Free shipping on orders above ₹1,999 · COD availableBy Assure Clinic - a doctor-led hair transplant network20,000+ procedures · 60+ doctors · 13 clinicsAssure Clinic · 4.8 on Google, 2,000+ verified reviewsFree shipping on orders above ₹1,999 · COD availableBy Assure Clinic - a doctor-led hair transplant network20,000+ procedures · 60+ doctors · 13 clinicsAssure Clinic · 4.8 on Google, 2,000+ verified reviews

Seborrhoeic Dermatitis

Also called: sebderm · dandruff (severe) · cradle cap

Seborrhoeic dermatitis is a chronic, relapsing inflammatory skin condition affecting sebaceous-gland-rich areas - primarily the scalp, face (nasolabial folds, eyebrows), and chest. It produces greasy flaking, erythema, and itch.

How it happens

The pathogenesis involves the commensal yeast Malassezia (previously Pityrosporum), which metabolises scalp sebum into oleic acid. In genetically predisposed individuals, oleic acid disrupts the stratum corneum barrier, triggering an innate immune response and the keratinocyte hyperproliferation that produces visible scale. Neurological conditions (Parkinson's disease) markedly increase risk due to seborrhoeic skin activity.

In India

Affects 3–5% of the adult population. Highly prevalent in humid climates such as coastal India. Peaks in infancy and again in the 30–60 age range.

Key symptoms

  • Greasy, yellowish scaling on scalp (may extend to hairline, behind ears)
  • Itching - often worse after periods of stress
  • Diffuse or patchy scalp redness
  • Dandruff-like white flaking (lighter variant)
  • Facial involvement: nasolabial folds, eyebrows, glabella

Common triggers

  • Malassezia overgrowth on sebaceous-rich scalp
  • Stress and sleep deprivation
  • Cold, dry weather or sudden humidity changes
  • Immunosuppression (HIV, organ transplant)
  • Neurological conditions (Parkinson's, epilepsy)

How it is diagnosed

  • Clinical diagnosis - distribution and scale appearance
  • Dermoscopy (to distinguish from psoriasis)
  • KOH preparation if tinea capitis is suspected

Tests are performed by a qualified dermatologist or trichologist after clinical assessment.

Treatment options

Ketoconazole / Ciclopirox ShampooEvidence A

Antifungal shampoos used 2–3× per week reduce Malassezia load. Leave on 3–5 minutes before rinsing.

Zinc Pyrithione ShampooEvidence A

Broad-spectrum antimicrobial with anti-Malassezia activity. Daily use for active flare.

Low-potency Topical CorticosteroidEvidence A

Short-course topical corticosteroid (e.g., desonide lotion) to suppress acute inflammation and itch.

Zinc Scalp TonicEvidence B

Zinc PCA tonic applied between washes to regulate sebum and maintain antifungal environment.

Timeline: Control (not cure) is the goal - most patients achieve good control within 4 weeks. Maintenance therapy 1–2× per month prevents relapse.

When to see a doctor

See a dermatologist if OTC antifungal shampoos fail after 4 weeks, if there is significant scalp redness or oozing, or if you develop facial involvement requiring prescription topicals.

Dermatologist perspective
“The distinction between simple dandruff and seborrhoeic dermatitis matters clinically - dandruff is fine white flaking with no erythema, sebderm produces greasy yellow scale with surrounding redness. The treatment is similar but the potency and adjuncts differ significantly.”
Dr. Abhishek Pilani · Gold Medalist Dermatologist · ISHRS Member · Co-Founder, Assure Clinic

Last reviewed March 2025. This page is clinical reference, not a diagnosis. Only an in-person assessment can tell you which condition you have.

Related conditions

Scalp Psoriasistinea capitisdandruff

Not sure this is what you have?

A dermatologist can tell you in one visit. The consultation is free.

Book a free consultFind your stage in 2 minutes