Is seborrheic dermatitis the same as dandruff?
They are related, and dandruff can be seen as the mildest form, without marked inflammation. Seborrheic dermatitis usually also brings redness, itching and more stubborn scales, and may appear on the face, eyebrows and behind the ears. In practice, the difference matters because simple dandruff usually responds to an anti-dandruff shampoo, whereas seborrheic dermatitis may need a medical plan and maintenance. The doctor distinguishes them by examination.
Why does my scalp flake and itch?
There is usually more than one factor: skin prone to producing sebum, a yeast called Malassezia that lives on the skin, and the immune system's reaction to it. Stress, little sleep, cold and dry weather often set off flare-ups. But scaling and itching also occur in psoriasis, in allergies to products or in infections, and so a consultation avoids treating the wrong thing blindly for months.
Can seborrheic dermatitis be cured?
As a rule, not in the sense of disappearing for good. It is a chronic or relapsing condition, with good periods and flare-ups, and the aim is to control it: treat the flare-up and then keep the skin calm so that relapses are rarer and milder. Some people go long periods without symptoms. The doctor explains what is realistic in your case and how to recognise a relapse early.
Is it contagious or a sign of poor hygiene?
No. It is not passed on to other people and it does not result from washing too little. On the contrary, it is the skin reacting in an exaggerated way to something that already lives on it. Washing regularly with a suitable product helps, but washing a lot or with harsh products may irritate. Feeling embarrassed is very common and eases when the skin improves, so do not put off the consultation because of it.
Which treatments does the doctor usually propose for the skin?
In general, topical products: antifungal shampoos and, when there is inflammation, a mild corticosteroid for short periods, or a calcineurin inhibitor when treatment is needed often or on the face. Shampoos are used regularly for a few weeks and then for maintenance. More difficult cases may need other options, decided by the doctor. All have their own indications, so do not use them on your own or at random.
Do anti-dandruff shampoos from the pharmacy help?
In mild cases they may help and, for some people, are all they need. For them to work, they should be left on the scalp for the time stated on the packaging and used regularly for a few weeks. If the skin remains inflamed, if the scales are thick or if there is pain, medical treatment is most likely needed. It is not worth continuing to switch shampoos without an assessment.
Does seborrheic dermatitis cause hair loss?
Seborrheic dermatitis in itself does not usually destroy the follicle, but very inflamed skin and persistent itching may be associated with more hair on the brush during flare-ups. If the hair is also thinner, it is worth checking whether another cause is present at the same time, such as heredity or stress. The doctor assesses both problems and treats the skin first. The evidence for this link is limited.
Can stress and cold cause flare-ups?
They can set off skin that is already predisposed. Many people notice worse flare-ups in winter and during periods of pressure, with little sleep. This does not mean that stress is the cause, nor that every flare-up can be avoided. What can be done is to plan ahead: agree with the doctor in advance what to use at the first signs, instead of waiting until the skin is very irritated.
When should I book a consultation?
If the scaling and itching last for weeks, keep coming back, spread to the face or do not improve with an anti-dandruff shampoo used as directed. Pain, sores, pus, crusts, intense redness, hair loss in patches or sudden hair loss should be seen without delay, as they may have another cause. It is also worth booking an appointment if the skin affects your sleep, your work or how you feel.
Which hair treatments does the clinic use?
Depending on the case: hair NCTF, hair PRP and hair exosomes. They do not treat seborrheic dermatitis, which is treated with topical products, and are only considered if, besides the skin, the hair is thinner and the skin is calm. They act on the scalp and the follicle and do not repair a strand that is already damaged. The evidence is limited and none is chosen before the assessment consultation.
Can I have PRP or microneedling with an inflamed scalp?
As a rule, this is not the right time. With inflamed skin, wounds, thick scales or infection, injections and microinjuries may irritate further and increase the risk of complications. The doctor starts by calming the skin and only then decides whether a hair treatment makes sense. That is why the order matters: first the dermatitis, then, if appropriate, the hair.
Does seborrheic dermatitis only appear on the scalp?
No. It also tends to appear in areas with more sebum: eyebrows, the folds beside the nose, forehead, behind the ears, beard and chest. In men with a beard, scaling beneath the hairs is very common. On darker skin, the appearance may be lighter or darker than the surrounding skin, rather than red. The doctor looks at the whole picture, and treatments for the face are different from those for the hair.
Are there associated conditions or medicines?
Associations have been described with some neurological conditions, with situations in which the body's defences are low and with certain medicines. In the vast majority of people with seborrheic dermatitis, there is no underlying disease. The doctor asks about your health and medication to have the full picture, and only requests tests when they make sense. Do not stop any medicine on your own.
Can I use natural or home products?
Many oils and home remedies have no studies showing benefit, and some may irritate or cause allergy, especially on skin that is already inflamed. Some oils even feed the yeast. If you wish to use any, speak to the doctor first. For everyday use, simple products without much perfume, and the treatment you were prescribed, tend to be the safest option.
