• Seborrheic dermatitis and dandruff might seem similar because they both lead to an itchy, flaky scalp, but they are not identical conditions.
• Seborrheic dermatitis is a more serious and long-lasting skin condition that can affect other parts of the body, not just the scalp.
• If you have skin symptoms, visit a dermatologist for a proper diagnosis.

Most people don’t realize that a flaky scalp — or dandruff — can be a very mild form of seborrheic dermatitis. The main difference between the two conditions is that dandruff has milder symptoms and is limited to the scalp, while seborrheic dermatitis can develop in other areas of the body and cause more symptoms due to inflammation.

“It started in my scalp, then my face, beard, behind the ears, neck, and chest. I have always had oily skin from the shoulder blades and up. For years, I had dandruff and used different dandruff shampoos,” a MySebDermTeam member wrote about their dandruff. ”They seemed to correct the situation. For the last three years, I had what I thought was my dandruff back. Did my shampoo routine, but I could not get rid of it.”

Although dandruff and seborrheic dermatitis are rarely serious, both conditions can have a negative impact on quality of life and self-esteem, especially when symptoms are visible. Seborrheic dermatitis is a chronic (ongoing) medical condition that may recur throughout a person’s life, but symptoms can be managed. It’s important to understand how these conditions are related and what you can do to feel your best. If you have dandruff, seborrheic dermatitis, or both, be sure to talk to your doctor.

Understanding Seborrheic Dermatitis

Seborrheic dermatitis is a common skin condition and a type of eczema. As many as 30 percent of all people experience some form of seborrheic dermatitis — including dandruff — at some point in their lives. Seborrheic dermatitis occurs on parts of the body where sebaceous glands that produce sebum (oil) on the skin are more prevalent. The upper back, chest, face, and scalp are commonly affected by seborrheic dermatitis, but it can develop in other places as well, especially in folds of skin.

Scientists believe seborrheic dermatitis is caused by a combination of environmental and genetic factors. One possible cause is an immune system response to Malassezia yeast, an organism that naturally lives on the skin’s surface. In people with seborrheic dermatitis, an overgrowth of Malassezia yeast may prompt the immune system to react, causing inflammation.

Symptoms of Seborrheic Dermatitis and Dandruff

Seborrheic dermatitis inflammation can cause a variety of symptoms that may resemble other skin diseases, such as psoriasis, rosacea, or the most common type of eczema, atopic dermatitis. Symptoms include:

• Flaky skin, or dandruff on the scalp and in areas of other facial hair
• Greasy skin with flaky crusts that may be white or yellow
• Scaly patches
• Dry skin
• Rash, the color of which varies depending on skin tone
• Itchiness

Dandruff causes a flaky and itchy scalp. Inflammation, such as a rash, discoloration, or swelling, is not visible. Dandruff can take different forms and may be dry or oily and yellowish or white flakes on the scalp.

If dandruff worsens on the scalp and signs of inflammation develop, the condition may be characterized as seborrheic dermatitis on the scalp rather than dandruff. The skin may peel or become crusty, pimply, or discolored. Sometimes, a rash may spread from the scalp to the forehead.

Flaking May Be Due to Dry Scalp

In rare cases, symptoms that look like dandruff may be caused by dry scalp due to factors such as irritants in hair products, age, or dry or cold weather. A dry scalp can cause itching and flaking skin that can look like dandruff. However, dandruff flakes are generally larger than those caused by dry scalp.

Risk Factors for Seborrheic Dermatitis and Dandruff

Some environmental, genetic, and other risk factors may cause or increase your risk of these conditions. Seborrheic dermatitis and dandruff may be triggered by factors such as:

• Psychological and emotional stress
• Changes in weather
• Neurological conditions such as Parkinson’s disease or epilepsy
• Depression and other mental health conditions
• Other immune system disorders, such as HIV or psoriasis
• Eating disorders
• Harsh chemicals, detergents, or other skin irritants
• Side effects from some medications

Seborrheic dermatitis generally develops in one of three stages of life:

• Infancy (typically on the scalp and is known as cradle cap)
• Adolescence
• Adulthood, around age 30 or later

Diagnosis and Treatment of Dandruff and Seborrheic Dermatitis

If you have signs of dandruff or seborrheic dermatitis, you may want to see a dermatologist. Dandruff and seborrheic dermatitis can often be diagnosed based on symptoms and a physical examination. Treatment options for dandruff and seborrheic dermatitis include a variety of medicated shampoos, topical therapies (placed on the skin), and oral medications.

Treatment of the Scalp

Treatment options for dandruff include over-the-counter dandruff shampoo and hair care products with ingredients such as coal tar, selenium sulfide, salicylic acid, or pyrithione zinc. For more persistent dandruff, prescription antifungal shampoo may be recommended with ketoconazole or ciclopirox.

In more severe cases that may point to seborrheic dermatitis on the scalp, a doctor may recommend prescription topicals like a phosphodiesterase 4 (PDE4) inhibitor, anti-dandruff shampoos with steroids such as betamethasone valerate, clobetasol, or fluocinolone.

Seborrheic Dermatitis Treatment in Other Areas

Depending on your particular condition, your health care provider may recommend a dandruff shampoo as a body wash for seborrheic dermatitis. Other treatment options — particularly with seborrheic dermatitis flare-ups — include topical corticosteroids (steroids), antifungals, PDE4 inhibitors, and calcineurin inhibitors (medication that weakens the immune system’s reaction, used to treat certain autoimmune disorders). Oral medications are sometimes prescribed if other topical treatment options don’t control symptoms.

Tips From MySebDermTeam Members

Many MySebDermTeam members have shared their experiences with seborrheic dermatitis and dandruff and how they manage symptoms.

One MySebDermTeam member wrote, “So, I’ve been following a regimen for the last three months of washing my face twice a day with Nizoral dandruff shampoo, then using prescription-strength ketoconazole cream. It works! My face has cleared up substantially — in fact on most days, my seb derm is completely gone.”

Another member wrote about managing shared scalp symptoms. “I’ve been trying an anti-dandruff shampoo for about a month now. The active ingredient is salicylic acid. I notice that it does leave my hairline area drier than before. I noticed that my problem areas still felt dry and crusty, but the flakes came out in bigger chunks (easier to brush out) rather than little flakes.”

“Having my hair cut, I was so embarrassed by my stylist seeing my scalp. She shampooed my hair,” a member wrote about going to a salon. “My scalp was tingling and it smelled like eucalyptus. She said it had tea tree oil in it with eucalyptus and pine. … I have been using it ever since.”

Next Steps

If you think you have dandruff or seborrheic dermatitis, it’s important to visit a doctor for the right diagnosis and treatment. You can often find helpful products at the store, but sometimes you might need a prescription from a doctor, especially if your symptoms are severe. The key is to understand your situation and get the right help to manage it effectively.

Find Your Team

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

Do you have dandruff or seborrheic dermatitis? Do you have both conditions? Share your experience in the comments below, or start a conversation by posting on your Activities page.