive ingredients in shampoos are very harsh.  They are also potent allergens.  Facial skin is just too sensitive and the seborrheic dermatitis makes it even more so. When skin has a 'rash' it's barrier strength is compromised meaning skin care products and irritants get in more easily- like putting lemon juice on a cut.  It's therefore even more important that a person use really gentle and soothing skin care products when a rash is present, including facial dandruff.  This is one of the reasons why the Noble Zinc (soon to be reformulated as my Calming Zinc Bar) and the Replenix CF Cream or Green Tea Antioxidant Skin Therapy - Replenix Power of Three Cream work so well to gain control of the dandruff.  They provide the necessary therapeutic ingredients in products that are not irritating to 'broken' skin. I also have patients use very mild, over the counter cortisone on their faces for the itch but I personally supervise their use of these products.  All cortisone products can be harmful for the facial skin and eyes so this requires physician supervision. I am not familiar with products available in the UK and you need to ask a doctor there for help. Use of the Buf Puf Facial Sponge and the Clarisonic need to be done very gently when skin is broken out.  They may even provide too much mechanical stimulation to be tolerated until the skin is better healed.  Again, the barrier function of skin with an active 'rash' is compromised and gentle care is necessary until the skin's barrier has sufficiently recovered.  This includes product ingredients, mechanical exposures and also climactic exposure such as harsh wind or sun. I'll ask my staff to see if we can mail the Noble Zinc to Ireland. Warm Regards, Cynthia Bailey, MD, Dermatologist

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