Have you ever found yourself staring at your hairbrush, wondering if your strands are staging a protest? When you’re living with a chronic skin condition, unexplained hair loss can be frustrating. Although seborrheic dermatitis can develop on the scalp, it doesn’t directly cause hair loss. Still, the two are connected.

Members of MySebDermTeam, the online social support group for people with seborrheic dermatitis, have reported experiencing hair loss. “My hair sheds really badly. I wish that I knew how to make it stop,” said one member. Another said, “I’ve always shed a lot, but in the last year, it has become exponential to the point of driving me to read about hair loss.”

This article discusses hair loss with seborrheic dermatitis, why it happens, and four ways to manage it. If you have seborrheic dermatitis and are experiencing a concerning amount of hair loss, contact your primary care provider or dermatologist. They can help you uncover the cause of your hair loss and formulate a treatment plan to address both your seborrheic dermatitis and hair loss.

How Common Is Hair Loss With Seborrheic Dermatitis?

It’s unclear how many people with seborrheic dermatitis also experience hair loss. Seborrheic dermatitis in general affects about 3 percent to 10 percent of the population, and some research from the journal Bioprocess and Biosystems Engineering has found that seborrheic dermatitis on the scalp occurs in about 5 percent to 14 percent of people.

What Causes Hair Loss With Seborrheic Dermatitis?

Seborrheic dermatitis is a type of eczema that affects parts of the body with high concentrations of oil-producing glands, including the scalp. Seborrheic dermatitis can cause dandruff or flaking skin, crusty skin, itchiness, rashes, greasy skin, and pimples.

Seborrheic dermatitis is influenced by a combination of environmental and genetic factors. It’s thought to be triggered in part by a reaction to Malassezia yeast — a fungus that naturally occurs on the skin. An overgrowth of Malassezia causes an immune system reaction, leading to a fungal infection and symptoms of seborrheic dermatitis.

Although seborrheic dermatitis doesn’t directly cause hair loss, some people with the skin condition experience it. Skin affected by seborrheic dermatitis may be very itchy. Excessive scratching of areas of the skin along or within the hairline may damage your hair follicles and lead to hair loss. Therefore, while seborrheic dermatitis doesn’t cause hair loss, scratching affected skin may lead to hair loss. “I have bald spots on the top front,” reported one member of MySebDermTeam.

Whether you’re experiencing a bit of shedding or excessive hair loss, there are some skin care techniques — including using gentle scalp care, taking medications, and making lifestyle adjustments — that may help you.

1. Practice Gentle Scalp Care

Seborrheic dermatitis on the scalp causes irritated, inflamed skin, which can worsen with the use of harsh shampoos and aggressive styling. Adopting a gentle scalp care approach can help minimize irritation, protecting delicate hair follicles from unnecessary stress.

The following tips can help you provide gentle love and care to your scalp:

Use Warm Water, Not Hot

Wash your scalp regularly with warm water. Avoid using hot water, as it may aggravate and irritate your skin further.

Try Over-the-Counter Shampoos

Over-the-counter (OTC) anti-dandruff shampoos can help reliev itchiness from seborrheic dermatitis on the scalp. Shampoos containing selenium sulfide, pyrithione zinc, coal tar, or salicylic acid have been available for many years. Azole-based shampoos, such as ketoconazole (Nizoral), are also available OTC and can help you control seborrheic dermatitis symptoms.

Finding the right shampoo for your specific skin type and condition may take time. Talk to your dermatologist before trying new OTC shampoos or other products for seborrheic dermatitis on your scalp to make sure they won’t cause irritation or make your symptoms worse.

Use Hair-Friendly Styling Tools

Using a soft-bristle brush or wide-tooth comb can also help minimize the tugging or pulling of hair, preventing hair breakage and loss. Other practices that can help you reduce hair loss include avoiding excessive styling and heat from styling tools and gently drying your hair with a soft towel instead of vigorously rubbing it after a shower or bath.

2. Ask Your Doctor About Topical Treatment Options

Topical treatments include medicated shampoos, lotions, foams, and creams that you can apply directly to affected areas of your scalp. Topical treatments that help reduce inflammation and prevent excess sebum (oil) production can help maintain a healthy balance of your scalp’s natural environment and keep seborrheic dermatitis symptoms at bay.

Your dermatologist can help you choose the proper topical treatment to help soothe your scalp and prevent further damage to your hair follicles. Usually, the first-line treatments for scalp seborrheic dermatitis are products with antifungal activity to help counter Malassezia yeast and/or topical corticosteroids to help reduce inflammation.

If your doctor believes that your hair loss is not associated with seborrheic dermatitis, they may run some tests and ask questions about your family history to try to determine the cause. They will then help formulate a treatment plan or refer you to a specialist to treat your specific case of hair loss.

For hair loss associated with scratching and irritation from seborrheic dermatitis, your dermatologist may recommend various options.

Medicated Shampoos and Corticosteroids

Your health care provider might suggest you use a medicated shampoo with 2 percent fluconazole or a product with two percent ketoconazole. Both of these ingredients are antifungals that can reduce the growth of Malassezia on your scalp. Your doctor may also prescribe a topical corticosteroid lotion, shampoo, or foam containing hydrocortisone, desonide, fluocinolone, or clobetasol to help reduce inflammation and control acute flare-ups (or sudden worsening) of your seborrheic dermatitis.

Phosphodiesterase 4 Inhibitors

Phosphodiesterase 4 (PDE4) inhibitors are a new treatment for seborrheic dermatitis. They work on the immune system to decrease levels of inflammation. Results of a randomized clinical trial found that people who used a topical PDE4 inhibitor, roflumilast foam, showed improvements in symptoms of seborrheic dermatitis, like redness, scaling, and itching when used once daily for eight weeks. The U.S. Food and Drug Administration (FDA) approved Zoryve — a formulation of roflumilast — for treating seborrheic dermatitis in December 2023.

Topical Calcineurin Inhibitors

Depending on your condition, your health care provider may also prescribe topical calcineurin inhibitors (TCIs), which may be more suitable than corticosteroids for long-term use. TCIs such as tacrolimus and pimecrolimus can modify your body’s immune system and response to Malassezia yeast and can help reduce seborrheic dermatitis symptoms.

With topical treatments, it’s essential to follow a consistent application routine as suggested by your health care provider to maximize their effectiveness and prevent the symptoms from coming back.

3. Make Lifestyle Changes To Help Manage Stress

Feelings of stress and anxiety can contribute to your seborrheic dermatitis symptoms and cause flare-ups. Additionally, high levels of stress are associated with some types of hair loss. Incorporating stress management techniques such as mindfulness, meditation, or relaxation exercises into your routine can help you manage your skin symptoms and reduce your risk of hair loss.

Stress management techniques also help promote your overall well-being. A calmer state of mind can help foster healthier lifestyle choices, including better dietary habits and improved sleep, both of which are factors that may affect seborrheic dermatitis symptoms.

4. Work Together With a Health Care Expert

There is no straightforward approach to managing seborrheic dermatitis and issues such as hair loss that may accompany it. Your primary care provider or dermatologist has the expertise to accurately diagnose your condition, identify the underlying cause of hair loss, and recommend targeted treatment plans. They can provide personalized guidance, considering the specific characteristics of your seborrheic dermatitis and its impact on your scalp health.

Your dermatologist can monitor how your treatment is working and make adjustments to your plan if necessary. By teaming up with your doctor, you’re making sure you get the best care tailored to your needs.

Talk With Others Who Understand

On MySebDermTeam, the social network for people with seborrheic dermatitis and their loved ones, more than 6,000 members come together to ask questions, give advice, and share their stories with others who understand life with seborrheic dermatitis.

Talking with people who are going through similar experiences can provide valuable insights and support. Whether you want to discuss hair loss or just share your journey, the community on MySebDermTeam is there for you. If you're living with hair loss due to seborrheic dermatitis, don't hesitate to share your experiences in the comments below, or start a conversation by posting on your Activities page.