Dandruff & Scalp Dermatitis
Dandruff is a mild form of seborrheic dermatitis limited to the scalp. More severe scalp dermatitis involves redness, itching, and thicker scale.
Symptoms
White or yellowish flakes with mild to moderate itching. Severe cases show red, scaly plaques and thick crusting extending behind the ears and onto the hairline.
Causes and risk
Malassezia yeast triggers inflammation in susceptible individuals. Oily skin, infrequent shampooing, stress, and immunosuppression are risk factors.
How it is evaluated
Clinical diagnosis. We differentiate from scalp psoriasis and tinea capitis. KOH when fungal infection is suspected.
Treatment
Medicated shampoos (ketoconazole, zinc pyrithione, selenium sulfide) used two to three times per week. Prescription corticosteroid solutions for flares. Our Chicago team recommends alternating shampoos.