Solutions & Treatments for Seborrheic Dermatitis – (Dandruff & Cradle Cap) – (Part 1 & 2) – S5E1 & S5E2

 

TRANSCRIPT (Part 1)

Abby:

Hey Eczema Conquerors, welcome to the podcast today. My goal for you is to offer you solutions so that it can lift you out of a dark place and give you hope that there is light at the end of the tunnel. So I hope that these podcasts will really help to uplift. Today, we are talking all about seborrheic dermatitis. It’s something that I’ve suffered from a lot, especially when I was younger. When I was in high school, I had a lot of eczema on my scalp. And at one point my scalp kept oozing and oozing, and the flakes were so large that my scalp and my hair actually got sticky and it stuck together.

Abby:

I was scared to shower because it would sting yet. At the same time, I couldn’t even call my hair properly because the comb wouldn’t go through my hair because all the oozing made my hair stick together. And so I remember it was so traumatic when I was able to pull skin flakes, almost the size of a coin from my scalp. And that was the most painful part. And thankfully that moment has passed and my skin has gotten a lot better. I know that a lot of you guys also go through this too. So we’re going to talk all about seborrheic dermatitis today

Abby:

I have such a great guest on here, and it is her second time on the show and I’ve invited her back on because she is just a wealth of information. She gives really, really great information about how to help your skin get better. And today we are specifically talking about dermatitis on air scalp, and I know a lot of you have messaged me about that. And a lot of you have so many questions about how to help your skin get better, especially if you’re affected by it in your head and your scalp region. I just had an email about it yesterday. So Dr. Julie Greenberg is a naturopathic doctor who specializes in dermatology there, aren’t a lot of them who specialize in dermatology. So I’m just really appreciative that I have her on the show today.

Dr. Julie Greenberg:

Hi Abby. Thanks so much for having me here. You know, I love the podcasts. I subscribe and listen to every episode. So it’s an honor to be here.

Abby:

Thank you so much. And for those who might not have heard you on the first episode, do you want to share a bit more about yourself, maybe where you’re located and how you got into specializing in dermatology, especially, especially integrative dermatology, because there’s not a lot of people who specialize in this area.

Dr. Julie Greenberg:

Yeah. So as you said, I’m a naturopathic doctor who specializes in dermatology for your listeners who don’t know what a naturopathic doctor is. That is an ND and not an MD. There are certain similarities and differences, both ND’s and MDs have four years of medical school. The first two years are basically the same. It’s like, what, how is the body supposed to work? And then what happens when the body does it malfunctions and disease. But the last two years are really different. So MD traditional, conventional doctors are trained really in the use of a prescription pharmaceuticals. That’s mostly their toolkit. That’s why when you go to the doctor, you kind of expect to get a prescription because that’s what they’re going to give you. But with a naturopathic doctor, we are trained in nutrition, supplements, herbs. I’m also a registered herbalist through the American herbalist Guild.

Dr. Julie Greenberg:

And our whole philosophy is let’s try to treat the root cause let’s not just focus on the symptoms, let’s treat the root cause. And in order to do that, we need to treat the whole person. And what that means is, you know, in conventional medicine, we kind of like to chop people up into different systems like, oh, you’re having eczema. That’s a skin problem. Go see a dermatologist. You’re having gut issues up, go see the gastroenterologist. And if you’re feeling depressed or anxious, go see the psychiatrist, right? And we pretend like those things are completely separate and have nothing to do with each other. And those doctors are not speaking to each other, but from a naturopathic perspective, we say, this is one person, one body, one mind, one spirit, and everything impacts everything else. And so that’s the way I practice. Although I specialize in dermatology and I only see patients who are having complaints with skin, hair or nails, I am absolutely trying to treat the root cause I am absolutely treating the whole person and I’m sure we’ll get into it, but I do a lot of treating testing and treating the gut in order to treat the skin.

Dr. Julie Greenberg:

Cause they’re so interconnected. And I just really have a passion for dermatology. I think part of it is because I think people who suffer from chronic skin conditions like eczema, like psoriasis, like acne, there really aren’t great options. A lot of times in conventional dermatology because it really is this let’s just treat the symptom, let’s put a topical steroid on it. Let’s shove that inflammation back down. And I, you know, I always say to my patients, obviously, you know, you or your child having eczema, the problem is not that you are deficient in topical steroids. So putting topical steroids on your skin over and over again. Yeah. We can suppress it for a certain amount of time and people will have the same history. When I first used the steroid, it went away, it was great, but then it came back and then we had to use more steroids and stronger steroids.

Dr. Julie Greenberg:

And then they stopped working. And then, you know, worst case scenario, you’re in something like topical steroid withdrawal, but it’s obviously not treating the root cause. And so I’m so passionate about it because people with these chronic skin conditions suffer so much, it really is a huge, emotional and psychological toll that it takes on people. And I don’t think people who are, who haven’t been through, it can fully understand just the actual toll it takes on people. And, I know that obviously not every doctor can help every patient in every case, but you know, a lot of the times I can really help people. And it’s really gratifying work to get in, to see what’s causing the problems and be able to fix these underlying root causes so that they can then go on and live their life, not being on medication, not being on supplements. And we’ve really corrected the underlying problems and change people’s lives. So I love doing it and it’s really gratifying work.

Abby:

That’s awesome. Dr. Julie, and yeah, I would love you to share more about how you actually start treating seborrheic dermatitis. What do you do when a patient first comes to see you with it?

Dr. Julie Greenberg:

Yeah. So Sebderm, as we call it or separate dermatitis, you can have it in multiple places. So you mentioned the scalp and that is a very common spot, but we can also get separate dermatitis and other areas like on the face and some of the common areas, we’ll see it on the face where I’m looking and I’m like, oh yeah, that’s Sebderm and not, you know, eczema is we call it the nasal labial folds. So here between the nose and cheeks around the eyebrows, the glabella, which is this area in between the eyebrows, the anterior hairline, those are some really common spots as well as of course, on the scalp. And in infants we call seborrheic dermatitis. Or actually at that point, it’s separate capita Titus cradle cap. And in adults, we call it dandruff. And I think the first thing about treating seb derm is understanding what it is.

Dr. Julie Greenberg:

It is different than eczema, although it really does come a lot together with eczema. And we can talk about that, but the underlying thing what’s causing the cradle cap or the dandruff for even the sebderm on the face is an organism called malassezia. And it’s a yeast, a yeast is within the fungal family. So I think we all know molds, you know, you leave a pencil bread out, you’re seeing fuzzy stuff. That’s mold, that’s a multicellular organism and a yeast like malassezia or candida is a single-celled fungal organism. And so it’s really, it’s really an issue with malassezia and that’s what’s causing the problem. So I can go a little bit more into malassezia or whatever direction you want to go.

Abby:

Sure. Well, why don’t we go a bit more into what you just mentioned and then we’ll go into seborrheic dermatitis.

Dr. Julie Greenberg:

Yeah. So malassezia is a yeast that is present on every mammal. So not just humans, but every mammal we call it a commensal most of the time it’s not doing anything. I have malassezia you have malassezia everyone who is listening to this podcast has malassezia on their skin and on their scalp. So it’s a normal organism. There’s about 13 or 14 different types of malassezia that colonize humans. And like I said, every mammal, so dogs will have different species. If you’ve ever seen a dog with mange, that is a malassezia overgrowth problem. So animals can be affected by it. We don’t call it seborrheic dermatitis. We call it mange, but pick an elephant a gorilla. It doesn’t matter if they’re a mammal, they have malassezia. And most of the time it’s just kind of hitching a free ride.

Dr. Julie Greenberg:

And we haven’t figured out what we are getting out of the deal, but malassezia gets food. So what malassezia wants, why it’s on our skin and scalp, is it eats, it’s called a lipophyllic yeast, which means it is attracted to fats. And it eats sebum and our skin and scalp in our hair follicle, we have a gland called the sebusite and it produces something called sebum. It’s really kind of a, of different oils and save them is good. It moisturizes our skin on our face and moisturizes our scalp and in proper amounts, we absolutely need and want that sebum. Now one skin problem where we have an overproduction of sebum is acne. So that’s where the hair follicle starts producing too much sebum. So just, you know, just like everything we don’t want too little, we’re going to get dry and flaky.

Dr. Julie Greenberg:

We don’t want too much. We can start getting acne. We want just the right amount of sebum. And themalassezia is usually just living on there, eating the sebum. The scalp and face are some of the most sebum, rich places on the body. So that’s where we have malassezia and when all is going well, it’s like you and I were sitting here. You there’s no rash. There’s no problem. There’s no cradle cap or dandruff. And our immune system is basically ignoring the malassezia and just leaving it alone. Now we get to separate dermatitis. Okay. What happened? We kind of have this situation where normally we’re just ignoring the malassezia but now we’ve got cradle cap. We’ve got scales all over the infant’s head. It’s red, they’re itching. It’s very irritated and aggravated people with dandruff. They’re getting white flakes.

Dr. Julie Greenberg:

It’s hard to wear dark clothes. They’re itching at their scalp all the time. And people with Sebderm on the face are having rashes, crusting, and scaling. And so obviously something is going wrong and there’s a couple of different things that can be happening that kind of turned this tide from normal malassezia is on there. Nothing’s happening to, oh yeah, we’ve got a big problem. One of it is we can have an overgrowth of malassezia and malassezia, and now is eating up all the sebum. Well, we said sebum is a moisturizer. And so that’s part of why we get those dry flakes. The scalp is not being moisturized or we’re trying to produce the sea of them so that we have a moisturized scalper phase, but the malassezia has overgrown and it’s eating it all. And that leaves us you know, the skin dry and flaky.

Dr. Julie Greenberg:

And, and we see that some of the reasons why Mala CZI can overgrow it tends to happen in the winter. So we think that the sun naturally that the UV rays just when we’re out and about in the summer, hitting our scalp, hitting our face, kind of keep it under control. Cause it’s very common for seborrheic dermatitis to, or dangerous to be worse in the winter. Some people will say you don’t have it in the summer. It only happens in the winter. And that’s why we think it’s that UV radiation, keeping populations under control. It seems to be less an overproduction of sebum. So if this isn’t really related to acne, and we talked about that, that acne is an overproduction of sebum. We don’t really see that as much in malassezia. the, the sebum that we produce is composed lots of different types of fats.

Dr. Julie Greenberg:

And we do see that there is this kind of shift in people with Sebderm, where the fats that they’re producing in their sebum kind of shift, and it’s not the right percentages. We don’t have a lot of information on that. Why is it happening? Why does it change? Because sometimes people will go in and out, like, you know, sometimes I have dandruff and then it goes away and then it’s back. And so we don’t really understand the shifting profile of those, what we call lipids or fats in the sebum. And then the third problem we can have, and you see this more, when you get those red inflamed patches, either in regular dandruff, a lot of people will kind of feel sores or they can see that there’s red spots on the scalp. And certainly an infants with cradle cap. You know, there’s, it’s not just the kind of yellow greasy flakes, but they can get very red, irritated scalps.

Dr. Julie Greenberg:

Now we are transferring into an immune response and the body has suddenly shifted and has said, okay, well, before I was looking at malassezia and I was kind of just walking on by like, it’s malassezia. But now something has happened and the body has become alarmed and it starting to attack and go after the malassezia. And we are still trying to figure this out, the redness and inflammation we see in people who have dandruff higher levels of histamine in their scalp, histamine causes itch. That’s why people are itching with dandruff. They likely have higher levels of histamine. So there’s this immune response happening. There are also things called inflammatory cytokines, which is a fancy word for chemicals that we produce that trigger inflammation and inflammation is not always a bad thing. We need inflammation to attack invaders and get rid of them to heal wounds, but we want it to be controlled.

Dr. Julie Greenberg:

We want to have inflammation to get rid of the invader or, you know, heal that wound. And then we want that inflammation to clear. We don’t want it to become chronic. And in sebderm, it just becomes this chronic inflammatory state. And what I see on in my patients with eczema and because I do a lot of gut testing stool and urine testing, I find that most of the patients who have eczema, who also have either cradle cap or dandruff or Sebderm of the face, they have candida overgrowth in their gut. And we’ve seen that we see that on the labs, either the stool test or the urine test, we can confirm that there is a candida overgrowth in their gut. And I mentioned before that candida is a single, also a single-celled yeast. It’s a single cell fungal organism, and we don’t have a lot of data on it.

Dr. Julie Greenberg:

But my hypothesis is that the body is busy trying to fight this candida overgrowth, candida in the gut. When it overgrows is very inflammatory, it causes a lot of inflammation in these cytokines. We were talking about and histamine and IGE antibody production. And so people’s systems get inflamed when they have cancer to overgrowth in the gut. And I think the immune system is fired up to look at yeast as a bad guy. And suddenly it starts seeing that malassezia and goes, wait a minute, candida single celled-yeast, malassezia, single cell yeast. Maybe you’re a bad guy too. And we start to get this kind of shift in the immune system where it really goes after the malassezia. And I do find that there’s, there’s definitely topical things. And, and I know we’re going to talk about some treatment options, so there’s definitely things we can do topically that can help or make the sebderm worse.

Dr. Julie Greenberg:

But you also do need to look at the gut and I, every podcast, I know I feel like a broken record, because I’m always talking about the gut when we’re talking about the skin, but it really is connected we’re tube. The skin is the outside. The guts are the inside and it meets at the mouth and it really all kind of talks to each other and every, every system impacts the other one. And yeah, so I know that was a long answer. So that’s, that’s kind of some of the underlying root causes of what’s going on with Sebderm.

Abby:

Awesome. We have Erin, who said great content. So I’m glad that you’re loving the content from Dr. Julie. I also have Isabelle, who said that hers improved when she treated her candida and apple cider vinegar also helped her dandruff.

Dr. Julie Greenberg:

Vinegar is a big part of my treatment plan.

Abby:

Awesome. So we will definitely talk more about topical treatments later and Dr. Julie, I think it’s great that you mentioned, how it’s all connected, especially our skin and our gut. And I think that is so important. Do you ever see any other root causes in terms of what can be causing subderm or do you usually just see candida and gut issues or do you ever see fungal overgrowth or any other issues that might be causing it or even nutrient deficiencies?

Dr. Julie Greenberg:

Yeah, that’s a great question. And there’s two pieces of that where I do see things. You mentioned the nutrient deficiencies, sometimes I’ll supplement with some B vitamins. There is evidence that because of those fat productions are off that like biotin and niacin, and some of those B vitamins, the production gets off in the scalp. So sometimes we’ll do some B to B complex to make sure that the person is being properly supported with the B vitamins. I haven’t found a lot of good research that connects seborrheic dermatitis with any nutrient deficiencies. And so, you know, in, in the naturopathic and integrative world where, you know, I’m always trying to find these root causes. I am kind of always straddling the field, looking for new research to see, you know, what can actually what’s out there, that’s published in the literature. But then a lot of times there isn’t a lot of research that’s based on my clinical experience with my patients and with their labs. I don’t tend to do a lot of nutrient testing on my patients because we’re really focusing more on the gut testing, but sometimes that B vitamin supplementation can help. And then I’m forgetting what was the first part…

Abby:

Sorry, have you found omega 3 or fish oil,liver oil, those types of oils, have they helped any of your patients?

Dr. Julie Greenberg:

I find it in about the same rates as with like eczema and psoriasis. You know, when people are polled who have eczema and psoriasis, 30% will say maybe they had a moderate improvement in the eczema or a moderate improvement in the psoriasis. I mean, fish oil is great. It’s great for skin health because skin has what we call a fossil lipid bi-layer, which means it uses a lot of fats to build skin. And it’s gonna look around for what fats are available. And omega 3 fatty acids are fantastic because they’re really flexible. So when we build skin from a mega three fatty acids, we get really good quality skin and they are anti-inflammatory in the system. And we know that. So I think it’s always helpful to supplement with fish oil. You know, as long as obviously someone doesn’t have an allergy or a problem with fish, but I’ve never seen it just like clear it up. So it’s one of those like vitamin D fish oil, usually not going to hurt, maybe it will help. And so then you kind of have to look at how many things are in your treatment plan. How many things, you know, am I asking my patients to do? And is this at the top of the list? Or, you know, maybe we need to focus on these other things first.

Abby:

I agree with you. I think it’s so much more than just nutrient deficiencies a lot of times. And like you mentioned, the gut is so important. And yeah, the other question I had earlier was whether if you see other root causes like fungal overgrowth or anything else that might be flaring up, the scalpin also in the face area sometimes.

Dr. Julie Greenberg:

Yes. And, the answer is it certainly can be the case. So I’ve seen in my patients, you know, I think people kind of have predispositions to be more susceptible to certain types of things. So certain people kind of tend to have this viral susceptibility where they’re going to get cold sores and warts and shingles or chicken fox. Right. And those are all viral skin problems and we’ll see kind of multiple things. Other people do tend to have, you know, I’ll say, you know, you’re a little bit funkily because they can have things like toenail, fungus along with, you know, Sebderm along with so malassezia is an underlying pathogen or organism that causes other types of skin problems. So we’ve been talking about malassezia in terms of dandruff cradle cap and a facial rashes, but it’s also responsible for something called tinea versicolor, which is more on the trunk, arms and back of the body where people they tend to see it more in the summer because they have what we call our hypopigmented or white or lighter spots.

Dr. Julie Greenberg:

And they’re not sure, like, am I flaking? Was that a sunburn? But it’s actually the malassezia yeast and it inhibits the production of melanin there. So they look lighter spots. So people tend to see that more in the summer like, oh, I’ve got these patches of light on my chest or back or arms. That’s probably tinea versicolor caused by malassezia. Malassezia can also cause something called fungal acne and malassezia, used to be called pity or pityrussforum. So that term is used interchangeably, but when people have acne particularly up around the forehead and it’s not responding to more conventional types of acne treatments, normally we think of acne is more of a bacterial thing. There’s an organism called GD bacterium acnes. It used to be called propionibacterium acnes, but when it’s really not responding and a lot of times when it’s on the forehead and it’s discreet white dots or on the back and chest as well, that’s probably fungal acne being caused by malassezia and malassezia can also cause secondary infections on top of eczema or psoriasis.

Dr. Julie Greenberg:

So to answer your question, yes, there are often times where I’ll see these other profiles and I will definitely ask people, you know, do you have any of these other conditions as well? And, and for women, I’m definitely gonna investigate the Cantina overgrowth problem and ask them, you know, do you get vaginal yeast infections? That’s a sign that there’s candida overgrowth in the gut in the system, because again, it’s connected and it gets into the vaginal microbiome and can overgrow. And one of the main reasons why we can get candida overgrowth in the gut or in the vagina is after taking antibiotics. So single a lot of women know, okay, if I’m doing antibiotics, I should take a probiotic or I should eat yogurt or something with probiotics because you don’t want to get that vaginal candida yeast infection that we’re going to know about, you know, as a woman, if you have a vaginal yeast infection, you don’t know, it’s not as apparent when the candida overgrows in the gut that that may require the testing.

Abby:

That’s really important. And yeah, I always encourage people to get tested, to figure out what their root causes and Isabel asks a really great question that I’ve been asked a lot is where do you get tested and can all dermatologists do gut testing? That’s a really great question.

Dr. Julie Greenberg:

Yeah. So I think Isabelle, you can pretty much assume that no dermatologists will be doing gut testing because it is really outside the realm of any of their training. And again, they are not trained to think the gut in this way. So the gut testing that I do is called functional medicine testing. It’s a stool test is one of them. Yes. My patients poop into a tray. They collect their stool from four parts, put it in a solution, FedEx picks it up. And then I get a report of what bacteria are in their gut. Is there candida, you know, lots of different things is their H pylori in their stomach. And then the second test is a urine test called an organic acid urine tests that I do where they pee in a cup and freeze it. And that gives me more information about candida and other fungal elements.

Dr. Julie Greenberg:

Like Aspirgillus, a mold.No dermatologist, no MD, classically trained dermatologist is going to understand what this is, have accounts with the labs or know what to do with it. So you have to see somebody who is a naturopathic doctor or a functional medicine practitioner who understands the importance of the gut has accounts with these labs, because this is not a blood draw. It’s a stool and a urine test. It’s not through like quest and lab Corp. And you have to have training on how to understand these labs and then apply it. So, your conventional dermatologist is not going to be a good person to go to for this. I have, I work with a group of wonderful integrative dermatologists who are fantastic and, you know, look at herbs and all sorts of things. I don’t know of a single conventionally trained dermatologist who would know how to do this.

Abby:

I agree with you. And it’s unfortunate that we do have to go to alternative or even functional or practitioners or naturopath doctors like yourself, but I’m glad that there are options. So in case anyone is wondering, Dr. Julie just shared about some options and other functional practitioners also do the same too. I hope you enjoyed part one of this episode, stay tuned for part two, where my guests will be sharing so much more information that I know you will find helpful, especially if you are going through this stay tuned. And I hope you have a great week.

 

Transcript (Part 2)

Abby Tai:

Welcome to part 2 of this podcast, where we talk all about tips and treatments for seborrheic dermatitis. We talk all about what treatments are good, what topical treatments help as well, and what natural treatments work. And you’ll also find out what natural oils are good for your scalp and what oils you should stay away from.

Abby Tai:

Back to the treatment options for sebderm. I would love to get into just hearing more about how you usually start to treat it once you figure out what the root causes for the person.

Dr. Julie Greenberg:

Yeah. And so there’s two aspects to it, right? One, is testing and treating the gut and one, is topically. What can we do to help them out? So I guess I’ll start with topically. So we’ve already said that malassezia wants to eat the sebum. It wants saturated fats. That’s going to feed it and make it blossom. So the first thing is, you know, kind of things we don’t want to do. You don’t want to throw like straight coconut oil on there because you will be feeding the malassezia. And actually in labs, when they’re trying to grow out malassezia, a yeast, they put coconut oil is what we call a substrate as the actual food to feed it. So don’t want you to start putting coconut oil in your hair or other oils or on your face because that can feed it. There are ways to adjust it. So there are herbal infusions we can do with coconut oil, with herbs, like neem, which is very antifungal there’s essential oils that we can add to coconut oil that then changed the profile of the coconut oil and we’ll fight the malassezia. So there are ways to use coconut oil, but I never recommend that patients just put straight coconut oil on their face or scalp particularly with malassezia, because you’re gonna make a bloom.

Abby Tai:

Dr. Julie, is there something about the profile of coconut oil that does cause it to flourish?

Dr. Julie Greenberg:

Well, it’s high in saturated fats and so it’s feeding the malassezia. Yeah. olive oil is another one. Do not use it with a separate dermatitis because olive oil is high in something called oleic acid. And a lot of people have a natural sensitivity to oleic acid. And one of the things that when the malassezia eats the fats, one of the things that leads behind is oleic acid. And so part of that inflammatory response can be that people just don’t don’t work well with oleic acid. And so I never recommend olive oil either because it’s just so high in oleic acid. So those are some of the things we don’t want to do for the face. You know, if you want to use moisturizer jojoba oil is a reasonable option because even though we call it an oil, actually, it’s a waxy ester and malassezia cannot utilize that as food.

Dr. Julie Greenberg:

So for cradle cap and infants, we do massage. I have patient parents massage the head with a hobo oil and you can get those little cradle cap brushes and kind of gently try to work the flakes off. And you can also use the hub oil as a facial moisturizer because the malassezia can’t use that as a food source. But there’s, there’s lots of options. And I will say as a caveat essential oils are a wonderful tool to use against bacteria and fungal and yeast elements. But I do not suggest that people start formulating with essential oils on their own because they can be dangerous substances. Both they get absorbed into our skin and may or may not be appropriate in infant use. I try not to use them in infants because they are going to absorb them.

Dr. Julie Greenberg:

There are other essential oils that are, phototoxic like bergamot. If it’s not Ferrano coumarin free, you can get very severe third degree burns with bergamot and other citrus oils. You really need an herbalist, a professional, someone who knows their essential oils and appropriate essential oils for appropriate people, appropriate percentages. Because you can get contact dermatitis and get sensitized to essential oils. So, so everything I’m about to talk about, I am absolutely not recommending that the listeners go do this on their own, but some essential oils that are good against malassezia you include things like tea, tree oil and Myrtle essential oil. Rosemary essential oil as a favorite of mine. But again, you need a professional to help you put together appropriate and safe compilations for you individually. You know, based on the individual. So essential oils are things that, that I use a lot.

Dr. Julie Greenberg:

There’s also shampoos. So I think people know, you know, when you go buy an a dandruff shampoo, it is going to be an anti-fungal shampoo. And the reason it’s an anti-fungal shampoo is it smells malassezia yeast. That’s part of the fungal world. So you can go to CVS and get some anti-dandruff shampoo, that’s one option. Some of the active ingredients that you’ll look for are zinc parathion, and that’s pretty effective. There are also like more natural options. I have no affiliation, but Happy Cappy is a gentle product with zinc pyrithione who that can be used in kids and adults. So that’s one that sometimes I’ll recommend, but you can just go get, you know, head and shoulders or whatever, but look, yeah, look at the active ingredients. Cause there are different active ingredients. A lot of people, when they go to the dermatologist, they’ll get a prescription for ketoconozole shampoo. Ketoconozole is an antifungal and that works well too.

Dr. Julie Greenberg:

So there’s lots of options for treating antifungals topically, either prescription or non-prescription. But a lot of people complain that, well I’ll use the Ketoconozole all shampoo and then the dandruff will go away, but then it comes back again. One of the listeners mentioned apple cider vinegar. That’s a big thing that I use. So in the shower I have patients do a mix of like 50, 50 apple cider vinegar to water. And after they’re done shampooing and conditioning their hair we do a rinse with the apple cider vinegar. And if they don’t mind the smell, we’ll leave it on. If they don’t want to smell like an Easter egg, we’ll wash it off, but malassezia hates apple cider vinegar. And the reason is pH, we haven’t talked about pH yet, but the skin has a normal pH, which is actually low or acidic.

Dr. Julie Greenberg:

And at that pH, we have things on our skin that can naturally fight overgrowth of malassezia, right? The skin is supposed to function while we’re not supposed to have overgrowth of organisms, either bacterial or fungal and at an acidic pH the skin does a pretty good job when that skin pH goes up and becomes more neutral or alkaline. malassezia has a great time. It can blossom and grow. It’s really happy. The skin can’t defend itself and apple cider vinegar is very acidic and it smells, malassezia hates it. And so it’s great to use during the shower. If patients can tolerate the smell, I have them spray it onto the scalp or face after the shower and a 50 50 dilution because that’s going to sit on the scalp. If they really don’t like that smell, there are things called hydrosols we can use after the shower.

Dr. Julie Greenberg:

I really like Rosemary, because it’s very good at working as an antifungal. So I will have patients spray their scalp with Rosemary hydrosol and then I sing about that as it smells fresh and nice. And it’s going to sit on the scalp and keep working to keep those malassezia levels down. So there’s different, there’s lots of different options for trying to control it topically, but you know, ultimately you do need to go in kind of look at that root cause, see if there’s candida overgrowth and treat the Kenziedo overgrowth in the gut.

Abby Tai:

So Dr. Julie, I love everything that you shared about just now. And I find that it’s very useful. Everything that you shared and I really appreciate it. So in terms of the scalp, I’ve also had a dermatologist who has recommended I think it’s tar or either cold tar. Yeah. What are your thoughts on that?

Dr. Julie Greenberg:

It’s also, you know, recommended for psoriasis for scalp psoriasis and sometimes scalp psoriasis can, can have an overlying malassezia where we know that actually, if we treat people with psoriatic, the scalp problems with antifungals, their scalp psoriasis gets better. So malassezia is definitely often involved in scalp psoriasis as well though. There’s other things going on, of course, but for me it’s cold tar. That’s not really something that I want to put on myself or an infant or a patient. So I personally don’t use it, but it can be effective at killing and it, it is an option. You can go buy it without a prescription. So I think that’s a personal decision, you know, if people would want to use that ingredient, it’s, it’s not one that I use or like.

Abby Tai:

Patients when I was prescribed it, I had a hard time finding one that had good ingredients in it. And so I think that’s why I never ended up using it.

Dr. Julie Greenberg:

Yeah. And I think because the fundamental thing is cold tar, right? It’s a petroleum by-product like, it’s not really in the world of holistic or herbal medicine. And so it’s not really used, that’s more where you’re fine, like the zinc parathion or something like that in kind of healthier types of products.

Abby Tai:

So in terms of the essential oils, you basically shared that you can either mix it with some sort of oil but try not to do it yourself because it can cause more harm in some cases. And also the other option is to have it in a hydrosol form and spray it on your scalp or either right your face.

Dr. Julie Greenberg:

Well, so, and let me, let me make two distinctions. One people should never put essential oils on meat. Meat means directly just topical without some sort of carrier. So you can very quickly, even if like, you’re like, oh, look, I put on teach real and nothing happened. You can sensitize yourself quite quickly and then ends up with a con, an allergy and a contact dermatitis to it. And you won’t be able to use it again and again, these are very powerful substances, so never put it on directly. I don’t like using them in a water base. So the Rosemary hydrosol and I should have explained this it’s not essential oils, essential oils are what we call lipophyllic. They want fats. And so they don’t disperse in water. So it’s a little hard to get a essential oil into a water-based product because they’re going to float on top.

Dr. Julie Greenberg:

I also don’t recommend that people add essential oils to their baths because you’ll notice it’s, it’s floating in this little oil slick, and then that oil slick will touch your skin. There’s fat on your skin. And it’s just going to sit on there, like you put it on directly. So it doesn’t really disperse in water. It will disperse and aloe Vera gel. So you can add it to allow that does tend to work, but shake it up. But a hydrosol is a little bit of a different product and it’s very safe for infants. I use it widely on infants and it’s safe for pets. And what a hydrosol is, is really a by-product of the essential oil making process. So let’s take Rosemary, a company wants to make Rosemary essential oil. They’re going to take hundreds of pounds of Rosemary, twigs, and leaves and plants, and put it into a copper distiller with water.

Dr. Julie Greenberg:

They’re going to put that fire underneath it and heat it up. And then we say essential oils are volatile oils, which means that they evaporate. So the steam and the essential oils are going to evaporate. And then it cools into a second vessel and the water comes over and the essential oils. So the essential oils, well, they’re not really oils. We call them oil. They’re going to float on top and the company will siphon that kind of oily layer. And that’s the essential oils, but the water that’s evaporated over with it is infused with that plant, like the Rosemary, but it doesn’t, it’s not like super concentrated, like an essential oil and that water is the hydrosol. So hydrosols are amazing because they still have some of that power of the plant, but they’re very gentle and they’re very safe. People don’t really get sensitized to them. And they’re just beautiful products to use safely every day on infants and adults. And everybody usually of course, unless if you have a calendula allergy, don’t use calendula hydrosol, but usually they’re very well tolerated in people.

Abby Tai:

Awesome. I love that you provided so many great options for people to try and I think it’ll be really useful because people are always looking for something natural, especially more natural to put on their skin and in order to help their skin get better. Have you heard of anyone using other things like, for example, red light therapy to help their sub Durham get better?

Dr. Julie Greenberg:

Yeah, it’s an interesting topic. There is, there is a red light cap that says that they are working well, that the people are using it. I don’t have any patients yet with just separate dermatitis who have opted for the cap, because it is almost a thousand dollars and it’s a pretty pricey treatment, you know, for something like Seb derm which is not to say separate dermatitis can be very dramatic. I did have a patient who came to me that she thought she had scalp psoriasis for 25 years. I took a look at herself and said, it’s not scalp psoriasis to separate dermatitis. And she has lost about half of her hair because of all the inflammation over 25 years. So I’m not trying to minimize how severe seborrheic dermatitis can be, but most of my patients don’t want to spend like a thousand dollars on a red light cap.

Dr. Julie Greenberg:

You know, that, they’re more FDA approved for Entergy estrogenic, hair loss. But they, some of their companies are claiming that they have dermatologists who are using it and it will help with Paradis or itch. And it does help a little bit with subdermal. So I think the jury is still out. I think it’s an interesting, it’s just expensive. And usually patients are like, you know, let’s, let’s drive a topicals, let’s try the apple cider vinegar before I spend a thousand dollars. And we can usually get things under control without needing them to get a red light therapy cap. But, you know, I think it’s, if you have the money and you’re interested in experimenting, it’s potentially a useful tool.

Abby Tai:

And also it doesn’t actually get to the root cause of the issue. And what other treatments do you usually use to get to the root? Cause let’s say if someone does have candida or fungal overgrowth, I know it will be so different for every person, but I was wondering if you have any recommendations that you usually do and usually recommend for people.

Dr. Julie Greenberg:

So this is one where you definitely need to be under the supervision of a licensed healthcare professional, somebody who does got tests and somebody who has extensive training with herbs or pharmaceuticals. So there are ways to treat candida or, you know, other types of overgrowth with pharmaceuticals. So maybe your primary care physician or your gastroenterologists, but again, they’re not going to really understand these functional medicine tests. But a lot of patients want to self-treat with herbs and supplements because they’re doing research. And I really think that no patient should be self dosing with herbs or supplements because they can be dangerous. And you don’t know what you don’t know. So as a naturopathic doctor, we receive four years of herbal training studying the herbs contra-indications what kind of herbs you can mix, what you can’t, what dose of the herbs is appropriate.

Dr. Julie Greenberg:

We formulate and treat with herbs throughout our education at our clinics. Like my medical school had a dispensary where we could order down formulations of herbal products. And we have to pass board exams on herbal medicine in order to become licensed naturopathic doctors. In addition to that, I mentioned I’m a registered herbalist with the American Herbalist Guild. So that’s additional certification that I am properly trained in herbal use. So, find somebody who is either like a licensed naturopathic doctor or a registered herbalist, somebody who for sure knows their herbs to guide you, but we have fantastic antifungal herbs that work great against candida. And there’s a lot of different formulas and types of herbs out there. I’m a little hesitant to start naming things because I know people that are going to go self dose, but really just get under the care of an herbalist or naturopathic doctor someone who’s even a traditional Chinese medicine or Ayurvedic practitioner, they are formally trained in herbs and can help you navigate this, do not dose on your own. Even something as seems as innocuous as vitamin D people can overdose on vitamin D. That’s a fat soluble vitamin, which means we store it. We don’t pee it out like B vitamins, and we can get vitamin D toxicity if you’re taking too much. So even something where people are just like, I’m just going to take vitamin D. Sometimes they come to me and they are on a very inappropriate dose for way long periods of time. And I really think people should not be self-dosing, herbs, or supplements.

Abby Tai:

Thank you so much for sharing that. I really appreciate it for people who just came on. Dr. Julie did mention to avoid coconut oil and olive oil, if you’re using it on its own for Sebderm, because it can actually grow the issue. Are there any other oils that you would avoid or is it just mainly these two?

Dr. Julie Greenberg:

So it’s hard because basically all oils are going to have something in there. That’s going to feed malassezia, so it’s, you know, that’s why I tend to move a little bit towards the hobo oil when we’re trying to get things under control. Because again, it says oil, but it’s a waxy ester. So if you’re going to use other types of oils, you still need some sort of like antifungal in there, either herbal extraction or essential oils so that you’re not causing a bloom. But it’s tricky because you know, this is a case where you could potentially make an argument for something like lotions or things made with petroleum oil, because that’s not going to be a food source, but I never use petroleum oil based products. So that’s where I tend to kind of add some antifungal elements to the oils that I’m using or kind of stick with a oil.

Abby Tai:

I love that. Thank you so much for that response. And I also had one other question because I remember when my son was little, he had cradle cap and thankfully it was really mild, but I remember I was a new mom and I was just asking people for advice and, you know, for cradle cap and they all said it’s normal. And even in the people, my other friends that I talked to, they all said that their babies had it too. So is it actually normal or is it not supposed to happen if your baby doesn’t have this overgrowth?

Dr. Julie Greenberg:

So I like to make is a distinguishing point between what is common and what is normal, right? Like actually acne in our society is very common. Over 90% of teens are going to get acne. So it is common and it is becoming even more common in adults, but it’s not normal, because we don’t see it in indigenous cultures. They don’t have acne at all. So common does not equal normal. I would say the same, you know, in cradle cap and babies, it is definitely common. But it’s still not normal. You know, we still want to try to help them out. There is an immune response. Something is happening either. There’s the overgrowth of

Abby Tai:

Welcome to part 2 of this podcast, where we talk all about tips and treatments for seborrheic dermatitis. We talk all about what treatments are good, what topical treatments help as well, and what natural treatments work. And you’ll also find out what natural oils are good for your scalp and what oils you should stay away from.

Abby Tai:

Back to the treatment options for sebderm. I would love to get into just hearing more about how you usually start to treat it once you figure out what the root causes for the person.

Dr. Julie Greenberg:

Yeah. And so there’s two aspects to it, right? One, is testing and treating the gut and one, is topically. What can we do to help them out? So I guess I’ll start with topically. So we’ve already said that malassezia wants to eat the sebum. It wants saturated fats. That’s going to feed it and make it blossom. So the first thing is, you know, kind of things we don’t want to do. You don’t want to throw like straight coconut oil on there because you will be feeding the malassezia. And actually in labs, when they’re trying to grow out malassezia, a yeast, they put coconut oil is what we call a substrate as the actual food to feed it. So don’t want you to start putting coconut oil in your hair or other oils or on your face because that can feed it. There are ways to adjust it. So there are herbal infusions we can do with coconut oil, with herbs, like neem, which is very antifungal there’s essential oils that we can add to coconut oil that then changed the profile of the coconut oil and we’ll fight the malassezia. So there are ways to use coconut oil, but I never recommend that patients just put straight coconut oil on their face or scalp particularly with malassezia, because you’re gonna make a bloom.

Abby Tai:

Dr. Julie, is there something about the profile of coconut oil that does cause it to flourish?

Dr. Julie Greenberg:

Well, it’s high in saturated fats and so it’s feeding the malassezia. Yeah. olive oil is another one. Do not use it with a separate dermatitis because olive oil is high in something called oleic acid. And a lot of people have a natural sensitivity to oleic acid. And one of the things that when the malassezia eats the fats, one of the things that leads behind is oleic acid. And so part of that inflammatory response can be that people just don’t don’t work well with oleic acid. And so I never recommend olive oil either because it’s just so high in oleic acid. So those are some of the things we don’t want to do for the face. You know, if you want to use moisturizer jojoba oil is a reasonable option because even though we call it an oil, actually, it’s a waxy ester and malassezia cannot utilize that as food.

Dr. Julie Greenberg:

So for cradle cap and infants, we do massage. I have patient parents massage the head with a hobo oil and you can get those little cradle cap brushes and kind of gently try to work the flakes off. And you can also use the hub oil as a facial moisturizer because the malassezia can’t use that as a food source. But there’s, there’s lots of options. And I will say as a caveat essential oils are a wonderful tool to use against bacteria and fungal and yeast elements. But I do not suggest that people start formulating with essential oils on their own because they can be dangerous substances. Both they get absorbed into our skin and may or may not be appropriate in infant use. I try not to use them in infants because they are going to absorb them.

Dr. Julie Greenberg:

There are other essential oils that are, phototoxic like bergamot. If it’s not Ferrano coumarin free, you can get very severe third degree burns with bergamot and other citrus oils. You really need an herbalist, a professional, someone who knows their essential oils and appropriate essential oils for appropriate people, appropriate percentages. Because you can get contact dermatitis and get sensitized to essential oils. So, so everything I’m about to talk about, I am absolutely not recommending that the listeners go do this on their own, but some essential oils that are good against malassezia you include things like tea, tree oil and Myrtle essential oil. Rosemary essential oil as a favorite of mine. But again, you need a professional to help you put together appropriate and safe compilations for you individually. You know, based on the individual. So essential oils are things that, that I use a lot.

Dr. Julie Greenberg:

There’s also shampoos. So I think people know, you know, when you go buy an a dandruff shampoo, it is going to be an anti-fungal shampoo. And the reason it’s an anti-fungal shampoo is it smells malassezia yeast. That’s part of the fungal world. So you can go to CVS and get some anti-dandruff shampoo, that’s one option. Some of the active ingredients that you’ll look for are zinc parathion, and that’s pretty effective. There are also like more natural options. I have no affiliation, but Happy Cappy is a gentle product with zinc pyrithione who that can be used in kids and adults. So that’s one that sometimes I’ll recommend, but you can just go get, you know, head and shoulders or whatever, but look, yeah, look at the active ingredients. Cause there are different active ingredients. A lot of people, when they go to the dermatologist, they’ll get a prescription for ketoconozole shampoo. Ketoconozole is an antifungal and that works well too.

Dr. Julie Greenberg:

So there’s lots of options for treating antifungals topically, either prescription or non-prescription. But a lot of people complain that, well I’ll use the Ketoconozole all shampoo and then the dandruff will go away, but then it comes back again. One of the listeners mentioned apple cider vinegar. That’s a big thing that I use. So in the shower I have patients do a mix of like 50, 50 apple cider vinegar to water. And after they’re done shampooing and conditioning their hair we do a rinse with the apple cider vinegar. And if they don’t mind the smell, we’ll leave it on. If they don’t want to smell like an Easter egg, we’ll wash it off, but malassezia hates apple cider vinegar. And the reason is pH, we haven’t talked about pH yet, but the skin has a normal pH, which is actually low or acidic.

Dr. Julie Greenberg:

And at that pH, we have things on our skin that can naturally fight overgrowth of malassezia, right? The skin is supposed to function while we’re not supposed to have overgrowth of organisms, either bacterial or fungal and at an acidic pH the skin does a pretty good job when that skin pH goes up and becomes more neutral or alkaline. malassezia has a great time. It can blossom and grow. It’s really happy. The skin can’t defend itself and apple cider vinegar is very acidic and it smells, malassezia hates it. And so it’s great to use during the shower. If patients can tolerate the smell, I have them spray it onto the scalp or face after the shower and a 50 50 dilution because that’s going to sit on the scalp. If they really don’t like that smell, there are things called hydrosols we can use after the shower.

Dr. Julie Greenberg:

I really like Rosemary, because it’s very good at working as an antifungal. So I will have patients spray their scalp with Rosemary hydrosol and then I sing about that as it smells fresh and nice. And it’s going to sit on the scalp and keep working to keep those malassezia levels down. So there’s different, there’s lots of different options for trying to control it topically, but you know, ultimately you do need to go in kind of look at that root cause, see if there’s candida overgrowth and treat the Kenziedo overgrowth in the gut.

Abby Tai:

So Dr. Julie, I love everything that you shared about just now. And I find that it’s very useful. Everything that you shared and I really appreciate it. So in terms of the scalp, I’ve also had a dermatologist who has recommended I think it’s tar or either cold tar. Yeah. What are your thoughts on that?

Dr. Julie Greenberg:

It’s also, you know, recommended for psoriasis for scalp psoriasis and sometimes scalp psoriasis can, can have an overlying malassezia where we know that actually, if we treat people with psoriatic, the scalp problems with antifungals, their scalp psoriasis gets better. So malassezia is definitely often involved in scalp psoriasis as well though. There’s other things going on, of course, but for me it’s cold tar. That’s not really something that I want to put on myself or an infant or a patient. So I personally don’t use it, but it can be effective at killing and it, it is an option. You can go buy it without a prescription. So I think that’s a personal decision, you know, if people would want to use that ingredient, it’s, it’s not one that I use or like.

Abby Tai:

Patients when I was prescribed it, I had a hard time finding one that had good ingredients in it. And so I think that’s why I never ended up using it.

Dr. Julie Greenberg:

Yeah. And I think because the fundamental thing is cold tar, right? It’s a petroleum by-product like, it’s not really in the world of holistic or herbal medicine. And so it’s not really used, that’s more where you’re fine, like the zinc parathion or something like that in kind of healthier types of products.

Abby Tai:

So in terms of the essential oils, you basically shared that you can either mix it with some sort of oil but try not to do it yourself because it can cause more harm in some cases. And also the other option is to have it in a hydrosol form and spray it on your scalp or either right your face.

Dr. Julie Greenberg:

Well, so, and let me, let me make two distinctions. One people should never put essential oils on meat. Meat means directly just topical without some sort of carrier. So you can very quickly, even if like, you’re like, oh, look, I put on teach real and nothing happened. You can sensitize yourself quite quickly and then ends up with a con, an allergy and a contact dermatitis to it. And you won’t be able to use it again and again, these are very powerful substances, so never put it on directly. I don’t like using them in a water base. So the Rosemary hydrosol and I should have explained this it’s not essential oils, essential oils are what we call lipophyllic. They want fats. And so they don’t disperse in water. So it’s a little hard to get an essential oil into a water-based product because they’re going to float on top.

Dr. Julie Greenberg:

I also don’t recommend that people add essential oils to their baths because you’ll notice it’s, it’s floating in this little oil slick, and then that oil slick will touch your skin. There’s fat on your skin. And it’s just going to sit on there, like you put it on directly. So it doesn’t really disperse in water. It will disperse and aloe Vera gel. So you can add it to allow that does tend to work, but shake it up. But a hydrosol is a little bit of a different product and it’s very safe for infants. I use it widely on infants and it’s safe for pets. And what a hydrosol is, is really a by-product of the essential oil making process. So let’s take Rosemary, a company wants to make Rosemary essential oil. They’re going to take hundreds of pounds of Rosemary, twigs, and leaves and plants, and put it into a copper distiller with water.

Dr. Julie Greenberg:

They’re going to put that fire underneath it and heat it up. And then we say essential oils are volatile oils, which means that they evaporate. So the steam and the essential oils are going to evaporate. And then it cools into a second vessel and the water comes over and the essential oils. So the essential oils, well, they’re not really oils. We call them oil. They’re going to float on top and the company will siphon that kind of oily layer. And that’s the essential oils, but the water that’s evaporated over with it is infused with that plant, like the Rosemary, but it doesn’t, it’s not like super concentrated, like an essential oil and that water is the hydrosol. So hydrosols are amazing because they still have some of that power of the plant, but they’re very gentle and they’re very safe. People don’t really get sensitized to them. And they’re just beautiful products to use safely every day on infants and adults. And everybody usually of course, unless if you have a calendula allergy, don’t use calendula hydrosol, but usually they’re very well tolerated in people.

Abby Tai:

Awesome. I love that you provided so many great options for people to try and I think it’ll be really useful because people are always looking for something natural, especially more natural to put on their skin and in order to help their skin get better. Have you heard of anyone using other things like, for example, red light therapy to help their sub Durham get better?

Dr. Julie Greenberg:

Yeah, it’s an interesting topic. There is, there is a red light cap that says that they are working well, that the people are using it. I don’t have any patients yet with just separate dermatitis who have opted for the cap, because it is almost a thousand dollars and it’s a pretty pricey treatment, you know, for something like Seb derm which is not to say separate dermatitis can be very dramatic. I did have a patient who came to me that she thought she had scalp psoriasis for 25 years. I took a look at herself and said, it’s not scalp psoriasis to separate dermatitis. And she has lost about half of her hair because of all the inflammation over 25 years. So I’m not trying to minimize how severe seborrheic dermatitis can be, but most of my patients don’t want to spend like a thousand dollars on a red light cap.

Dr. Julie Greenberg:

You know, that, they’re more FDA approved for Entergy estrogenic, hair loss. But they, some of their companies are claiming that they have dermatologists who are using it and it will help with Paradis or itch. And it does help a little bit with subdermal. So I think the jury is still out. I think it’s an interesting, it’s just expensive. And usually patients are like, you know, let’s, let’s drive a topicals, let’s try the apple cider vinegar before I spend a thousand dollars. And we can usually get things under control without needing them to get a red light therapy cap. But, you know, I think it’s, if you have the money and you’re interested in experimenting, it’s potentially a useful tool.

Abby Tai:

And also it doesn’t actually get to the root cause of the issue. And what other treatments do you usually use to get to the root? Cause let’s say if someone does have candida or fungal overgrowth, I know it will be so different for every person, but I was wondering if you have any recommendations that you usually do and usually recommend for people.

Dr. Julie Greenberg:

So this is one where you definitely need to be under the supervision of a licensed healthcare professional, somebody who does got tests and somebody who has extensive training with herbs or pharmaceuticals. So there are ways to treat candida or, you know, other types of overgrowth with pharmaceuticals. So maybe your primary care physician or your gastroenterologists, but again, they’re not going to really understand these functional medicine tests. But a lot of patients want to self-treat with herbs and supplements because they’re doing research. And I really think that no patient should be self dosing with herbs or supplements because they can be dangerous. And you don’t know what you don’t know. So as a naturopathic doctor, we receive four years of herbal training studying the herbs contra-indications what kind of herbs you can mix, what you can’t, what dose of the herbs is appropriate.

Dr. Julie Greenberg:

We formulate and treat with herbs throughout our education at our clinics. Like my medical school had a dispensary where we could order down formulations of herbal products. And we have to pass board exams on herbal medicine in order to become licensed naturopathic doctors. In addition to that, I mentioned I’m a registered herbalist with the American Herbalist Guild. So that’s additional certification that I am properly trained in herbal use. So, find somebody who is either like a licensed naturopathic doctor or a registered herbalist, somebody who for sure knows their herbs to guide you, but we have fantastic antifungal herbs that work great against candida. And there’s a lot of different formulas and types of herbs out there. I’m a little hesitant to start naming things because I know people that are going to go self dose, but really just get under the care of an herbalist or naturopathic doctor someone who’s even a traditional Chinese medicine or Ayurvedic practitioner, they are formally trained in herbs and can help you navigate this, do not dose on your own. Even something as seems as innocuous as vitamin D people can overdose on vitamin D. That’s a fat soluble vitamin, which means we store it. We don’t pee it out like B vitamins, and we can get vitamin D toxicity if you’re taking too much. So even something where people are just like, I’m just going to take vitamin D. Sometimes they come to me and they are on a very inappropriate dose for way long periods of time. And I really think people should not be self-dosing, herbs, or supplements.

Abby Tai:

Thank you so much for sharing that. I really appreciate it for people who just came on. Dr. Julie did mention to avoid coconut oil and olive oil, if you’re using it on its own for Sebderm, because it can actually grow the issue. Are there any other oils that you would avoid or is it just mainly these two?

Dr. Julie Greenberg:

So it’s hard because basically all oils are going to have something in there. That’s going to feed malassezia, so it’s, you know, that’s why I tend to move a little bit towards the hobo oil when we’re trying to get things under control. Because again, it says oil, but it’s a waxy ester. So if you’re going to use other types of oils, you still need some sort of like antifungal in there, either herbal extraction or essential oils so that you’re not causing a bloom. But it’s tricky because you know, this is a case where you could potentially make an argument for something like lotions or things made with petroleum oil, because that’s not going to be a food source, but I never use petroleum oil based products. So that’s where I tend to kind of add some antifungal elements to the oils that I’m using or kind of stick with a oil.

Abby Tai:

I love that. Thank you so much for that response. And I also had one other question because I remember when my son was little, he had cradle cap and thankfully it was really mild, but I remember I was a new mom and I was just asking people for advice and, you know, for cradle cap and they all said it’s normal. And even in the people, my other friends that I talked to, they all said that their babies had it too. So is it actually normal or is it not supposed to happen if your baby doesn’t have this overgrowth?

Dr. Julie Greenberg:

So I like to make is a distinguishing point between what is common and what is normal, right? Like actually acne in our society is very common. Over 90% of teens are going to get acne. So it is common and it is becoming even more common in adults, but it’s not normal, because we don’t see it in indigenous cultures. They don’t have acne at all. So common does not equal normal. I would say the same, you know, in cradle cap and babies, it is definitely common. But it’s still not normal. You know, we still want to try to help them out. There is an immune response. Something is happening either. There’s the overgrowth of malassezia or they’re mounting an immune response. And, you know, sometimes it will just clear up on its own. So I don’t think cradle cap is a reason to panic. But if it’s not clearing up on its own, you know, if you’re, if you do that kind of gentle massage with the little cradle cap brush and you know, the, the scales come off, but then they keep coming back and it’s red and inflamed and babies itching, you know, that would be the time to go seek some, some help and care. That’s not self, you know, pretty quickly, that is an indication that, you know, there are things that you can do to help baby out. So common is not normal.

Abby Tai:

And would the previous treatments that you recommended for adults also apply to babies who are going through it? Right.

Dr. Julie Greenberg:

So I really try to keep essential oils off of infants. So I would never start with that. Again none of this should be construed as medical advice for a specific situation. You need to consult with a licensed practitioner on what’s appropriate for you or your infant. And I always recommend what’s called patch testing, which is before you put something over a wide area, you want to put it on a little spot on a healthy area of skin, wait 12 to 24 hours, make sure there was no reaction, then put it on a little patch of irritated skin because irritated skin can act very different than healthy skin. Make sure that that irritated skin doesn’t have a flare to it. And then you can start using it more widely. But so, some of the things are the same, but if possible I do try to keep essential oils off of infants because they’re so powerful and we know that we absorb it into our skin and into our bloodstream.

Abby Tai:

Thank you, Dr. Julie, I definitely agree with you about the essential oils.

 

 

 

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