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Welcome to another episode of Skinside Out where Science Meets Beauty. In this episode, Dr. Zain and Courtney dive deep into the topic of Winter Scalp Health. They discuss the common issues people face during winter, such as dry, flaky, and itchy scalps, and offer solutions and tips to manage these problems. The conversation covers the impact of dry air, the use of hot showers, the role of hat-wearing, and the importance of moisturizing and conditioning. They also debunk common myths about dandruff and scalp health. Whether you're dealing with seborrheic dermatitis, psoriasis, or just looking for ways to maintain a healthy scalp during the cold months, this episode is packed with valuable information.
00:00 Introduction to Winter Scalp Health
01:01 Understanding Winter Scalp Issues
01:43 Impact of Environment and Stress
02:10 Hot Showers and Scalp Health
02:48 Biochemistry of Scalp Dryness
05:51 Winter Hair Care Tips
07:08 Medicated Shampoos and Treatments
08:31 Hair Washing Frequency and Techniques
13:16 Common Winter Scalp Mistakes
17:30 Scalp Health Myth Busters
19:36 Conclusion and Final Tips
Creators and Guests
Host
What is Skinside Out?
Welcome to Skinside Out, where science meets beauty, the ultimate dermatology podcast! Dive deep into the fascinating world of skin health with expert insights, evidence-based discussions, and myth-busting truths. Each episode explores the medical, cosmetic, and surgical aspects of dermatology, while keeping you informed about trending skincare topics. Whether you’re a skincare enthusiast, medical professional, or just curious about how to achieve your best skin, Skinside Out is your go-to resource for staying informed and inspired.
38 - Skinside Out - Scalp
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[00:00:27] Dr. Zain: Welcome to Skin Side Out where Science Meets Beauty. I'm your host, Dr. Zane with Courtney. So today we are talking about Winter Scalp Health. So it's winter time. Our skin's dry, our scalps dry, we're all flaking, and we're not talking about snowflakes. So, you know, I, I think that we notice a lot of changes in our skin.
Um, but I think one of the key areas is our scalp.
Mm-hmm.
I feel like everyone's scalp is inflamed. Um, people are really itchy. They're flaky, and they're often coming to us for solutions. So tell me a little about what's going on with our scalp.
[00:01:04] Courtney: Um, a few things, I guess. So I think. In the winter months, you know, obviously there's colder, drier air.
So when you don't have that humidity to add a little bit more moisture into the scalp, certain things can create irritation. So, you know, sometimes we look at things like certain shampoos or certain scalp products that people are using. Even, you know, over the counter, like minoxidil sometimes can be irritating for those patients when the scalp is dry and can't really handle that in that moment.
So, um. Sub derm, psoriasis. I think those conditions that we'll kind of get into more we see definitely fluctuate in the wintertime as well.
[00:01:43] Dr. Zain: Yeah, definitely see seic dermatitis, um, flaring up and I do think it's partially due to the environment, um, drier conditions leading to more yeast, um, overgrowth, imbalance leading to more inflammation.
But also I think it's also a time where we're stressed. Mm-hmm. The holidays. You know, that raises you. Cortisol, we're all stressed. Um, and that also has impacts on our skin, including our scalp.
[00:02:10] Courtney: Yeah. You know, it's funny, even things like hot showers. Mm-hmm. We've talked about the hot showers previously, but what's the first thing that's getting hit in the shower is your scalp.
So. I never thought about that. I'm on so the Einstein of Scalps. Um, but it's the first thing that's being hit in that water. We've all talked about how we love our hot showers, but it really, oh, I love myself a hot shower. It dries it out. It dries it out. Um, you know, women know from a hair standpoint, sometimes I'll actually rinse my hair with cool water at the end of my shower, um, just to try to avoid frizz.
But, um, yeah, the, the showers and the indoor heat too can be a big offender.
[00:02:46] Dr. Zain: Yeah. So in terms of what's really happening, so let's break it down on the molecular level, on the biochemistry. So we're seeing that there's a loss of the lipid layer. So lipids are these fats that help to keep our skin barrier intact and also moisturize.
So we see there is a, you know, a compromise in that. So the hair is oftentimes rougher, um, and less protected. Um, in addition, we see increased trans epidermal water loss. So this is a term that we use for the amount of water that we lose to the environment from our skin.
Mm-hmm.
So we see a, definitely a rapid, um, you know, increase in that with these drier conditions.
Mm-hmm. Um, leads to, you know, dehydration, itching, and flaking.
[00:03:35] Courtney: I think we wear more hats in the winter. Mm-hmm. The beanies, especially toboggans. Um, and sometimes I think that. You know, occlusive environment can create more of the yeast overgrowth. Yeah. That's
[00:03:50] Dr. Zain: sweat. Yeah. Um, you know, yeast love that stuff.
[00:03:52] Courtney: Yeah.
[00:03:53] Dr. Zain: Yeah. I mean, that's the feast for them. So I always tell my patients, um, you know, try to let your scalp breathe. Mm-hmm. And also oiling your hair is not going to help. In fact, it's going to feed the yeast leaning to more inflammation. So a lot of my patients, oh, like my scalps really dry. It's irritated.
I'm just gonna coconut oil in it. Um, and it's not getting any better. Well, the reason why is because you're probably feeding the problem.
[00:04:18] Courtney: It's a really cool band named yeast feast. Wouldn't that be yeast feast?
[00:04:23] Dr. Zain: Alright,
[00:04:23] Courtney: Courtney,
[00:04:24] Dr. Zain: let's do it.
[00:04:25] Courtney: I think it would be a really cool, like metal van yeast feast.
Um, it's kind of gross actually. It is really gross. Um, some things I also, some. Well, thing about is I think after the holidays or sometimes during the holidays, people will get gifts of new hair products, shampoos, conditioners, things like that. So sometimes if you're switching what you're using, you can get irritation from, you know, whether it be fragrance or things within those products that people don't think about often.
[00:04:53] Dr. Zain: Yeah. Um, oftentimes also patients complain about their hair looking dull. Mm-hmm. In the wintertime. Why is that?
[00:05:01] Courtney: I think, you know, the light reflection sometimes like decreases when that cuticle lifts. It's funny, my friend, um, Ari is a hairstylist and we have this conversation all the time. We should have
[00:05:14] Dr. Zain: Ari on the show one day.
[00:05:15] Courtney: I know. It's funny. I actually texted her yesterday and said, can you come and meet us for a podcast? And she said, um, not this last minute, but, but it's, I love hearing her perspective on. Hair health and scalp health from someone who does hair daily and sees all of these things on kind of the other end of the spectrum.
And it's always really interesting. But I think, um, you know, like I said, that light reflection, just, um, you know, without that humidity, without that oil, it's just dry. It's dry. The light reflects and just looks dull. Yeah. Sad. Aw. Yeah. Not mine personally, but,
[00:05:51] Dr. Zain: all right, so let's go over into our Winter Harris Revival Guide.
So. Let's kind of dive in. So what recommendations can you make to help our audience's hair look amazing?
[00:06:03] Courtney: Number one, avoid the super hot showers. I know no one wants to hear that, but it is the sad truth that it will dry you out. And like I said, when your scalp is the first thing being hit in that shower and that water is scalding, it's just gonna further dry you out.
So I think avoiding that as best as possible, at least using maybe a lukewarm or something. Ish.
[00:06:26] Dr. Zain: That's the one thing I can't, my, my, like, my heat is like on fire. Like it's, it's scalding hot. Yeah. What I have tried
[00:06:37] Courtney: to do is before I take a shower, and I don't know that this is much better, but I try to turn my heat in my apartment up to like 74 or 76 so that I don't feel like I have to have such hot water in the shower because it fits.
Warmer because otherwise it's cold and you're like, oh, I don't wanna get in the water if it's, you know. So I think that's what leads to that. So sometimes just while I'm showering, I'll have my heat up like really high. And then once I get out and I'm, you know, I'll dry it off, I'll turn it back down. But, um, yeah, I think just trying to mitigate that as best as possible.
[00:07:08] Dr. Zain: Yeah. Oftentimes when my patients are coming in with Seic dermatitis, um, I often, you know, recommend either over the counter or prescription, um. Antifungal like shampoos that help with dandruff. Mm-hmm. I do think that that can help significantly reduce the yeast population and reduce inflammation. So some of the key ones that I recommend, like Head and Shoulders, the zinc tends to help Nial, which has Ketoconazole and Ciclopirox Ox, which is a prescription.
And sometimes we have to use, um, steroids such as clobetasol. Um, and that can help. So these are all tools that we can use to help reduce inflammation.
[00:07:48] Courtney: You know, it's funny, I'm just thinking about the, you know, dry scalp, how people will say that they have dry scalp or dry flakes and it's really that separate dermatitis, I think, because there's such a stigma behind, you know, dandruff is separate dermatitis, right?
And so I think there's such this stigma around dandruff and having like this, you know. Poor hygiene and whatnot. Mm-hmm. So people would rather think their scalp is just dry. Mm-hmm. Oh, it's the winter, it's dry. Instead of realizing like it is dandruff, but so many people have dandruff, so many people, so mm-hmm.
Realizing that, hey, maybe I should just add in a medicated shampoo. It might save you, you know, a lot of. Heartache in the long run. So,
[00:08:31] Dr. Zain: um, and then in terms of washing your hair, the frequency, I feel like that can also impact mm-hmm. Our scalp health. What do you typically recommend to your patients?
[00:08:40] Courtney: Um, I think it depends on hair type.
You know, a lot of my patients with skin of color, they are washing their hair, you know, maybe every two weeks. So I think as providers it's also really important to have that conversation. I think, you know, previously we've always told our patients. Okay, well you should be washing your hair every single day and using the shampoo.
Mm-hmm. Maybe every day for the first couple weeks. But I think also, you know, as we shift, um, into. Just being a more inclusive field. Yeah. Um, it's so important to have that conversation. And women in general, any woman you'll ask, and I know Dr. Am is we, most of us are not washing our hair every day. You know?
Um, it's,
[00:09:21] Dr. Zain: I never knew what a huge thing it was to like, wash, wash. There's hair, wash food. There's hair wash days until I was married, I had no idea.
[00:09:28] Courtney: Yeah. And it's
[00:09:29] Dr. Zain: like a thing, like, and you know. It's a process. Oh yeah. Like you have to plan this stuff.
[00:09:35] Courtney: I have three types of showers. I have my normal rinse, my normal wash shower.
Mm-hmm. Okay. That excludes the hair wash. I have my hair wash and regular shower. Mm-hmm. And then I have the shaved wash. Hair. Oh yeah.
[00:09:48] Dr. Zain: Yeah. Those days I, I have learned, I have learned and there's a time commitment.
[00:09:53] Courtney: Yeah, yeah. And don't talk to a woman on those days 'cause we're on a mission. Yes.
[00:09:58] Dr. Zain: So I learned the hard way.
[00:09:58] Courtney: So I think being, you know, being aware of mm-hmm. The fact that. Less washing on the hair can increase conditions like separate dermatitis. So I think that being said, just being aware that hey, maybe you want to make sure you're consistently, you know, for myself, I'm normally washing two to three times a week.
Um mm-hmm. Also a lot. So dependent on my activity level. Feel like in the summer there's more humidity and more sweating and you know, if I'm exercising, whatever, um, then it's a lot more frequently. But just being mindful of how much you're washing.
[00:10:31] Dr. Zain: Absolutely. And then while you're washing, um, trying to avoid using harsh, you know, clarifying shampoos mm-hmm.
That can lead to more inflammation. Mm-hmm. Um, really dries out your scalp. And you know, that's something that you probably wanna avoid.
[00:10:45] Courtney: Yeah. And I think being mindful of, you know, conditioner is a huge thing. Mm-hmm. I always tell my patients, you really want to be conditioning the end of your hair. What happens, yeah.
Is when you're conditioning your roots, it's so much occlusion, all that moisture is sitting on that scalp. So I really try to encourage patients when they're washing their hair, especially using a medicated shampoo, to really only work it into your scalp and leave it on for a few minutes. That way it can really get absorbed.
[00:11:12] Dr. Zain: So that's something, you know, I also learned later on, after having three girls. Yeah. Um, and like bathing them. Like I used to like slather on like the conditioner, like, you know, sometimes that conditioner like would get on their scalp and on their shoulders and lead to irritation, and then Dr.
Ona kind of instructed me to do it on the ends. Yeah. Don't condition the roots condition. The ends shampoo the roots. Yes, yes, yes, yes, yes. Um, one tip that I also really, um, like telling my patients is about drying after the shower.
[00:11:46] Courtney: Um, so a lot of times with the hair dryer, most times people don't think about the heat that's being used, but that heat can really dry out. Mm-hmm. The scalp as well. So trying to use more of like the cooler setting. Most hair dryers will have that little snowflake button for the colder setting. That's something else
[00:12:02] Dr. Zain: I learned about.
[00:12:03] Courtney: It's a whole, I'm telling you, there's a whole world of, of hair and, um, I do like drying my. Roots, um, post-show because I think, again, when that water and that moisture is sitting there, I notice that I tend to get more dandruff after a shower if I'm not drying it out. But, um, especially if you're letting your hair sit in a towel, after all of that moisture is just sitting on your scalp.
So I try to at least do a towel dry, and then at least blow dry just the, the roots and make sure those are dry so I can limit any septer.
[00:12:35] Dr. Zain: You know, something else I learned. Kirby Twist, you know about those. Oh, oh, I know. Yeah.
[00:12:39] Courtney: I'm aware.
[00:12:40] Dr. Zain: So that was such a foreign concept to me, and then now I know how to tie it like a pro.
[00:12:45] Courtney: Yeah. In fact, they make special towels. Yeah. To do that. I used to just do it with a regular towel and one year for Christmas, my sister gave me, it's like a special, it's got like, um,
[00:12:56] Dr. Zain: a little loop thing. The, yeah. And
[00:12:57] Courtney: it's like, so you can do a perfect twist every time. Yeah. I'm so good at them though. But you don't wanna sit in those.
I've made the mistake of, you know, sleeping in one, you fall asleep on the, you just, you know, you're so cozy and comfortable and then you wake up the next morning, your hair's still wet, and then your scalp is itchy and you just have to wash again. It's awful. Yeah.
[00:13:16] Dr. Zain: Um, so let's dive into some common winter scalp mistakes.
So dry shampoo. Talk to me about dry shampoo.
[00:13:24] Courtney: Yeah, I think this time of year we use a lot more. Well. I think with so many parties and events, you know, people might want to elongate their, you know, hairstyle. As you've probably learned, it's a lot to girl hair. It is a lot to straighten hair. Mm-hmm. Any girl can relate to being in the bathroom.
Overstimulated. You're hot. You're, you have so much hair. Your arms are tired. Oh
[00:13:53] Dr. Zain: my god. This is starting to like deja vu.
[00:13:54] Courtney: You're like about to pass out and like someone comes up to you like, when are you gonna shut up? Oh my god. Sense. You're like adult now. Yeah. So I think, you know, being careful of how much dry shampoo you're using, and I get it, you don't wanna have to go through the whole hair wash and not only the hair wash, but the hair dry and then the hair styling.
But, um, that dry shampoo can create buildup and then can also further irritate the scalp. So just being mindful of how much you're using. Um, I think also holiday travel, sometimes we're staying in. Hotels and using different shampoos and conditioners that they have, um, as well as different soaps. So I think being mindful of those products and if you're someone who is a little bit more sensitive, maybe just bring your own, you know, travel size of whatever shampoo you normally use.
[00:14:37] Dr. Zain: Yeah. Um, another thing that we see, um, patients doing is using like these rich bombs. Mm-hmm. Um, and their scalps. And that can lead to occlusion, leads to also inflammation. So. Um, I always tell my patients to kind of back off on some of those because it can call lead to more inflammation flakes and it can also lead to folliculitis.
[00:14:57] Courtney: Yeah.
[00:14:57] Dr. Zain: Um, I tend to get that with, um, you know, more occlusive like oil-based products.
[00:15:02] Courtney: Yeah. I think, um, you know, another one is like. These people scare me if you do this, I'm sorry, I'm scared of you, but the people who like, after they shower instead of drying their hair, they'll just like throw it up in a hat or throw it up in like a ponytail and like leave the house.
People who leave the house with wet hair, oh my God, like scare me. They're different breed patients that I
[00:15:23] Dr. Zain: see who come in for skin checks and they're, and their hair's still wet and they apologize to me, oh, I just got outta the shower. I'm like. Come on, girl.
[00:15:31] Courtney: No, not you judging. I'm just scared because in the cold weather,
[00:15:37] Dr. Zain: mm-hmm.
[00:15:37] Courtney: If my hair is wet. They, you could get whatever information you needed out of me. If, like the US Marines, that would be my form of torture is making me go outside in the cold with wet hair. That's my biggest nightmare. Did you see that
[00:15:50] Dr. Zain: lady who, um, had wet hair and it froze, and then that's my fear. And then someone like, hit it and it all fell off.
No,
[00:15:56] Courtney: I don't believe you. I don't believe that. But that is like a, like a fear that I have that my hair's gonna like freeze hair les, and then it's gonna like, crunch off. But, but people that throw it in the beanie again, it's like that wet hair is just sitting there. So don't let it sit and fester. Got it.
Um,
[00:16:13] Dr. Zain: and don't pick the flakes. Oh, that's gross. Yeah. I'm guilt, I'm not gonna lie. Guilty people pick out their skin, pick out their flakes, pick out their toes, like, I mean, just stop it.
[00:16:24] Courtney: Picking the flake will make it worse. It will. And especially if you have psoriasis, because the trauma of that picking, it's just going like re
[00:16:33] Dr. Zain: you know, relapse actually.
Well, you can actually bleed from it too. Oh yeah. Not picking on it. So,
[00:16:38] Courtney: and what sucks is not that I've done this or anything, but when you pick your scalp before you shower and you go into the shower and it's all raw and the water hits it, it hurts so bad. So don't do it. Just use the medicated shampoo.
Let the medicated shampoo sit for like seven minutes and then rinse. And you'll be fine. And then dry your hair. Those are my tips.
[00:16:59] Dr. Zain: Got it. So I think that this was an excellent survival guide for your scalp health in the winter months. So let's recap some of the things that we talked about. Moisturizing and conditioning, it's really important, um, you know, to reduce inflammation, um, but also preserve that moisture in the hair shafts to, um, you know, maintain that hydration, regular washing.
That does help with reducing a lot of, um, sub derm, um, avoiding friction and harsh products. We're gonna do a few scalp myth busters.
So I'm gonna go with winter flakes. Do they equal dry scalp?
[00:17:38] Courtney: Not necessarily. Most times it's sub derm. Mm-hmm. Which is not dryness. It's yeast. Mm-hmm. Got it. Almost the opposite.
[00:17:48] Dr. Zain: What a thought. Um, how about this? Washing less help stand?
[00:17:52] Courtney: No. Wash your hair unless you're on Accutane, you know, not that washing less mm-hmm.
Still helps, but you might not have to wash as often. Um, but yeah, washing more regularly will help the dandruff and especially if you are in like a flare, um, maybe just increasing. To more than what your norm is for that period.
[00:18:13] Dr. Zain: Got it. Dandruff is caused by poor hygiene.
[00:18:17] Courtney: False. And if you are someone that thinks that I'm coming after you, because we should not be judging people for having dandruff.
Something that you can't control, you know, in this day and age. Yeah. So don't be mean to people's, that's like the bottom line.
[00:18:32] Dr. Zain: That's, that's her motto. Don't be mean.
[00:18:34] Courtney: Yeah. Be kind. It, it reminds me though of, um, from the breakfast Club when she like. Like, she draws the picture and then like she like flakes her scalp and all the flakes come down and it's like snow.
Did you watch the Breakfast Club? I have the day. Okay. You didn't seem like you like knew the reference. So it's been a while since I've seen that's such a memorable scene and it's like nasty. It's like the, I think it's in the opening of the, she's like and all those snowflakes. Yeah.
[00:18:58] Dr. Zain: Um, and then lastly, um, oils can cure flaking.
Is that true?
[00:19:04] Courtney: No. False. Again, it's, you know. It's yeast. So when you're adding oil back to the yeast feast, um, it's just creating an environment for that yeast to continue to grow and, and worsen. So trying to use something like a medicated shampoo in place is, you know, what you should be trying. And again, probably seeing a dermatologist to rule out anything else, but I think always starting with medicated shampoo, whether that's over the counter, um, or from like a PCP is a good start and then going from there.
[00:19:35] Dr. Zain: Perfect. So scalp health is really important. I think that we see a lot of conditions flare up in the winter, and you have to give your scalp a little TLC, you know, it requires certain, you know, ingredients, certain um, care tactics that will help you kind of get through the winter with minimal inflammation and irritation.
So hopefully you can take these tips and put 'em into use. If you have any questions about scalp health or anything skin related for the winter feel free to message us. Um, you know, comment follow, subscribe and like, but until next time, skin side out.