Derm-it Trotter! Don't Swear About Skincare.
Feeling frustrated or overwhelmed with everything skin? Does the skinformation overload make you want to swear about skincare? Join Dr. Shannon C. Trotter, board certified dermatologist, as she talks with fellow dermatologists and colleagues in skincare to help separate fact from fiction and simplify the world of skin. After listening, you won’t swear about skincare anymore!
Derm-it Trotter! Don't Swear About Skincare.
Hair Not Cooperating? Your Scalp is Calling
Your best hair day starts where most routines stop: the scalp. In this episode, we break down the habits that truly help with flakes, itch, oil, and shedding. Dr. Shannon Trotter and Erica Ramos, DMSc, PA-C, unpack how inflammation and buildup disrupt growth and comfort, then lay out practical steps you can start using tonight. From medicated shampoo “masking” to washing frequency by scalp type, you’ll learn techniques that actually work without sacrificing softness or shine.
We also dive into scalp sun protection, double cleansing, and exfoliation for product lovers and dry shampoo devotees. You’ll hear when persistent itch signals conditions like seborrheic dermatitis or psoriasis, which treatments to reach for, and how newer options like JAK inhibitors fit into care under medical guidance. If you want stronger hair and a calmer, clearer scalp, consider this your go-to guide.
Frequency of washing, like you mentioned.
SPEAKER_01:I think a lot of people think that it's it's a terrible thing if you necessarily wash. I tell people all the time, you would never go five days without washing your body. Why are you doing that to your scalp? That definitely has changed the game for me and my skin because I'm kind of a burn even though I have sunscreen on.
SPEAKER_00:Welcome to Dermot Trotter, Don't Swear About Skin Care, where host Dr. Shannon C. Trotter, a board-certified dermatologist, sits down with fellow dermatologists and skincare experts to separate fact from fiction and simplify skincare. Let's get started.
SPEAKER_02:Welcome to the Dermotrotter, Don't Swear About Skin Care Podcast. We have an exciting topic here today. We're going to talk about the scalp because that's what so many people want to know is how do I take care of my scalp? And it's all the rage now. So we're going to talk about tips and tricks you can do to have a healthy scalp. So in essence, you have healthy hair as well. I have a special guest here today, Erica Ramos. She's a doctor of medical science and a certified dermatology physician associate with over 21 years of clinical experience. And she actually has a product dedicated to improving scalp care, which we'll talk about at the end. But welcome to the podcast. It's nice to have you here, Erica.
SPEAKER_01:So happy to be here, Dr. Trotter. Truly honored to be on your podcast. Thank you for having me.
SPEAKER_02:Well, you deal with scalp a lot, so much so it inspired you to develop a product, which we'll get to, but I really just want to talk about this trend. You know, that we're seeing a lot of people are focusing on scalp care as much as they think of skincare. Why do you think that's becoming so popular now?
SPEAKER_01:You know, I was thinking about, I don't, I don't know if it was the emergence of head spas because there's all these head spas popping up and it's kind of like what came first, the chicken or the egg, right? Did the head spas come first and everybody's caring about scalp health now? Or um, you know, has there this there's this increase in talk about it on social media? Um, people are really caring about the ingredients they put on their skin now. And so I don't know exactly what sparked it, but it's definitely a fiery, fiery, fiery little trend that um that's good. It's good that people are finally talking about the scalp. I think it's not been a conversation. A lot of my um patients will wash their skin every day and care what they put on their skin, but have no care in the world what they're putting on their scalp. And then they'll come in and ask why they have hair loss or other conditions. And so I'm glad that it's a topic of conversation now.
SPEAKER_02:Yeah, I think that's a good point you bring up. The scalp has been a little ignored, but now it's catching on. And I agree with you, it's all over social media. I think the focus on hair and hair health has led us to the scalp. I kind of think of the scalp sort of like, you know, soil, if you will, and the hair kind of grows out of it like a plant grows out of soil. And if the soil is healthy and it's doing well, then you're gonna have a great plant, just like you're gonna have strong, healthy hair. And I think with hair loss being a topic that a lot of people want to address more aggressively now, and then you're right, people caring about what they're putting on their skin has drawn a lot of attention to what we can do to really improve the health of our scalp. And I think just having hair there, people ignore it. Um, my husband is completely bald. He's he's definitely a guy that we focus on scalp health. And I think one of the things I talk with him, you know, for scalp care is just the products and what he should be putting on it. So I wanted to ask how you talk about sort of do's and don'ts with scalp care. What is your recommendations that you give patients?
SPEAKER_01:Well, I think the majority of patients that we have this conversation with come to us and they have some sort of flake or scale or itch. So that's when the conversation comes up the most. And um, for them, you know, a lot of them are frustrated because they've tried every single over-the-counter option. Maybe they've been to another dermatologist and they've also had the couple of prescriptions that we've had traditionally. And they just they're frustrated. And I really tell my patients look, the the ingredients, all these common ingredients that we have, it's a it's a same theme throughout every shampoo conditioner. It's just one of a few ingredients. They all work. It's just, I tell my patients, you're probably not leaving it on long enough. If I imagine myself in a shower, I'm going to rub my shampoo in, and I'm literally next move going to turn around and rinse it right back out. And at that point, your medicine hasn't had a chance to do anything. It's just going down the drain. So I kind of encourage my patients to wear their medicated shampoos as a mask and wear it for about 10 minutes before they even get in the shower. And that way it's had time to sit there before they actually get in and rinse it off.
SPEAKER_02:Yeah, I like that because we're all in a rush, right? I feel like showering unfortunately becomes more utilitarian for all of us as we get busier. You kind of need to get in and out, clean, and get on your way. And for scalp care, you know, you're mentioning this contact time. You know, I think it does take time, you know, to treat the scalp, especially if you have a condition like sebrate dermatitis, or you mentioned kind of that flake or that itch or struggling with dandruff. And I just think people, like you said, they rush it, you know, kind of in and out and don't realize there's some benefits to kind of going after the scalp and treating it. And like you mentioned before, you know, the hair loss component, when people have some of that inflammation, like you mentioned, you know, all forms of hair loss, we know can be linked back to some form of inflammation. I don't think people realize they could have something, you know, as dandruff that's pretty significant or sebrec dermatitis and truly have hair loss linked to that. Have you seen that in your practice as well with people just so inflamed?
SPEAKER_01:Yeah, definitely. I mean, you can tell the difference um between, I mean, there's light, flaky dandruff, and a lot of times that's not gonna have that erythema and inflammation of the skin, but you start piling on a little bit more of that yellow, greasy scale, and you're gonna see that underlying redness and that inflammation that's being caused on the scalp. And it makes sense that our hair can't really grow very well in a situation where there's all that inflammation. Our body's just not gonna support a good healthy growth if it feels like it's under attack.
SPEAKER_02:Yeah, and I know another topic a lot of people like to talk about is double cleansing, you know, specifically for the face. We think of that where you might cleanse with like an oil-based cleanser, a micellar water, take off that makeup sunscreen, then do your gentle cleanser, go into your routine. I really challenge people to think about double cleansing for the scalp. I think there's some true value in doing that, especially nowadays. I don't know about everyone out there, but I'm busy, work full-time. I have three small children, love to do all kinds of extra things, including the podcast. And so there are just multiple days where I don't shampoo. So I am one of those folks using dry shampoo or other products to kind of mask, you know, sort of what I've been doing to my hair. Plus, I damage my hair, diet, heat, you know, instruments, all the things I do to kind of torture it. That I feel like when I go to shampoo, cleansing first with one of those medicated shampoos you've mentioned, whether it has Brithrone zinc in it or maybe salicylic acid, can definitely be helpful before even going into that regular shampoo routine. Have you ever recommended that to patients or found it to be helpful as well?
SPEAKER_01:Yeah, I do. I because a lot of people don't love the medicated shampoos. And you know, it's not great for colored hair. They're a little bit drying to the hair, they're great for our scalp, but nobody really gets that, you know, great feeling of I just had the most fantastic shampoo and conditioner by using their medicated shampoos. And so that's again, well, where I'll tell people, hey, think of this more as a mask. And then you can get in the shower and you can literally use whatever shampoo conditioner you love because you've already treated your scalp by the time you get in there. So I will tell people to do that. Um and people that are um sorry, extending time between washes. Um, you know, I've seen a lot of social media supporting um using like a glycolic or a salicylic on the scalp before you wash. So I've seen that trend as well.
SPEAKER_02:Yeah, I think that exfoliation for the scalp is helpful for people like myself that do uh get that buildup, whether it's product or simply oil in the scalp or just a little bit of those flakes, doing like a pretreatment with a salicylic acid or glycolic acid and leaving it on, just like you talk about, you know, before shampooing out, maybe you know, 10, 15 minutes beforehand can really help get that stuff off the scalp. And I like what you mentioned too, that you said, you know, focus on the scalp. And I think that's just a different mindset to make people change their mind, right? That we think of shampoo for hair, but when we're recommending these medicated shampoos, we're really talking about scalp care, not really focusing on using them on the hair, like you mentioned. So great tip. I like how you mentioned that that, you know, use that for your scalp and then follow with you know traditional shampoo or conditioner that you actually love that's good for the health of your actual hair. And that's that's a tip I love to share too when I talk with patients about it. And also the frequency of washing, like you mentioned. I think a lot of people think that it's it's a terrible thing if you necessarily wash every day. And I like to tell patients, you know what, you wash based on your individual scalp and hair needs. Some people that could be an everyday, some people that could be every few weeks or so. Uh, do you tend to walk patients through that too? Because I feel like that's a little bit of a misconception that you can't do it every day because you're totally going to destroy the hair.
SPEAKER_01:Yeah, and I also think it depends on if you're um if you have tightly coiled hair or, you know, it really depends on the hair type. The scalp type, like you said, if somebody's getting super oily, it makes sense that they may actually wash every single day. If somebody has really dry scalp and tightly coiled hair, they don't necessarily want to wash every day. And sometimes it's a battle for even to get them to wash their hair once a month. Um, so but we just know that we can't make our scalp better if we're not washing it a little bit more frequently. And so I tell people all the time, you would never go five days without washing your body. Why are you doing that to your scalp? Right?
SPEAKER_02:Yeah. And I think it's just you kind of individualize it to the patient, like you said, because some people are lucky they can get away with quite a bit of time without having to wash. And unfortunately, if you have something like separate dermatitis or suffer with dandruff, bumping up that frequency can definitely make a difference. And I always tell patients too, you know, if you're using good quality, you know, hair products, you know, that are sulfate-free, that can be hydrating or moisturizing, then if you're washing the hair more often, typically you're not going to see damage from that. But you do have to keep in mind the aftermath, etopia washing. If every time you wash, you have to use a straight iron or a flat iron or a curling iron or some sort of heat device. Unfortunately, yes, then that can add up to the downside of washing more frequently because you're getting additional damage just because of what you have to do after all the washing. So it can be a double-edged sword, I know, with patients too.
SPEAKER_01:So much stuff we do, like you said, to our hair. So definitely really depends on all the layers of everything that we do that um affects the health of our hair and our scalp.
SPEAKER_02:So we talked a little bit about kind of general scalp care, focusing it more as a part of skincare, you know, using good products, adjusting washing based on your individual scalp needs. What about some protection? Because I mentioned early on, my husband completely bald, so I'm after him all the time. How do you talk with patients about, you know, some protection? Do you have particular recommendations you like to make on products you think that work really well for scalp skin? Or do you typically just recommend hats? Or how do you go about that? Because that can be a nuisance to protect the scalp, especially if you have hair.
SPEAKER_01:Yeah, physical blockers like hats. A lot of people will get these hats though that have the big holes in them, and you're, you know, we're not protecting very much with that. So we talk about UPF protection of clothing, and um, it really comes down to the tightness of the weave and what's litting those UV rays through through. So if we have a very loose weave, of course, we're still going to kind of get some effects of the sun on our scalp. Um, so definitely hats. And, you know, I'm I'm one of these people who suffered from pretty thin, fine hair my whole life, and I cannot count how many times I've actually burned my scalp throughout my lifetime before getting into Derm. And so definitely, I think in the beginning, like years ago, it was really hard to find something that you could protect your scalp with. But there have been some newer products that can have come out. Uh, like Supergoop has a poof, a powder poof that is sunscreen. Um, so, or some of the other sprays, though I don't know, they're they're a little bit greasy in the way that they go on. If you're using a traditional aerosol spray that you're is meant for your skin, sometimes that's gonna affect how your hair looks. So I'd probably go with more of like a powder, a powdered zinc or um something like that, like the um super goop poof.
SPEAKER_02:Yeah, I get you're right, because just if you have hair, the challenge is getting through all of that. But the part line is definitely where I think most people forget or miss. It's one of those you know spots I feel like always, you know, the tops of your feet, the rims of your ears, and always the scalp seem to be the places we forget to put.
SPEAKER_01:We always forget our ears. What do you recommend for the scalp? What do you tell your patients to use for the scalp?
SPEAKER_02:I typically you know recommend using similar to what you recommend, things that are going to be good that don't weigh the hair down. And that's variable for everyone. So if they can do a spray and it's pretty drying, I'll tell them a spray is fine. The biggest piece is just a nice even coating. So, downside with some of the powder, so even how they apply it, if they're not applied evenly, sometimes in the actual coverage, and it's really all about user air, right? To a degree, are they getting it where they need to go? So I think just making sure if they're not doing it themselves, somebody's helping them to make sure even application is going on there. And I think too, you know, some of the other sunscreens, it's just if they're dry touch, even if they're liquid, some of them will absorb well into the scalp. But if you've got hair there, inevitably people are going to get some on that hair. And and hopefully it's not too much of a distraction. They're going to the beach, they're doing other things, that they don't mind if the hair's a little mess. And if they do, I would really push them to do the physical blockade, like you mentioned. Um, you know, try to avoid hats that maybe do have that loose weave, sort of the tighter weave, and just do the physical blockade if they don't even want to mess with sunscreen up there. But it's hard to get people to wear hats. My hat, you know, my husband again, not a hat wearer, and he's got that entire area exposed. So it's something that people can struggle with because unfortunately, if you got hair, there's just no great way to avoid some of the irritation factor that that sunscreen may give to your hair or weigh it down and be an inconvenience.
SPEAKER_01:The other thing I worry about with the powder, too, is that um, you know, like you said, if you're at the beach, you're going in the water, um, I don't know if we're gonna get that um, you know, I don't think that it says water resistant, water, you know, sweat resistant. And so if it gets rinsed off in the ocean, you may have to do a little bit more reapply with that type of sunscreen.
SPEAKER_02:You're exactly right, which is why I tend to just go back to traditional, you know, the sprays if they can get it up there, if it's you know liquid enough and just deal with the hair, you know, issues that come with it, or obviously if they can get a lotion or something else up, or if they're willing to wear a hat. But if you're going under the water, it's gonna be a challenge to keep a hat on. And you're right, the powders just tend to wash off. So not great if you're gonna be doing water work or if you sweat a tremendous amount. Unfortunately, scalp can be a sweaty area for a lot of us too, for some protection.
SPEAKER_01:You know, another thing um is um that I recommend and I actually personally use when I go to the beach is Helio Care. Um, or you know, there's some other brands that are popping up around that. Um, but that definitely has changed the game for me and my skin because I'm kind of a burn, even though I have sunscreen on um type of skin tone. And uh now that I've started using helio care, I don't burn. And I'm, you know, I'm able to get that every two-hour reapplication that we need for the sunscreen, but it's definitely changed my opinion on being able to be out at the beach all day long and not get burned.
SPEAKER_02:Yeah, I think you know the polypodium and helio care, some of the other products that have it great add in to sort of enhance your sun protection. Like you said, use it in addition to your sunscreen and sun protective clothing, not necessarily a replacement for it. Definitely not a replacement. Key takeaway, because everyone's sunscreen and a pill, but we're still not there yet. So we we talked about this in a little bit earlier about sort of salicylic acid, glycolic acid, scalp exfoliation. Do you recommend this to your patients on a regular basis or before every type of shampoo? Or I think you know that's becoming the rage, like you mentioned, with just a lot of you know, social media, you know, little blurbs about use glycolic acid, salicylic acid for this, but can somebody overdo it too and create problems on the scalp?
SPEAKER_01:Yeah, I think um there is a potential, although they're really um very well tolerated um ingredients. I think that there is a potential for irritation with that if it's overused. And so I think it really depends on if they do have dandruff, sebderm, psoriasis, you know, how thick is that scale or that plaque on maybe how they could tolerate how often they could tolerate it. But I think anywhere, you know, sometimes in that range of how thick the flake is, um, or if they're just using it for a um clarifying, maybe just a couple times a week, if they've got thick plaques of psoriasis, maybe they need to use it more to on the four to five days a week to actually get the benefit of the medication and that turnover of the skin to reduce that plaque.
SPEAKER_02:Yeah, and I've I've come to be a little bit of a fan of some of these scalp brushes too. You probably have seen these advertised kind of the rounded silicone ones that you can kind of massage into the scalp. Um, I like those with sometimes using that with the glycolic acid or silicylic acid to do a little manual exfoliation, although we tend to stay away from mechanical exfoliation and derm. I know we tend to recommend more of the chemical forms, but I feel like those silicone ones, they're softer tips, they don't cause much trauma to the skin, but they have the added bonus of being pretty darn relaxing. And then also I like to tell patients you have a little bit increased circulation potentially going there to the hair follicle, might help us a little bit with hair loss if patients are experiencing that as well. And one thing I didn't touch upon earlier that I wanted to give you an opportunity to talk to talk about is just scalp itch. I think that that's something I feel like people come in all the time, maybe even the absence of actually seeing rash. And I wanted to get your thoughts on like how do you address that or is that different than how you would address anything else that we've talked about? Because I think scalp itching is just one of those things that drives people batty. They're coming in trying to figure out how to, you know, correct it. But I think some of the tips you mentioned before could be a key to actually helping patients with that as well.
SPEAKER_01:Yeah, I think if we get rid of some of the things that are causing itch, the inflammation in the skin, then maybe we reduce the itching a little bit. If there's an underlying condition, there are some conditions that we really need to kind of think, they need to be at least in the back of our head. Are we missing something that's causing itch? Um, but if it's just kind of related to scalp health and scale and flakes and psoriasis, those things will be super itchy. Um, then reducing the inflammation can be really helpful. So in clinic, of course, we've got our topical steroids. And um, there's also with this crossover of septum and psoriasis, there's Zareve, which entered the market as a foam, which can also really help with itch as well. So um, but some people will just have that chronic itch, and we may need to say, hey, is there some sort of underlying eczema? Do we need to maybe treat with, you know, was there full body itching? Can we use some of these other tools we have that really are demonstrating great efficacy in reducing people's itch overall? So there's the um injectable medications and the jack inhibitors and all this great stuff that we have coming out for itch in dermatology.
SPEAKER_02:So well, in addition to what we have to treat those conditions, you've got a product called Restora Scalp that can be used to help actually treat the scalp and different conditions on it. Tell me a little bit about it and when do you recommend it for patients?
SPEAKER_01:So I think that anybody that is wanting scalp health and still loves to maybe extend their time between washes, then restora scalp is the dry shampoo for you. You don't have to have dandruff and sebderm and psoriasis to use this dry shampoo. You could just use it as an exfoliative, clarifying dry shampoo. It does have some ingredients in it. We just talked about itch. So it does have some ingredients in it, um, the herbal remedies that help with itch and anti-inflammation, and some that help with a little tiny bit of moisture and detoxifying. So there's some really cool herbal remedies in there that have a little bit of a backing through medical research. And um, so it really is something that, like if you have an itch, an itchy scalp, then those ingredients could help. If you just want something that's getting rid of dead skin cell and promoting natural turnover of skin cells so that we can kind of offload the debris around our hair follicles, then it's a great dry shampoo. Um, but definitely if you have dandruff, sebaric dermatitis, or psoriasis, uh our active ingredient is salicylic acid, which we've talked about a couple of times. And so that's what's helping with that exfoliation, that clarifying of the scalp, but also is a known FDA trusted ingredient for the treatment of dandruff, sebaric dermatitis, and psoriasis.
SPEAKER_02:Yeah, I think a lot of people will be familiar with that because they've probably tried shampoos with salicylic acid in it before, or maybe used it to treat acne if they had some breakouts. So having it on something that can stay on the scalp, but I I love the fact that sort of a double duty type thing, you know, I use dry shampoo like a fiend. I feel like sometimes I could have stock in dry shampoo and you look at the money you may spend. But to have a dry shampoo that also has ingredients in it that can promote health of the skin, the scalp, and then also maybe reduce some of that buildup or help the skin cell turnover. I mean, that can definitely be a win-win. And I love products that do more than one thing. So I think that's wonderfully unique about Restore Scalp and could be a benefit, you know, to patients out there.
SPEAKER_01:Yeah. The other thing I would add is that also, you know, a lot of people extend the time, want to extend the time between washes just to have less um drying effects on their hair, but maybe they get too greasy. And I've seen a lot of social media posts on trying to get rid of that grease in between washes. And traditional dry shampoos, all they're gonna do is land, soak up oil, and they're highly fragranced because they're just gonna cover up the odor of all that debris, adding up dead skin cells, oil. And so the restorer scalp with that active ingredient salicylic acid, we know that salicylic acid actually can help to reduce oil a little bit over time. So with prolonged, extended use of the restorer scalp, you also could become a little less oily in between your washes.
SPEAKER_02:Another added bonus. I think that's what people are looking for because you know, if you don't necessarily need to wash every day, a lot of people prefer not to. We're just busy people nowadays, right? And it takes time. Um, you know, showering, unfortunately, has become more of just a duty as opposed to being relaxing for a lot of us. So to have a product that could extend that or just make it easier to take care of our scalp, fantastic. Thank you so much, Erica, for coming on the podcast and talking more about scalp care. I think people out there are really gonna look at their scalp a little differently now.
SPEAKER_01:Awesome. Thank you so much for having me. This has been really fun and an honor again to be on your on your podcast.
SPEAKER_02:Of course, of course. And for those of you out there, look at your scalp in a new way. It's skincare just like everywhere else. And stay tuned for the next episode of Dermot Trotter. Don't swear about skincare.
SPEAKER_00:Thanks for listening to Dermot Trotter. For more about skincare, visit dermittrotter.com. Don't forget to subscribe, leave a review, and share this podcast with anyone who needs a little skincare sanity. Until next time, stay skin smart.
