Q: I have eczema all over my body, but I moved to a colder, dryer place and now I have dry, itchy, flaky skin on my scalp. I know it’s not dandruff. I tried using Neutrogena T/Gel Therapeutic Shampoo, but it just made my skin even itchier. I thought about taking fish oil pills with Omega-3. What are your thoughts on that?
A: You may have seborrheic dermatitis, which is a form of eczema due to oil, the bacteria and yeasts that live on the oil, and the body’s reaction to them. Normally harmless bacteria and yeasts live on the skin surface using body oils as their food source. They break our body oil sebum down into triglycerides and free fatty acids. The newly formed acids may irritate the skin. Although the skin of the scalp may seem dry, and although shampoos can sometimes dry out the scalp, shampooing is usually a good idea because doing so removes not only the oil but also those harmless bacteria and yeasts. Although tar shampoos slow down the body’s reaction to the irritations, often shampoos that contain ketoconazole (e.g., Nizoral) or zinc pyrithione (e.g., Head and Shoulders) that target the organisms work better. If the eczema is a flare-up of your atopic dermatitis, you may need to get a prescription for a low-or mid-strength topical corticosteroidsolution, spray, or foam to apply to theskin after shampooing. The fish oil pills are not likely to be of much help.