01
Dandruff
Mainly Flaking.
Usually limited to the scalp and generally considered a milder form within the seborrheic dermatitis spectrum.
Scalp-limited
Visible flakes
Itching may occur
Less obvious inflammation
Scalp & Facial Dermatitis · New York City
Seborrheic Dermatitis & Dandruff Treatment in NYC
Flaking is easy to see. The reason behind it is not always obvious.
Seborrheic dermatitis is a common, recurrent inflammatory skin condition that often affects the scalp and other oil-rich areas of the face and body. Dandruff is generally considered a milder, scalp-limited form of seborrheic dermatitis.
Persistent scale, itching, redness or recurrent facial involvement may require more than simply changing shampoo.
The Clinical Approach
Identify the pattern.
Control the flare.
Build a maintenance plan.
01
Identify the Pattern
02
Rule Out Mimics
03
Control the Flare
04
Prevent Recurrence
Similar Symptoms · Different Problems
Dandruff, Seborrheic Dermatitis or a Dry Scalp?
Flaking does not automatically mean that the scalp is dry.
Distribution, inflammation, type of scale and response to previous treatment help distinguish these problems.
02
Seborrheic Dermatitis
Scale with Inflammation.
May involve the scalp, eyebrows, sides of the nose, ears, beard area, eyelids or upper chest.
White or yellow scale
Redness or discoloration
Itching or irritation
Several characteristic areas may be involved
03
Dry Scalp
Barrier Dryness.
Dryness can also cause fine flaking, but it does not follow the same inflammatory and sebaceous distribution.
Fine dry scale
Tight or dry sensation
May follow harsh cleansing
Different treatment strategy
Why the Distinction Matters
Repeatedly treating an inflammatory scalp
as simply “dry skin”
may delay the correct diagnosis.
Where Seborrheic Dermatitis Appears
It Is Not Always Just a Scalp Problem.
Seborrheic dermatitis favors areas with higher sebaceous activity.
Some patients notice only dandruff. Others develop recurrent inflammation in several characteristic locations.
Scalp
Flaking, scale,
itching and inflammation
Eyebrows & Nose
Recurrent scale
around the brows and nasal folds
Ears & Beard
Scaling around the ears
or underneath facial hair
Eyelids
May coexist
with seborrheic blepharitis
Chest & Other Sebaceous Areas
Red or scaly areas
may occur beyond the scalp and face
Why It Flares
It Is More Complex Than “Too Much Fungus.”
Seborrheic dermatitis appears to reflect an interaction between skin yeast, sebaceous lipids, barrier function and an individual inflammatory response.
Skin Microbiome
Malassezia
Malassezia normally lives on human skin. Seborrheic dermatitis is not simply a contagious fungal infection.
Sebaceous Environment
Sebum & Lipids
The condition favors oil-rich regions of the scalp, face and upper body.
Host Response
Inflammation
Individual inflammatory responses influence redness, itching and the degree of scale.
Skin Barrier
Irritation
Scratching, irritating products and barrier disruption may contribute to symptoms.
Flares May Be Influenced By
Stress
Weather
Skin Irritation
Hair Products
Changes in Routine
Seborrheic Dermatitis & Shedding
Can Seborrheic Dermatitis Cause Hair Loss?
Seborrheic dermatitis is not usually a primary cause of permanent follicular hair loss.
Significant inflammation, scratching or an accompanying scalp condition may contribute to increased shedding. Seborrheic dermatitis can also coexist with an unrelated hair-loss disorder.
If shedding continues after the scalp improves, or if density is progressively changing, hair loss should be evaluated separately.
Look Beyond Dandruff When There Is
Explore Hair Loss Evaluation
Persistent shedding
Widening of the part
Receding hairline
Focal patches
Pustules or significant pain
Loss of follicular openings
Dermatologic Evaluation
Not Every Flaky Scalp Is Dandruff.
Most cases can be diagnosed from history and clinical examination.
A closer evaluation is particularly useful when the presentation is unusual, significant hair loss is present or treatment repeatedly fails.
Conditions That Can Look Similar
Inflammatory
Psoriasis / Sebopsoriasis
Thicker or more sharply defined plaques may suggest psoriasis, although overlap can occur.
Exposure Related
Contact Dermatitis
Hair dyes, fragrance, preservatives and styling products can cause allergic or irritant scalp dermatitis.
Infectious
Tinea Capitis
Fungal infection can produce scaling, inflammation and hair loss and requires different treatment.
Eczematous
Atopic Dermatitis
Atopic dermatitis may involve the scalp or face as part of a broader eczema pattern.
Hair-Loss Differential
Inflammatory Scalp Disorders
Pain, pustules, scarring or progressive hair loss may point to another diagnosis.
Seborrheic Dermatitis Treatment
Control the Flare. Then Keep It Controlled.
Treatment should match where the dermatitis occurs, how inflammatory it is and how often it returns.
The objective is not simply to remove visible flakes for a few days, but to create a practical strategy for recurrent disease.
Scalp
Medicated Shampoo Strategy
Depending on the presentation, anti-dandruff or antifungal shampoos may include ingredients such as ketoconazole, ciclopirox, selenium sulfide or zinc pyrithione.
Face · Brows · Ears · Beard
Topical Antifungal Treatment
Topical antifungal medications may help manage yeast-associated inflammation in facial and body areas.
Inflammation
Reduce Redness & Itching
Short courses of appropriately selected topical corticosteroids or steroid-sparing anti-inflammatory agents may be used according to location and severity.
Nonsteroidal Option
Roflumilast Foam
Roflumilast foam 0.3% is an FDA-approved nonsteroidal topical option for seborrheic dermatitis in patients 9 years of age and older.
Scale Control
Remove Scale Without Over-Irritating
Selected scale-control ingredients may be useful when scale is prominent, but overly aggressive cleansing can worsen barrier irritation.
Resistant Disease
Reassess Before Escalating
Extensive or treatment-resistant dermatitis may occasionally require additional therapy, but persistent disease should first prompt reconsideration of the diagnosis and current regimen.
Documented Clinical Cases
The Same Diagnosis Can Look Very Different.
Seborrheic dermatitis may involve different areas and may require a different treatment strategy from patient to patient.
Individual treatment and results vary.
Dermatology + Dermatopathology
Persistent Scalp Problems Deserve the Correct Diagnosis.
Seborrheic dermatitis is common. Persistent scale, however, is not always simple dandruff.
Dr. Viktoryia Kazlouskaya is board-certified in dermatology and dermatopathology. This perspective is particularly useful when scalp or facial dermatitis is atypical, resistant to treatment or occurring together with hair loss.
The goal is to identify what is driving the symptoms, simplify treatment when possible and create a practical long-term plan.
Practice Principle
Treat the diagnosis,
not simply the visible flakes.
Upper East Side · Manhattan
801 Madison Avenue, 4th Floor
New York, NY 10065
Schedule a Consultation
Seborrheic Dermatitis FAQ
Questions Patients Often Ask.
Seborrheic dermatitis becomes easier to manage once the diagnosis, treatment strategy and maintenance plan are clear.
01 Is dandruff the same as seborrheic dermatitis?
Dandruff is generally considered a milder form within the seborrheic dermatitis spectrum. It is limited to the scalp and usually has less visible inflammation.
02 Is seborrheic dermatitis caused by dry skin?
Not simply. Seborrheic dermatitis often affects oil-rich areas and appears to involve interactions among Malassezia yeast, skin lipids, barrier function and inflammation.
03 Why does seborrheic dermatitis keep coming back?
It is typically a chronic, relapsing condition. Maintenance treatment can therefore be useful after an active flare is controlled.
04 Can seborrheic dermatitis affect the face?
Yes. Common facial areas include the eyebrows, sides of the nose, ears, beard area and eyelids. It can also affect the chest and other sebaceous regions.
05 Can seborrheic dermatitis cause hair loss?
It is not usually a primary cause of permanent follicular hair loss. Significant inflammation or scratching may contribute to shedding, while another hair-loss disorder may also occur at the same time.
06 What shampoos are used for seborrheic dermatitis?
Depending on the presentation, treatment may include shampoos containing ketoconazole, ciclopirox, selenium sulfide or zinc pyrithione. Frequency should be individualized.
07 Does medicated shampoo need contact time?
Many medicated shampoos need adequate time on the scalp before rinsing. Instructions vary, so the regimen should follow the specific product or physician recommendation.
08 Is Zoryve used for seborrheic dermatitis?
Roflumilast foam 0.3%, marketed as Zoryve, is an FDA-approved nonsteroidal topical option for seborrheic dermatitis in patients 9 years of age and older.
09 When should persistent dandruff be evaluated by a dermatologist?
Evaluation is particularly useful when dandruff does not improve with an appropriate regimen, when inflammation is significant, or when pain, pustules, hair loss or unusual distribution are present.
10 Is a skin biopsy usually required?
No. Seborrheic dermatitis is usually diagnosed clinically. Biopsy may be useful when the presentation is atypical, treatment-resistant or another diagnosis is suspected.
Seborrheic Dermatitis · Dermatology Circle NYC
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Get the Flare Under Control. Then Keep It There.
Persistent dandruff, scalp itching or recurrent facial scale may benefit from a dermatologist-led diagnosis and a plan designed for both active flares and maintenance.