Seborrhoeic Dermatitis

Understanding Seborrhoeic Dermatitis of the Scalp

Seborrhoeic dermatitis is a common inflammatory skin condition that typically affects areas of the body where there are larger numbers of sebaceous — or oil-producing — glands.

On the scalp, it can range from relatively mild dandruff and flaking to more noticeable inflammation, itching and persistent scale.

Although seborrhoeic dermatitis does not usually permanently damage the hair follicles, an uncomfortable or inflamed scalp can affect hair and scalp health and may occur alongside other causes of shedding or thinning.

Understanding exactly what is happening is therefore important when scalp symptoms and hair loss occur together.

What Causes Seborrhoeic Dermatitis?

The precise cause of seborrhoeic dermatitis is complex.

A naturally occurring yeast called Malassezia, which normally lives on the skin, is thought to play an important role alongside individual susceptibility, the skin’s oil production and inflammatory response.

It is not caused by poor hygiene and it is not contagious.

The condition commonly follows a pattern of improvement and recurrence rather than disappearing permanently after one episode.

What Does Scalp Seborrhoeic Dermatitis Look Like?

Symptoms vary considerably between individuals.

Common signs include:

• Dandruff or persistent scalp flaking
• Yellowish or white scale
• Itching
• Redness or inflammation
• Scalp sensitivity or soreness
• Greasy areas of scale
• Dry-feeling or irritated areas
• Flaking around the hairline or behind the ears

Seborrhoeic dermatitis can also affect areas outside the scalp, particularly the eyebrows, sides of the nose, ears and central chest.

Seborrhoeic Dermatitis and Hair Loss

Seborrhoeic dermatitis itself does not normally cause permanent scarring hair loss.

However, significant scalp inflammation, persistent scratching and heavy scaling can sometimes be associated with temporary increased shedding or hair breakage.

Hair loss occurring at the same time should not automatically be attributed to seborrhoeic dermatitis.

Pattern hair loss, telogen effluvium, psoriasis and inflammatory or scarring scalp disorders can sometimes coexist or produce overlapping symptoms.

This is one reason why assessing both the hair and the scalp can be useful when somebody presents with persistent flaking alongside noticeable thinning or shedding.

Assessment at YT Medical

Your consultation may include examination of the scalp, discussion of your symptoms and assessment of any associated hair changes.

We may consider:

• The appearance and distribution of scaling
• Scalp inflammation
• Itching, soreness or sensitivity
• How long symptoms have been present
• Previous episodes or treatments
• Changes in hair shedding or density
• Other areas of affected skin
• Current hair and scalp products

Digital trichoscopy may also be useful where closer examination of the scalp and hair follicles is appropriate.

Where the appearance is unusual, symptoms are severe or another inflammatory skin condition is suspected, further assessment by a GP or dermatologist may be recommended.

Managing Seborrhoeic Dermatitis

Management is generally aimed at controlling inflammation and reducing the yeast and scale associated with the condition.

Depending on severity, commonly used approaches can include medicated or antifungal shampoos and treatments prescribed to settle inflammation when required.

Once symptoms have improved, some people benefit from ongoing maintenance because seborrhoeic dermatitis has a tendency to recur.

The appropriate approach depends on the severity and location of the condition and any treatment already being used.

Supporting a Healthy Scalp

Scalp health is an important part of a wider hair-restoration assessment.

Where seborrhoeic dermatitis is active, bringing inflammation and scaling under appropriate control may be prioritised before certain elective scalp procedures are considered.

Patients should also avoid aggressively scratching or scraping an inflamed scalp, as repeated physical irritation can further compromise the skin barrier.

A treatment plan should therefore address the condition of the scalp as well as any separate concern about hair density.

When Should You Seek Further Medical Advice?

Medical assessment is particularly important where scalp symptoms are severe, persistent or associated with:

• Significant pain
• Weeping or crusting
• Signs of infection
• Extensive inflammation
• Sudden or significant hair loss
• Smooth areas where hair follicles appear to have disappeared
• Symptoms that do not respond to appropriate treatment

These features may require further investigation or indicate that another scalp condition is present.