Are Your Flakes From Seborrheic Dermatitis or Dandruff?

Seborrheic dermatitis and dandruff are both common skin conditions that affect the seborrheic areas of the body. The seborrheic areas are responsible for producing oil on the skin, also known as sebum.

Both seborrheic dermatitis and dandruff are on a spectrum of the same condition, with dandruff being a mild form of seborrheic dermatitis. Combined, both conditions affect about half of adults in the United States. 

While seborrheic dermatitis and dandruff both cause a dry, itchy scalp, they have other symptoms that allow us to tell them apart. Dandruff is always found only on the scalp, while seborrheic dermatitis can spread to other seborrheic areas like the face, ears, and upper chest.

Fortunately, both conditions are treatable either at home or by your dermatologist. 

Dandruff in the hair and scalp

Aliaksandr Litviniuk / Getty Images

Dandruff vs. Seborrheic Dermatitis 

Dandruff causes white or yellow flakes of dry skin on the scalp. Seborrheic dermatitis also causes flaky skin. In addition, this condition can lead to scaling, itching, redness, swelling, and inflammation of the skin.

Dandruff is always found only on the scalp, while seborrheic dermatitis can spread to other seborrheic areas like the face, ears, and upper chest.

Seborrheic dermatitis tends to occur during certain phases of life and peaks during infanthood and adolescence. Cradle cap, a common skin condition on the scalp of infants, is caused by seborrheic dermatitis.

Seborrheic dermatitis affects about 42% of infants, and can be found on an infant’s face and diaper area as well. 

In adolescents, seborrheic dermatitis often affects the scalp, face, upper chest, underarms, and inguinal folds, or folds in the groin. It is more common in men than women.

Dandruff is also more common and occurs more often in men than women. Dandruff usually starts during puberty, peaks around age 20, and is less common after age 50.

How to Tell the Difference

Seborrheic dermatitis and dandruff can both cause itchy, flaky skin on the scalp. Dandruff usually presents as small, white flakes in the hair and on the scalp. 

Seborrheic dermatitis usually presents as defined plaques of greasy, yellow scales on the scalp, behind the ears, and on the nose, upper lip, eyelids, eyebrows, and upper chest. These lesions usually appear symmetrically on the body and are not contagious.

Seborrheic dermatitis tends to follow a seasonal pattern and is more common in the cold, winter months. In babies, seborrheic dermatitis usually presents as cradle cap. In adults, the condition can be chronic and recur.

Seborrheic Dermatitis Doctor Discussion Guide

Doctor Discussion Guide Old Man

Risk Factors

Seborrheic dermatitis has several known risk factors, including:

  • Presence of yeast on the skin: Studies have shown that higher levels of Malassezia yeast on the skin are associated with an increased incidence of seborrheic dermatitis. This may be due to the skin’s inflammatory response to yeast overgrowth. 
  • Increased oil production: Both seborrheic dermatitis and dandruff are associated with increased sebaceous activity in the skin. The sebaceous glands are most active shortly after birth and again at puberty. Males tend to produce more sebum than females, putting them at higher risk of seborrheic dermatitis and dandruff. 
  • Immunosuppression: You are more at risk of developing seborrheic dermatitis if your immune system is compromised. Individuals diagnosed with HIV/AIDS are at increased risk of developing the condition.
  • High cholesterol: There may be a connection between high levels of cholesterol and your risk of developing seborrheic dermatitis. This may be due to the fact that the Malassezia yeast can cause a breakdown of triglycerides in the blood, leading to high cholesterol and free fatty acids. 
  • Parkinson’s disease: There is a high correlation between Parkinson’s disease and seborrheic dermatitis. This may be due to the sebum changes that occur during the disease. 
  • Family history: Recent research suggests that there may be a genetic component to seborrheic dermatitis and dandruff. If these conditions run in your family, you may be at higher risk of developing them. 
  • Emotional stress: Seborrheic dermatitis tends to be more common in people who are experiencing depression or emotional stress. 

Other Causes of Dry, Itchy Scalp

Besides seborrheic dermatitis and dandruff, there are other skin conditions that could lead to a dry, itchy scalp in children and adults. Examples include dry skin, psoriasis, atopic dermatitis, tinea capitis, rosacea, and lupus.

Dry Skin

Dry skin occurs when the skin loses moisture, leaving it dry and flaky. This common skin condition can be caused by a number of factors, including aging, medication side effects, ethnicity, cold weather, smoking, nutritional deficiencies, and chronic health conditions.

While dandruff and dry skin can both cause dry, flaky skin, dry skin can appear anywhere on the body. Dandruff only appears and causes flakes on the scalp.

Psoriasis

Psoriasis is an autoimmune disease that causes the skin cells to reproduce too quickly. This leads to a buildup of dead skin cells that cause plaques on the skin. Psoriasis tends to run in families and is not contagious.

While seborrheic dermatitis and psoriasis both cause plaques of skin to form, the plaques appear differently. Seborrheic dermatitis plaques are yellow and greasy, while psoriasis plaques are usually much thicker and have a silvery-white color. Psoriasis plaques are also covered in scales.

Contact Dermatitis

Contact dermatitis is a common skin condition that occurs when something that has touched your skin causes irritation. This skin allergic reaction can come from soaps, laundry detergents, clothing, the sun, or any other irritant that causes a reaction on your skin. 

Contact dermatitis presents as a dry, itchy rash and sometimes blisters. While both dandruff and seborrheic dermatitis can cause itching, the sensation is usually not as intense as contact dermatitis.

Treatment

Both dandruff and seborrheic dermatitis are treatable. Dandruff is often treated at home, and seborrheic dermatitis may require a visit to your dermatologist. 

If you are experiencing contact dermatitis, treatment will depend on identifying which irritant is causing the reaction. Once you know why you are experiencing an allergic reaction, you will be able to avoid the irritant and prevent contact dermatitis. 

If you are experiencing psoriasis, work with your dermatologist to find the right combination of medications and light therapy to address the plaques of skin. 

Dandruff can usually be treated effectively with regular use of a dandruff shampoo at home. Dermatologists recommend using a treatment shampoo once weekly if you are Black and twice weekly if you are Asian or White.

Treatment for seborrheic dermatitis often requires a topical antifungal ointment or shampoo. If your lesions do not respond to treatment, your dermatologist may recommend:

  • Anti-inflammatory medications
  • Coal tar shampoo
  • Phototherapy
  • Immune modulators

How to Get Relief From Itching and Flaking

To relieve itching at home, the following remedies may be helpful:

  • Moisturize: Apply a gentle moisturizer to your skin after showering or bathing to help prevent dry skin and flaking.
  • Opt for lukewarm water: Hot showers may feel amazing, but they can be rough on your skin. Try keeping baths and showers to five minutes and using lukewarm water that won’t dry out irritated skin.
  • Go for unscented: When choosing household items that touch your skin like soaps or laundry detergents, look for gentle, unscented types since these are less likely to cause skin irritation. 
  • Try coconut oil: Using coconut oil on the scalp has been shown to hydrate the skin and may reduce inflammation as well.
  • Look for tea tree oil: Tea tree oil has been used for other skin conditions like athlete’s foot, and a 2002 study found that shampoos infused with tea tree oil may be effective at treating dandruff.
  • Manage stress: Because stress can increase the risk of developing seborrheic dermatitis, find healthy ways to reduce stress like getting enough sleep, practicing mindfulness, and meeting with a therapist.

Frequently Asked Questions

What is the best treatment for seborrheic dermatitis?

The best treatment for seborrheic dermatitis will depend on where the lesions appear on your body and how severe they are. Treatment often includes topical antifungal medication and other treatments as necessary. 

How do you get rid of seborrheic dermatitis on the scalp naturally?

It’s best to work with your dermatologist to treat seborrheic dermatitis since this condition can be chronic and recur in some people. To help manage the itching on your own, you can try home remedies like a gentle moisturizer, unscented skin products, lukewarm baths or showers, coconut oil, tea tree oil, and stress management techniques. 

How often should you wash your hair if you have seborrheic dermatitis?

When you have seborrheic dermatitis or dandruff, your shampoo schedule depends on your hair type. If you are Black, dermatologists recommend washing your hair once per week with a dandruff shampoo. If you are Asian or White, aim to wash your hair every day and incorporate a dandruff shampoo about twice weekly.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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