Angela Payumo, MD

Dr Payumo’s medical practical has taken her around the globe, from the Philippines to Haiti, to various cities in the US. She hails from a family of physicians and has been practicing herself since 2011. Dr. Payumo appreciates the sense of family and community that she sees and feels in Hawaii, and with CloudWell Health she hopes to provide greater healthcare access to the Hawaiian people, and to anyone in immediate need.



Dandruff is common. We know this condition as seborrheic dermatitis. Dermatitis means inflammation of the skin. Seborrheic indicates that a condition affects the sebaceous glands, which are the oil glands for the skin. In brief, it causes flaky skin on the face and upper body.

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To start, seborrheic dermatitis occurs most often amongst young adults. We know this condition as dandruff. In fact, emotional stress aggravates dandruff. Of note, the lack of cleanliness does not cause it. Additionally, cradle cap is a similar condition that babies have. It usually clears within a few months. Dandruff prescription is available. In brief, doctors prescription medication where antifungal creams don’t help.

Of note, the exact cause of seborrheic dermatitis is unknown. It is not just a simple skin infection. Also, it is not contagious. Specifically, one cannot catch the condition from others. An antifungal shampoo and/or an antifungal cream usually clears dandruff and rash.


Most skin glands that make the oil (sebum) can get affected. Thus, this condition is more common in greasy areas of the skin. Of note, common areas include the scalp, forehead and chest. Additionally, areas such as the T-zone of the face (nose and eyebrows), armpits and groin are common greasy areas of the skin, as well. In mild cases, bad dandruff may be all that occurs. Dandruff is the scaling of the scalp . In fact, it happens because of seborrheic dermatitis. The scalp may also become itchy, too. To add, mild patches of flaky skin may also develop on the face. In worse cases, a rash may also develop. The scalp also becomes itchy. Medical investigation is not necessary, and the typical symptoms and rash are good enough to confirm the presence of dandruff.


Commonly used treatments include the following. For instance:

Many times, antifungal shampoos, such as ketoconazole, help. This treats the scalp, eyebrows, and other hairy areas. In fact, the dandruff prescription shampoo removes the fungal infection.  Thus, it cures the skin. One can apply antifungal shampoo twice a week. Leave the shampoo in your hair for about five minutes before rinsing off. An anti-dandruff shampoo that contains zinc pyrithione or coal tar may also treat dandruff in mild cases too. For example, Head & Shoulders®. An antifungal cream can treat dandruff in other parts of the body. It often takes 2-4 weeks to clear dandruff or rash completely. Hence, do not stop using the cream or shampoo. In fact, this is to prevent reoccurrence. Also, avoid cosmetic products that contain alcohol as it may dry out the skin.

Other treatments:

  • Firstly, a scalp softener can help the scalp. For best results, use with antifungal shampoo.
  • Secondly, using a mild steroid cream or steroid scalp lotion can help in severe cases. Specifically, this is if you also use an antifungal cream or shampoo. Use the steroid cream if the skin or scalp is badly inflamed. Steroid creams and lotions dampen inflammation. Thus, redness symptoms may be treated.
  • Thirdly, a 5-day course of antifungal tablets if the dandruff is not clearing with the help of an antifungal cream.
  • Lastly, light treatment (phototherapy) with ultraviolet B rays is also used in curing severe cases.

Often, seborrheic dermatitis reoccurs in a few weeks after a course of treatment. Each episode can be treated as it occurs. Once the symptoms have gone with treatment, the following may help to keep the condition from recurring. For instance:

  • For the scalp, continue to use a dandruff prescription antifungal shampoo. Shampoo such as ketoconazole once every 1-2 weeks. Leave on the scalp for five minutes before rinsing.
  • For the body, take regular baths with soap and water help to remove the greasy sebum from the body. Some people may need to use an antifungal cream 1-2 times a week on the affected areas of the skin.

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