How to Tackle Dandruff

Seborrheic dermatitis, also known as dandruff or seb derm, is a common inflammatory skin condition that affects the sebum-rich areas of the body including the face (especially ears and nasal creases), scalp, ears, upper chest and back. This typically presents with redness and overlying white/yellow crust and scale. In skin of color, seb derm can cause lightening of the skin. Pigmentary changes may persist after treatment but often fade over time.

The cause of seb derm is not known with certainty but may be associated with an abnormal immune response to a common type of yeast Pityrosporum (Malassezia) that lives on the skin. Seb derm is known to exacerbate under certain conditions, such as stress or weather changes.

While seb derm tends to be chronic, there are a combination of over the counter (OTC) and prescription products that can alleviate flares. A common misconception is that the hair should be washed less frequently due to the flaky, dry skin present. However, since these flakes are caused by an inflammatory response to yeast and sebum, the hair should be washed more frequently with appropriate anti-dandruff shampoos. Ingredients such as ketoconazole, zinc pyrithione, or selenium sulfide can be helpful. Salicylic acid can help chemically exfoliate scale build up. These ingredients can be found in several over-the-counter shampoos and can be alternated for optimal results.

Seb derm can overlap with or mimic other dermatologic conditions such as rosacea, psoriasis, acne, or periorificial dermatitis. Schedule an appointment with Megan Quinn, PA-C, in Fort Washington or Lansdale, PA, to help diagnose and establish an appropriate treatment plan.

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