Scalp Exfoliation: Is this something to consider?

scalp exfoliation erum ilyas dermstore

January 03, 2021

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Should we exfoliate our scalp? Why?

Exfoliating the scalp can mean different things to different people. 
For some, over time there can be a ‘build up’ of residues from hair products, shampoos and conditioners as well as an accumulation of natural oils and dead skin cells. Exfoliating or treating this build up can help return hair’s natural luster and make the scalp less ‘flaky’ or dry and, hopefully, less itchy. 
For others, inflammation can lead to significant scaling and flakiness to the scalp. Commons examples of this are psoriasis and seborrheic dermatitis. For these conditions, exfoliating the scalp or trying to actively remove or dislodge this scale can result in significant discomfort, raw or tender sensation, and even bleeding. This scaling and flakiness can be treated, however, the approach is different.

Understanding and accurately diagnosing the causes of different scalp conditions is important prior to deciding to use a scalp exfoliator. 

What happens to the scalp if we don't exfoliate? 

Regardless of the cause of buildup, flakiness or scaling to the scalp, this really should be addressed. Any kind of build up or scaling can result in a few problems. 

Buildup of dead skin cells and oils from not washing routinely or from product buildup that is not addressed can make our scalp feel itchy. This itching can cause flakes and dead skin cells to fall on our clothing which can be a bit embarrassing when wearing darker colored clothing. Excess itchiness can result in hair breakage as well.

If dry flaky scalp is the result of inflammation, then the underlying cause of the inflammation should be treated or addressed. If the inflammation becomes chronic, then it can interfere with hair growth and become a source for discomfort as well. 

What's in a scalp exfoliant? What are the common ingredients and what do they do?

Most products marketed as scalp exfoliants use ingredients intended to chemically exfoliate the scalp similar to acne products or hydrating ingredients intended to address itching and flaking of the scalp.

Common ingredients
Charcoal has become a popular ingredient for products to include when targeting excess oil or impurities. Although I could not find a single medical study to show the effectiveness of charcoal in treating scalps directly, I can find potential benefits to using products that contain it.
What is charcoal? Activated charcoal used in products and in medicine is made by heating substances rich in carbon such as wood, sawdust, coconut shells, etc.  This is an interesting process because it allows the carbon to become more adsorbent. Adsorbent means that it can bind more molecules.  In medicine activated charcoal has been used to treat overdoses and poisonings as it can adsorb these toxins quickly.  It has been used in wound healing in addition to a number of other uses.

Charcoal applied to the skin is overall harmless and is not likely to irritate the skin. The theory behind adding it to products is that it may possibly absorb extra oil from the skin. If you have found a benefit in treating your scalp with charcoal containing topicals then it is perfectly ok to continue. It would likely be best for people that have an oily scalp. It is a milder alternative to help reduce the oiliness without excessively drying the skin or hair.  

Coconut oil is gaining a lot of attention in skin care products. It is a proven emollient that can effectively hydrate the skin. It also has antimicrobrial and anti inflammatory properties. These can beneficial for dry flaky scalps to help hydrate and improve scaling or flaking to the scalp.

I don’t think a day goes by where a patient doesn’t tell me that they used apple cider vinegar to treat something! ACV has anti yeast properties and has been used to even treat diaper rash. Seborrheic dermatitis is thought to be related to yeast that overgrown on our skin. It can often be added to scalp exfoliators to help address the underlying yeast that triggers inflammation resulting in scaling.

Tea tree oil has become one of the most common ingredients to find in skin care products. It is known for its antimicrobial and antiseptic properties in its activity against bacteria, viruses, fungus, mites, etc. When added to scalp exfoliators it is likely addressing some of the underlying triggers for scalp inflammation that result in scaling and itching. The only caution is that it does have about a 1-2% chance of causing a contact dermatitis in those that use it. If using a product that has tea tree oil and your itching and flaking is getting worse, it’s important to take a look at your products and make sure they are not making it worse! 

Salicylic acid breaks apart superficial skin cells to help remove dead skin cells from the  surface. It is used in acne medications but can also be found in higher concentrations in wart treatments.  It can be effective without being too irritating.  In scalp products it can help remove excess dry skin and scale. 

How and how often should we exfoliate our scalp? Any dos and don’ts?

If you would like to try a scalp exfoliator, start off using every other week or up to once a week. It may help to get used to them a bit and avoid over drying your scalp. Excess use may strip your scalp of natural oils and even strip away some hair color if you are coloring your hair.

It can feel really good to use a scalp exfoliator the first time you use it. It’s almost like a really good salon wash with a great scalp massage. However, try not to go overboard. At first your hair will look great. If overused, you will start to lose the natural luster to your hair. It’s actually helpful to follow up these treatments with a leave in conditioner or regular conditioner to rehydrate your scalp and hair. 

The charcoal in this product can help absorb some of the excess oil in the scalp while the coconut oil can hydrate and dislodge built up scaling. This is a nice product because it exfoliates and rehydrates in one product. This product also contains tea tree oil to assist with the anti yeast and antimicrobial qualities. Of course, remember that tea tree oil can cause allergic reactions so if your itch is getting worse and not better, consider the possibility that you could be sensitive or allergic to the tea tree oil. 

The apple cider vinegar in this product targets the bacteria and yeast building up on our scalp to reduce inflammation and scaling that these cause. Although it does still smell like apple cider vinegar, I don’t find the smell to be overwhelming. The product does have a gritty or grainy quality that helps with its exfoliating action. It does help to apply this when your hair is wet and parted to the problem areas to treat. Applying it to dry hair makes it really difficult to get it to where it needs to work. This is overall a helpful product to help with seborrhea a couple times a month. 

The salicylic acid in this product can help remove excess flaking and keratin build up on the scalp. The argan oil is helpful to rehydrate the scalp to avoid overdrying.  If you have sensitive skin, scabs from picking or scratching, this product may be a bit milder and less irritating to try with the argan oil to help balance out the exfoliating action. 

The charcoal can help absorb excess oil while the tea tree oil will reduce inflammation through its antimicrobial qualities. This product also contains witch hazel. One of my patients from Puerto Rico brought in a bottle of this and said she uses it for everything. In Spanish I believe it is called agua maravilla.  This translates to “wonder water”.  This also checks all the boxes for antimicrobial, eliminating oil and reducing inflammation. 

This product may provide some scalp exfoliating from its gritty texture provided by apricot seed powder. 

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