This is a complete guide to treating eyebrow seborrheic dermatitis (commonly known as eyebrow dandruff). Topics covered include:
- What is seborrheic dermatitis (dandruff)
- The most common cause of seborrheic dermatitis
- What makes the eyebrows prone to seborrheic dermatitis
- Popular seborrheic dermatitis treatment approaches and review of their usage for the eyebrow area
This guide tries to provide a solid foundation to empower you to better deal with your skin issues. If you have any questions or suggestion, please leave a comment at the end of the article.
Table of Contents
- 1 The Basics of Seborrheic Dermatitis (Dandruff)
- 2 Common Treatments for Eyebrow Seborrheic Dermatitis
- 2.1 Introduction to Seborrheic Dermatitis (Dandruff) Treatments
- 2.2 Pyrithione Zinc
- 2.3 Selenium Sulfide
- 2.4 Ketoconazole
- 2.5 Coal Tar
- 2.6 Topical Steroids (Corticosteroids)
- 2.7 Raw Honey
- 2.8 Caprylic Acid Triglycerides
- 2.9 Nystatin
- 2.10 Other Possible Treatments for Eyebrow Dandruff
- 2.11 General Tips for Seborrheic Dermatitis Treatment Around the Eyes
- 3 Additional Areas of Interest for Individuals Treating Eyebrow Dandruff
- 4 Summary
The Basics of Seborrheic Dermatitis (Dandruff)
Seborrheic dermatitis (dandruff) is a widespread skin condition which may affect individuals of any age. The condition usually presents itself as flaky (scaling) red patches of skin which may be either overly oily or dry.
Seborrheic dermatitis is also commonly called dandruff
Both words often used to describe the same condition. Seborrheic dermatitis is more frequently used when areas other than the scalp are discussed; dandruff is most commonly used when the scalp is affected. In this article, the terms will be used interchangeably.
A Bit About Malassezia and Its Role In Seborrheic Dermatitis
Most medical professionals agree that seborrheic dermatitis and dandruff are usually caused by various members of the Malassezia yeast species. These unique fungi are lipophilic (depend on lipids/oils for their survival) and as a result are commonly present at sebum-rich areas of skin.
Malassezia is present on the skin of almost everyone. However, only in certain individuals does it appear to cause skin issues such as seborrheic dermatitis. And to this day, researchers have mixed opinions on which specific factors that determine what causes this drastic difference.
Why Some Get Seborrheic Dermatitis While Other Don’t
The following factors appear to influence the likelihood of seborrheic dermatitis and dandruff:
- The density of Malassezia found on the skin appears to drastically increase in adults after puberty, declining in the late middle age (1)
- Normal sebum is typically compromised of about 13% free fatty acids, but after exposure to Malassezia this increased to 32% (2)
- Sebum appears to differ in healthy individuals and those with seborrheic dermatitis. For those with seborrheic dermatitis, triglycerides and cholesterol are higher, while squalene and free fatty acids are lower (3)
- Some individuals appear to be more susceptible to the specific free fatty acids (mainly oleic acid) which the Malassezia produce (4)
- The presence of the free fatty acids produced by Malassezia (even without any fungi present) can trigger seborrheic dermatitis on susceptible individuals (5)
It appears that some individuals simply do not tolerate the byproducts of the Malassezia feeding cycle. However, what determines this individual susceptibility remains a mystery.
Where Does the Breakdown Occur?
Does the skin of people who experience seborrheic dermatitis and dandruff simply produce lower quality sebum (more prone to consumption by Malassezia)? Or perhaps their skin barrier is simply malfunctioning and overreacting to the free fatty acids produced by the active Malassezia?
What Causes Seborrheic Dermatitis To Occur in the Eyebrows
The most common area affected by seborrheic dermatitis is the scalp (6) and this is when it usually referred to simply as dandruff. Yet, in some individuals seborrheic dermatitis can affect the eyebrows, ears (both inside and behind the ear), nasal folds, cheeks and/or chest (7).
The reason why seborrheic dermatitis typically occurs in these specific areas appears to be related to the unique characteristics of the skin. At these sites, the density of sebaceous glands (a small gland that secretes sebum onto the skin) is much higher than other areas.
Due to this higher density of sebaceous glands, these areas are typically rich in sebum (a combination of oils, wax esters, and squalene) (8). And many researchers believe it is this abundance of sebum that makes these areas prone to seborrheic dermatitis and dandruff.
That’s the most basic explanation and will suffice for the purpose of this article. However, if you would like to learn more about the underlying mechanism behind seborrheic dermatitis and dandruff, check out the “What is Seborrheic Dermatitis” section.
Common Treatments for Eyebrow Seborrheic Dermatitis
Now let’s move on to some common seborrheic dermatitis treatment approaches that are most applicable to the eyebrow area.
Introduction to Seborrheic Dermatitis (Dandruff) Treatments
The internet is full of potential treatments for getting rid of dandruff on the eyebrows. Many of which are purely speculative and don’t have any facts to back up the usefulness.
Claims exist for a variety of herbal concoctions, topical oils, supplement combinations and a vast variety of dietary recommendations. But after years of experimenting with a significant amount of these, I have come to realize that there are only a few that appear to be of any use in the majority of cases.
Some of these are synthesized in the lab and are part of various commercial products. Others are natural approaches that can carry the same level of relief with a reduced potential for possible side effects.
Pyrithione zinc (sometimes referred to as zinc pyrithione) is one of the most popular and most researched approaches to treating dandruff (seborrheic dermatitis). It is a metal complex developed as an antifungal by researchers in the 1930s.
One of the biggest benefits of pyrithione zinc for many of its users is the fact that it may also help restore hair growth (9). And this fact, has been discussed in greater detail in a previous post: Reversing Seborrheic Dermatitis and Hair Loss.
Treatment of Eyebrow Dandruff with Pyrithione Zinc Containing Shampoos
Pyrithione zinc is widely available in its shampoo form and most commonly sold by the brand Head and Shoulders. With availability in recent years drastically increasing as many other companies have released their own dandruff shampoos containing pyrithione zinc.
Usage on the eyebrows is straightforward. Simply apply a bit of shampoo onto the eyebrow, gently massage into the skin, leave on for a few minutes and wash off with water. However, you need to be very careful, as getting the shampoo into the eye will cause irritation.
Treatment of Eyebrow Dandruff with Pyrithione Zinc Containing Creams
In addition to the various pyrithione zinc containing shampoo, there are also some creams that contain it. The availability of these creams isn’t the best, and usually, you need to buy online.
However, in some cases, they may be more useful than a wash off solution (such as shampoo). For example, when a pyrithione zinc product needs to be left on the skin throughout the day (useful in aggressive cases) or if you experience excessive skin irritation to the surfactants (cleaning agents) of shampoos.
My Own Experience With Zinc Pyrithione for Eyebrow Dandruff
In contrary to the high success rate that this treatment appears to have in the medical textbooks and research papers, my results were not so great (except for the case of regular scalp dandruff).
The first product that I have attempted using to treat dandruff on my eyebrows was a simple Head and Shoulders shampoo (more specifically, it was the 2-1 Classic). I was pleasantly surprised, as the results came quickly; the skin cleared up within days and I was left wondering why I didn’t try it sooner. And after my experience with products prescribed by my family doctor (first a hydrocortisone cream, next an antibiotic cream, and third an antifungal cream containing clotrimazole) I couldn’t be happier.
Unfortunately, these results didn’t last long. After about 1-2 weeks of usage, the effectiveness appeared to simply disappear and my eyebrow dandruff returned (along with seborrheic dermatitis on other parts of my face).
A short while after, I gave up and started testing other approaches. After a few months, I decided to once again attempt using pyrithione zinc, but in alternative products (one was a cream and the other was a soap I purchased from Amazon; Noble Formula). Again the results were the same. It would work really well for a short period of time, but then the symptoms always seemed to creep back.
Selenium sulfide is another popular antifungal agent that is now being used in a variety of anti-dandruff shampoos. The most popular of these is Selsun Blue, but many other companies have released their own version (even Head and Shoulders has one).
In general, companies appear to market it as a stronger alternative to pyrithione zinc (Head and Shoulders calls their version a clinical strength anti-dandruff shampoo). However, the effectiveness of selenium sulfide has been documented to be about the same as pyrithione zinc (10). Regardless of this, there are people across the web that have claimed that selenium sulfide has helped when pyrithione zinc containing products failed.
Using a Selenium Sulfide Shampoo for Eyebrow Seborrheic Dermatitis
Using selenium sulfide shampoo for eyebrow seborrheic dermatitis is not different than using a pyrithione zinc shampoo. Simply massage a small amount of shampoo into the skin, leave on for a few minutes and rinse off with water (making sure to not get it into the eye).
Is Selenium Sulfide A Safe Treatment Method?
Its safety profile doesn’t appear to be as strong as it’s two main competitors (zinc pyrithione and ketoconazole) (11) and the potential for side-effects is more significant (12). In addition to this, creams containing selenium sulfide are no-where to be seen, suggesting it may not be suitable for extended application.
Based on this knowledge, I have never personally attempted any selenium sulfide products. If did plan on using one, I would have been very careful to start (testing on a small area of the skin) and would be very strict with how long I left it on my skin.
Ketoconazole is one of the most documented dandruff treatments that exist today. It first came into existence in 1976 when a group of scientists tried to improve on the azole antifungals available at the time (miconazole, econazole, and clotrimazole) (13).
It is available in a wide range of options, from shampoos and creams, to even oral tablets. And clinical trials demonstrate it is a superior alternative to both pyrithione zinc and selenium sulfide (14).
Ketoconazole Shampoos for Eyebrow Seborrheic Dermatitis
Arguably the most popular ketoconazole product today is a shampoo by name of Nizoral. It’s widely available in stores across North America and is commonly sold without a prescription. However, other products that contain ketoconazole also exist on the market.
Using a ketoconazole shampoo on eyebrow seborrheic dermatitis is exactly the same as with the other two options described above (zinc pyrithione and ketoconazole). Massage a small amount into the eyebrows, let sit for a few minutes and rinse off with water making sure to avoid contact with the eyes.
Ketoconazole Containing Creams
Similar to pyrithione zinc, ketoconazole is also available in cream formulations. However, the availability of these is much more limited and a prescription is typically required.
The instructions for different creams depend on the ingredients used and the concentration of ketoconazole. Use the cream as described in the instructions that should accompany it.
How Safe is Ketoconazole?
More recent investigations have revealed that it oral ketoconazole can have negative effects on that liver that far outweigh any potential benefits (15). This led to a ban of its usage in several countries (China, Australia) and a decline in popularity for oral prescriptions in the USA (FDA withdraw its usage for Candida and dermatophyte infections).
Despite its decline in oral prescriptions, ketoconazole is still widely used in topical applications. From a review of the literature, clinic trials appear to show fewer side-effects and complications when compared to selenium sulfide (16).
My Experience With Using Ketoconazole for Eyebrow Seborrheic Dermatitis
My attempts at using Nizoral shampoo to combat dandruff in the eyebrows were limited as I had to give up after just a few treatment attempts.
It was very drying for my skin and caused the eyebrow hairs to feel extremely unhealthy. This came as a surprise, as I had high hopes for this anti-fungal agent after seeing some of the research behind it.
Another widely available antifungal agent is coal tar and it’s usage goes back more than 2000 years (17). It is used in a variety of shampoos, creams, soaps, and lotions.
Coal tar is actually a by-product of coal and is produced at high temperatures. This makes it much more complex then synthesized antifungal agents (such as pyrithione zinc, selenium sulfide, ketoconazole, etc) as it is actually a combination of over 10,000 various other compounds (18).
Its effectiveness has been shown to be comparable to that of ketoconazole against Malassezia (19). However, it’s usage against seborrheic dermatitis and dandruff does not seem to be as popular amongst the scientific community. This may potentially be attributed to its strong odor, potential adverse reactions (which include tar folliculitis, contact dermatitis, and general irritation) or possible carcinogenic properties (20).
Coal Tar Shampoos for Treatment of Eyebrow Seborrheic Dermatitis
The most popular coal tar product is a shampoo formulation made by Neutrogena called T-Gel. It is sold in stores across North America and does not require a prescription. Additionally, many other shampoos are available on Amazon and various other online outlets.
Using coal tar shampoos for eyebrows affected by seborrheic dermatitis is identical to other anti-fungal shampoos discussed. Apply to skin, let soak in for a few minutes, and rinse off (avoiding the eyes).
Coal Tar Creams and Lotions
In addition to coal tar shampoos, creams are widely available.
Leaving the coal tar on the skin, should (in theory) improve its anti-fungal potential and result in improved results. However, due to its dark color and ability to stain the skin, it may darken the treated area of skin and limit it’s usage (you probably don’t want to have a smelly patch of dark skin when you’re leaving the house).
My Own Experience With Coal Tar for Seborrheic Dermatitis
Out of all the treatment approaches discussed so far, my results with coal tar were the most impressive. When used on the eyebrows, it helped control the flaking, reduce inflammation and didn’t dry the skin as much as other antifungal products I had used.
And I actually exclusively used Neutrogena T-Gel to manage my facial seborrheic dermatitis for several months. Thought it worked quite well, but I grew afraid that it might have negative long-term effects on my skin. This belief was rooted in the fact that it seemed to be making my skin quite sensitive and pale looking (lacking any kind of vibrance).
Topical Steroids (Corticosteroids)
Corticosteroids are a class of steroid hormones produced within the body and used in a wide variety of biological processes; from immune response regulation to behavior modulation. Due to their broad range of action, scientists are able to use external corticosteroids to modulate various natural bodily functions.
Synthesized versions of these hormones are being used to treat for a variety of skin diseases.
Hydrocortisone is a synthesized version of the hormone cortisol. Low potency hydrocortisone is often prescribed for the treatment of seborrheic dermatitis and dandruff on areas of the skin such as the eyebrows (21).
Potential Side Effects of Long-Term Hydrocortisone Usage for Eyebrow Dandruff
Their popularity for the treatment of seborrheic dermatitis and dandruff appears to be linked to how quickly they can produce results. However, long-term usage is associated with a variety of negative effects, including:
- Atrophy – breakdown and degeneration of cells
- Telangiectasias – appearance of small veins near skin surface (also referred to as spider veins)
- Perioral dermatitis – small itchy tender bumps accompanied by general skin irritation
As a result, only short-term usage of hydrocortisone products is advised. Since long-term maintenance is often required for the treatment of eyebrow seborrheic dermatitis, the usage of hydrocortisone may be considered contradictory (22).
My Experience With Hydrocortisone for Eyebrow Seborrheic Dermatitis
A hydrocortisone cream was actually one of the first treatment approaches I had attempted for my seborrheic dermatitis. This was even before I knew what it was that I was dealing with and at the time it was only visible on the right side of my nose.
After a week of usage, the small patch of flaking I had at the time disappeared and I thought that was that. However, as usage was stopped the issue quickly returned. Luckily, I was quick to learn about the potential dangers of long-term usage and never attempted any other hydrocortisone products since.
Throughout history, honey has been recognized for it’s antimicrobial and wound-healing properties (23). It is widely available, well tolerable, and highly delicious.
Raw honey is used to describe honey in its crude form without any of the wax being filtered out; which is believed to result in enhanced antimicrobial properties and improve its effectiveness in the treatment of various skin issues.
Its ability to resolve seborrheic dermatitis (dandruff) has been demonstrated in a small-scale study carried out in 2001 (24) and individuals across the internet have since reported great results.
Using Raw Honey on the Eyebrows
To use raw honey for the eyebrows, you must first dilute the honey with water to make the consistency more fluid. This can be done by mixing roughly 9 parts honey (90%) to 1 part warm water (10%) in a small container. Once the mixture is prepared, it needs to be spread on the eyebrows and left on for 2-3 hours to do its job. Once enough time has passed the sticky mixture need to be rinsed off with cold water and left to try.
One application is unlikely to prove sufficient and this procedure must be repeated every second day for several weeks. Once progress is made and seborrheic dermatitis symptoms reside, twice a week maintenance applications are recommended.
Additional comments on the honey treatment method:
- Adding too much water has been shown to decrease honey antimicrobial properties (25)
- There appears to be some variation in antimicrobial activity of various honey (26), as a result, some honey may produce superior results
- The antimicrobial activity of most honey appears to be related to its ability for topical hydrogen peroxide production (27)
My Experience Using Raw Honey
My attempts using raw honey to treat my eyebrow dandruff were quite good. After several treatments, all signs of flaking subsided and skin appeared to return to normal.
The biggest issues were related to the difficulty of this treatment approach (required me to have sticky honey on my face for long periods of time every other day). In addition to this, the stickiness of the honey resulted in frequent removal of eyebrow hairs.
Caprylic Acid Triglycerides
Caprylic acid is a medium chain fatty acid that is naturally present in oils extracted from coconuts and palm fruit. Its usage in the cosmetic industry is substantial and it is found in various moisturizers, cleanser, shampoos, and ointments.
Though not officially recognized by the medical community as a viable treatment approach to dandruff (seborrheic dermatitis), caprylic acid triglycerides have been shown to possess significant antifungal potential against Malassezia (28). As a result, products containing enough caprylic acid may be useful in resolving dandruff.
My Experience With Caprylic Acid Triglycerides
After my most successful treatment approach (using Cetaphil Restoraderm products) ceased to stop working, I decided to investigate why it may have worked in the first place. After studying each individual ingredient of the Restoraderm formula, I had come to the conclusion that it may have been the caprylic acid triglycerides which resulted in the effectiveness I had experienced.
Based on my findings, I decided to try and create a formulation which contained caprylic acid triglycerides at various concentrations to see what percentage would be most effective. Eventually, this experimentation produced a single formula that surpassed my expectations and has been my go-to solution since the summer of 2015.
If you would like more details on this, you can find a more detailed write-up in the dedicated article: My Seborrheic Dermatitis Skin Regimen 2.0.
Nystatin was first brought to my attention by an early member of the SkinDrone community, Joakim (thanks Joakim!).
First discovered in 1950, Nystatin is an anti-fungal agent considered one of the most important medications of a basic health system by the World Health Organization. Its usage for the treatment of seborrheic dermatitis and dandruff does not appear to be very popular amongst the medical community (other antifungals seem to be preferred).
However, it does appear to be effective against the Malassezia fungus (29) and based on the feedback this treatment method has received, nystatin may be an excellent alternative to many of the more popular antifungals.
Acquiring a Nystatin Cream for Treatment of Seborrheic Dermatitis on the Eyebrows (Eyebrow Dandruff)
The availability of nystatin preparations is fairly limited and a prescription is required in most countries. As a result, a consultation with a medical professional may be required.
However, SkinDrone readers have suggested obtaining the cream online via Amazon or eBay. Not sure what the legal implications of this would be, but it may be worth the risk.
Additional Notes on Nystatin
- There appear to be some Malassezia species which are resistance to nystatin (30)
- The original submission for this treatment approach can be found here: Nystatin A Potential Seborrheic Dermatitis Treatment
Other Possible Treatments for Eyebrow Dandruff
In addition to the methods described above, many other less common treatment approaches exist. Covering all of them in detail in this article is not very practical. Instead, they are provided here for reference (with links to previous posts where available ):
- Apple Cider Vinegar
- Sea Salt
- Baking Soda
- Various Other Azole Antifungals (Bifonazole, Miconazole, Fluconazole, etc.)
- Lithium Succinate
- Benzoyl Peroxide
- Propylene Glycol
General Tips for Seborrheic Dermatitis Treatment Around the Eyes
The majority of the approaches that aim at resolving seborrheic dermatitis and dandruff usually employ some sort of antifungal agent. As a result, it is very important to avoid contact with the eyes during treatment.
Additionally, the following recommendations may be useful:
- Always thoroughly wash hands before and after each treatment
- If a solution is left on the skin for an extended amount of time, keep a napkin handy and remove any excess residue that may be running down towards the eyes
- If using any solution that has a strong odor, try to avoid getting too close to the eye as odor contact alone could lead to irritation
- Natural does not imply that the treatment is completely safe, exercise caution irrelevant of how natural the treatment approach may be
- When starting a new treatment approach, always spot test on small area of skin (preferably one that away forms the eyes and not readily visible)
Additional Areas of Interest for Individuals Treating Eyebrow Dandruff
The treatment approaches discussed in this article primarily target the topical control of Malassezia. However, there are other aspects of treatment which may be quite important once the Malassezia activity is controlled.
These other relevant topics are discussed next.
Minimizing Hair Loss/Shedding
If eyebrow dandruff is allowed to progress long enough, significant hair loss is very likely. In order to help reverse this, stimulating hair growth may be beneficial.
A previous article on the website discussed this in significant detail.
Some relevant highlights from that article:
- Pyrithione zinc and ketoconazole have been shown to improve hair growth
- Increasing stimulation of the hair follicle may improve nutrient delivery and result in improved hair growth
- Various supplements are likely not as useful as some other website may portray them
- Research in this area mainly deals with deficiencies and how they may contribute to hair loss
- Minoxidil is one of the most popular products for stimulating hair growth, however as with most medication, potential side effects exists
And this article can be found here: Reversing Seborrheic Dermatitis and Hair Loss.
Reducing Sebum Production
Since the Malassezia fungus requires lipids for its existence (which it acquires from your sebum), it may be beneficial to reduce the level of sebum output.
Factors that appear to have the most significant effect on sebum production include:
- Retinol (Vitamin A) levels in the body may assist in regulating sebum production (31)
- Drastic changes in blood sugar (high glycemic load) and the resulting insulin spikes appear to result in increased sebum production (32)
- Hormone levels in the body appear to have a direct connection to sebum production, however, the relationship is complex and difficult to control (33)
- Dairy consumption may have a direct influence on IGF (insulin-like growth factor) production resulting in increase sebum production (34)
If you want to explore this topic in more detail, a whole section of the online eBook has been dedicated to it: Stabilize The Skin
Improving Skin Barrier Function
As discussed at the beginning of this article, the Malassezia fungus is present on the skin of even healthy individuals, but it only causes seborrheic dermatitis issues in a portion of the population (those of us unfortunate enough to fall into this category).
As a result, some researchers have speculated that skin barrier issues may be an important factor in determining whether or not an individual is affected by seborrheic dermatitis and dandruff.
Based on this, it may be beneficial to improve the skin’s natural barrier, which in-turn could reduce skin sensitivity to the by-products of the Malassezia feeding cycle (documented to be the main irritant causing seborrheic dermatitis and dandruff in the first place).
There are various products on the market that have been specifically designed to improve skin barrier function. Many of these products target the facial skin making them a perfect fit for targeting eyebrow dandruff. And the best part is that users have reported significant improvements in the state of their seborrheic dermatitis from these types of products alone (without using any antifungal agents).
If this approach to treatment is of interest to you, you can find additional details in the dedicated section of the SkinSuport program (a step-by-step program aimed to help resolve seborrheic dermatitis for the long term): Improving Barrier Function
Some of the Most Popular Skin Barrier Repair Products
Here is a list of some of the most popular skin barrier repair products (based on internet discussion and various comments on this website):
- Cetaphil Restoraderm (worked really well for me)
- Gold Bond Ultimate Healing Lotion (used with relatively good results as well)
- Avene Skin Recovery Cream
- La Roche-Posay Cicaplast Baume B5
- EpiCeram (prescription required)
Results for skin barrier repair creams appear to be quite mixed. What works for one person, doesn’t always work for another. Thus, acquiring free product samples from your local pharmacy may be a good way to test a large range of products without spending too much money.
This article aimed to go over some of the most important aspects of dealing with eyebrow seborrheic dermatitis (aka eyebrow dandruff) and provided a detailed review of most common treatment approaches.
Here are some of the key points for your review:
- Malassezia is a fungus which resides on the skin of the majority of humans and feeds off of our skins natural oils
- Majority of research suggests dandruff is caused by the by-products (oleic free fatty acids to be exact) of the Malassezia fungus
- Individual sensitivity to these fatty acids varies and this appears to determine whether or not the person experiences dandruff
- Controlling the Malassezia population using antifungals can provide quick relief and is the most common approach to treatment
- Continuous maintenance is often required when using antifungals
- Topical steroids are often very effective, but long-term use can result in many negative effects
- Reducing sebum production may be a useful approach for Malassezia reduction
- Improving skin barrier function may make the skin less sensitive to Malassezia by-products and relieve symptoms without the need for antifungal
- A combined approach (skin barrier repair and antifungal treatment) may be useful for quick long lasting results
Hopefully, this article has provided you with enough information on eyebrow seborrheic dermatitis (aka eyebrow dandruff) and may help you resolve your issues once and for all.
If you have any tips, recommendations, or simply want to share your experience on dealing with eyebrow seborrheic dermatitis, please join the conversion using the comments section below.
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