What helps against seborrheic eczema on your scalp?

A shampoo against yeasts, such as a shampoo with ketoconazole, is especially helpful against seborrheic eczema on your scalp. You wash it at least twice a week, let the shampoo work for 3 to 5 minutes and rinse thoroughly. Itching and flaking usually subside after a few washes, but it can take up to 4 weeks to completely go away^[3]. Itching and flaking usually subside after a few washes, but it can take up to 4 weeks to completely go away^[3]. Seborrheic eczema is a chronic condition that often comes back, so after that you keep it calm with an anti-dandruff shampoo 1 to 2 times a week^[1]. If things do not improve after 4 weeks, go to the doctor. Do you use minoxidil? Then first ensure a calm scalp.

Contents

• What is seborrheic eczema on the scalp?
• Is it dandruff or seborrheic eczema?
• What helps against seborrheic eczema on your scalp?
• How long does it take before you notice a difference? see?
• Can you get hair loss due to seborrheic eczema?
• Can you use minoxidil with seborrheic eczema?
• When do you go to the doctor?
• Frequently asked questions
• Sources

What is seborrheic eczema? eczema on the scalp?

Seborrheic eczema is a form of eczema with redness and dry or oily flaking of the skin^[2]. It occurs in places with many sebaceous glands, and the scalp is the most common place. The eyebrows, the folds next to the nose, the ear canal, the chest and the back can also participate.^[2].

A yeast that naturally lives on the skin plays a major role. In people with seborrheic eczema, this yeast occurs in larger quantities and the immune system reacts with inflammation. It is not known why one responds to this and the other does not^[1]. It is not known why one responds to this and the other does not^[1]. It is not contagious and not an allergy^[2].

About 5% of people suffer from it, slightly more often men than women^[1]. Stress, cold autumn and winter weather and dry air in heated rooms can make the complaints worse. In a more extensive form, the scalp becomes red and itching and flaking increase. The flakes are often yellowish and look waxy or greasy^[1][2].

Is it dandruff or seborrheic eczema?

Dandruff is the mildest form of seborrheic eczema: fine flakes on the hairy scalp, sometimes with some itching^[1]. In a more extensive form, the scalp becomes red and itching and flaking increase. The flakes are often yellowish and look waxy or greasy^[1].

It sometimes also resembles psoriasis of the scalp. A doctor can assess the difference, possibly with a dermatoscope^[4]. If you have any doubts, have it checked out. Do you have a tight, dry scalp without redness and greasy flakes? Then also read our blog about a dry scalp in the winter.

What helps against seborrheic eczema on your scalp?

Seborrheic eczema cannot be cured permanently, but you can keep it under control^[1]. The treatment focuses on the yeast and the inflammation. These are the steps that sources mention:

1. Start with an anti-dandruff shampoo. Shampoos with selenium sulfide or zinc pyrithione often help^[1].
2. Does that help too little? Choose a shampoo with ketoconazole. Ketoconazole kills mold and yeast. Dermatologists often prescribe it for seborrheic eczema^[1][3].
3. Use the shampoo correctly. Spread it over the wet scalp, massage gently, leave on for 3 to 5 minutes and rinse with warm water^[3]. Only then use a cream rinse, because a rinse can reduce the effect of the ketoconazole shampoo^[3].
4. Anti-inflammatories only through the doctor. In case of severe inflammation, the doctor can prescribe a lotion with a corticosteroid for as short a time as possible^[1][2].
5. Keep your scalp clean and reduce stress where possible. Wash and rinse your hair regularly^[1].

Studies have examined ketoconazole 2% shampoo in a schedule of 2 times a week for 4 weeks^[4]. In the Netherlands you get this strength through your GP or pharmacy. Nizoral 1% is a lower strength that you can order without a prescription. If you want to know what the difference between 1% and 2% means, read our blog about ketoconazole shampoo for hair loss.

Anti-dandruff shampoo with ketoconazole

Nizoral Anti-Dandruff Shampoo 1%

Shampoo with 1% ketoconazole against dandruff and flakes. You use it twice a week and let it work for a few minutes.

from € 44.99View Nizoral →

Customer experience

★★★★★

"This shampoo from Nizoral really works great against dandruff. I have tried many different shampoos, but nothing helped. Since I started using this product, my dandruff has improved. disappeared almost immediately. This is what the progression looks like:

K., Nizoral Anti-Dandruff Shampoo 1% · Review via Judge.me · Results vary per person.

How long does it take before you see a difference?

You will usually see rapid improvement with a ketoconazole shampoo, but always complete the treatment, even if the complaints have already disappeared^[3]. This is what the progression looks like:

Rely on it coming back. Seborrheic eczema is chronic and can flare up as soon as you stop treatment^[1][4]. A regular maintenance routine therefore works better than only doing something when it itches again.

Can you experience hair loss due to seborrheic eczema?

Yes, but usually temporary. If flaking covers the entire scalp, temporary hair loss may occur^[1]. If the inflammation calms down, the hair loss should recover.

Are your inlets getting deeper or your crown thinning while your scalp has long calmed down? Hereditary hair loss is probably a factor, which an antifungal shampoo will not allow to grow back. If your hair falls out suddenly or in bald spots, go to the doctor.

Can you use minoxidil with seborrheic eczema?

That is possible, but pay attention to the moment. The official product information of a minoxidil solution states that the scalp should be healthy, normal and intact before starting^[5]. In case of inflammation or wounds, such as psoriasis, sunburn or open spots, the skin absorbs more minoxidil and the risk of side effects in the rest of the body increases. If you scratch your scalp or it is bright red and wet, consult your doctor or pharmacist first.^[5]. If you scratch your scalp or it is bright red and wet, consult your doctor or pharmacist first.

There is another point that many people do not know. According to the same product information, you should not use minoxidil at the same time as topical corticosteroids, retinoids or occlusive ointments such as Vaseline, because they increase absorption^[5]. Have you been prescribed a hormone lotion for your scalp? Then ask your doctor or pharmacist how to coordinate this with minoxidil. A ketoconazole shampoo that you rinse out is not covered by this warning.

The product itself can also make a difference. Minoxidil lotion often contains propylene glycol, which can irritate the skin^[5]. Rogaine foam does not contain propylene glycol^[6]. If you have a sensitive scalp, a foam or lotion for sensitive skin is a logical choice. Always check the ingredients list yourself and read the package leaflet.

If your scalp is calm again, wash with the ketoconazole shampoo, rinse well, dry your scalp completely and then apply minoxidil. Do not use minoxidil if you are pregnant, breastfeeding or younger than 18, and first consult your doctor if you have heart or blood pressure problems. If you experience chest pain, rapid heartbeat, dizziness or sudden swelling, stop and contact a doctor.

Foam instead of lotion

Kirkland Minoxidil Foam 5% 1 Month For Men

Minoxidil 5% as foam, for those who do not tolerate lotion on the scalp. Check the ingredients list if you are sensitive.

from € 34.99View the foam →

For a sensitive scalp

Foligain Lotion 5% For Men, Sensitive Skin

Minoxidil 5% lotion that according to the product description is intended for people who are sensitive to alcohol-containing products.

from € 64.99 (3 months)View Foligain →

For women, the usual dose of 5% foam is once a day; read the package leaflet. The following also applies: first a calm scalp, then minoxidil.

For women, once a day

Kirkland Minoxidil Foam 5% For Women

Minoxidil 5% foam for women with thinning hair. One bottle is enough for about 2 months.

from € 39.99View the foam →

When do you go to the doctor?

If you recognize the complaints, you can always consult your doctor^[2]. In any case, go if:

• it is not better after 4 weeks of proper use of a ketoconazole shampoo^[3];
• your scalp is bright red, painful, wet or crusty, or if you scratch it open (it may become infected)^[2];
• you are unsure whether it is psoriasis or another skin condition^[4];
• your hair is sudden, in tufts or in bald spots falls out;
• the shampoo causes a burning sensation or irritation that does not go away quickly^[3].

Frequently asked questions

Does seborrheic dermatitis on the scalp go away on its own?

Usually not permanent. It is a chronic condition that often returns, even after treatment^[1][2]. With an anti-dandruff shampoo as maintenance, 1 to 2 times a week, you can keep things calm for many people^[1].

How often do you wash your hair with ketoconazole for seborrheic eczema?

At least 2 times a week. If you wash more often, use the shampoo with every wash and let it work for 3 to 5 minutes^[3].

Is seborrheic eczema contagious?

No. It is not contagious and is not an allergy. You should not use minoxidil during that period.^[1][2].

Can you use ketoconazole shampoo when you are pregnant?

According to Apotheek.nl, this is allowed, even if you are breastfeeding^[3]. You should not use minoxidil during that period.

Will my hair grow back if the eczema is calm?

Hair loss due to an inflamed, flaking scalp is usually temporary^[1]. If your hair remains thin on the crown or in the inlets, hereditary hair loss may also play a role.

This article is general information and does not replace medical advice. Always read the package leaflet and, if in doubt, consult your doctor or pharmacist. Prices are from November 2026.

Sources

1. Amstelland Hospital, Seborrheic eczema (patient brochure dermatology)
2. Health and Science, Seborrheic eczema
3. Apotheek.nl, Ketoconazole on the scalp
4. Dall'Oglio F. et al. (2022), Clinical, Cosmetic and Investigational Dermatology, An overview of the diagnosis and management of seborrheic dermatitis (English)
5. Medicine Evaluation Board, Medicines Information Bank, Summary of Product Characteristics Minoxidil Linn 20 mg/ml solution
6. Bernstein Medical, Allergic reaction to Rogaine liquid but not foam? (English)