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Inflammatory Physician Reviewed

Seborrheic Dermatitis — controlled by dermatologists, not medicated shampoos alone

A chronic, relapsing inflammatory condition driven by yeast overgrowth — explained and managed with evidence-based precision at DermaVue's 7 clinics across Kerala & Tamil Nadu.

Seb Derm Seborrhoeic Eczema Cradle Cap (infants) Sebopsoriasis
Affects Scalp, Face, Chest
Age Group 18 – 55 years
Contagious No
Treatment 2 – 5 sessions
Consultation ₹300
At a Glance
0–5%
of the global adult population affected by seborrheic dermatitis
0%
of adults experience dandruff — the mildest form of this condition
0%+
DermaVue patient satisfaction across 7,400+ reviews
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7 clinics · Kerala & Tamil Nadu · ₹300 consultation

What Is It

Understanding Seborrheic Dermatitis

Reviewed by Dr. Minu Liz Mathew, MBBS MD DVL — February 2026

Seborrheic dermatitis causes red, flaky, greasy patches on the scalp, face, and chest — areas where oil glands are most active. It is not caused by poor hygiene. The underlying driver is an overgrowth of Malassezia yeast that feeds on skin oils, triggering inflammation. Stress, fatigue, weather changes, and Kerala's humidity can all trigger flares. The condition is chronic and tends to relapse, but with the right combination of antifungal therapy, anti-inflammatory agents, and maintenance protocols, flares can be controlled and intervals between episodes significantly extended. DermaVue dermatologists design personalised regimens based on affected area, severity, and skin type.

Seborrheic dermatitis is a chronic, relapsing inflammatory dermatosis of sebum-rich skin regions — scalp, face (nasolabial folds, eyebrows, glabella), retroauricular area, and presternal chest. Pathogenesis centres on the commensal lipophilic yeast Malassezia globosa and M. restricta, which hydrolyse sebaceous triglycerides via lipase activity, releasing oleic acid and other unsaturated fatty acids that penetrate the stratum corneum and trigger a non-immunogenic irritant inflammatory response mediated by IL-1α, IL-6, IL-8, and TNF-α.[1] Individual susceptibility is modulated by sebaceous gland density, sebum composition, epidermal barrier integrity, and immune status — explaining increased prevalence and severity in HIV/AIDS and neurological conditions (Parkinson's disease). Histopathology shows spongiotic dermatitis with "shoulder" parakeratosis centred on follicular ostia.

M
Dr. Minu Liz Mathew, MBBS MD DVL
Consultant Dermatologist · RealSelf Recognised · DermaVue Kochi
Last reviewed: February 2026
Signs & Symptoms

What does Seborrheic Dermatitis look like?

Symptoms range widely in severity. Identifying which type you have determines the right treatment.

Scalp Flaking
White to yellowish greasy flakes on the scalp — more adherent and oily than dry dandruff. Often the earliest and most common presentation.
Mild
Erythematous Patches
Red, inflamed patches with well-defined borders on the nasolabial folds, eyebrows, glabella, and behind the ears. May be itchy.
Moderate
Greasy Scales
Yellowish, oily, adherent scales overlying erythematous skin — characteristic of seborrheic dermatitis and distinct from dry psoriatic scales.
Moderate
Scalp Pruritus
Persistent itching of the scalp, often worse after sweating or in humid conditions. Scratching can worsen inflammation and lead to secondary infection.
Moderate
Facial Involvement
Erythema and scaling around the nose, eyebrows, eyelid margins (blepharitis), and beard area. Can mimic rosacea or lupus on first presentation.
Mod. Severe
Chest & Trunk Patches
Petaloid or annular erythematous patches on the presternal chest and interscapular area. Often overlooked by patients until significant.
Mod. Severe
Recurrent Flares
Episodic worsening triggered by stress, sleep deprivation, seasonal change, or humidity. Chronic relapsing course is the hallmark of this condition.
Mod. Severe
Secondary Infection
Bacterial superinfection from scratching — presenting as crusting, oozing, and increased pain. Requires prompt antibiotic intervention alongside antifungal therapy.
Severe
Root Causes

What actually causes Seborrheic Dermatitis?

Multiple factors act together — understanding them helps prevent recurrence after treatment.

🦠
Malassezia Yeast Overgrowth
Malassezia globosa and M. restricta — lipophilic yeasts present on normal skin — proliferate in sebum-rich areas, breaking down triglycerides into irritant fatty acids that trigger inflammation. This is the primary driver.
Excess Sebum Production
Sebaceous glands in the scalp, face, and chest produce more oil than other body sites, creating a lipid-rich environment that sustains Malassezia colonisation and fuels the inflammatory cycle.
🧬
Immune Dysregulation
Individual differences in innate immune response to Malassezia determine susceptibility. Immunocompromised states — especially HIV/AIDS — dramatically increase prevalence and severity (up to 80% in advanced HIV).
Stress & Fatigue
Psychological stress and sleep deprivation impair skin barrier function and modulate sebum composition, triggering or worsening flares. A consistent pattern reported by most patients.
Kerala's Tropical Humidity
High ambient humidity increases sweating and skin surface moisture, which promotes Malassezia growth and disrupts the stratum corneum barrier — making Kerala residents particularly prone to flares.
🧴
Harsh Topicals & Steroid Misuse
Self-prescribed potent topical steroids initially suppress redness but cause rebound flares, skin atrophy, and steroid-dependent dermatitis. Alcohol-based hair products strip protective lipids and worsen dryness.
Who gets seborrheic dermatitis in India?
  • 3–5% of adults have clinically significant seborrheic dermatitis; up to 50% have dandruff (its mildest form)
  • Men are affected more frequently than women — androgen-driven sebaceous gland activity is a contributing factor
  • Peak onset occurs in young adults (18–40) with a second peak after age 50
  • Kerala's humid climate promotes Malassezia proliferation and is a recognized trigger for recurrent flares
  • Immunocompromised individuals (HIV, organ transplant recipients, neurological conditions like Parkinson's) have markedly higher prevalence and severity
Diagnosis Process

What happens at your DermaVue consultation?

A structured clinical assessment — not a quick glance and a prescription pad. Here's exactly what to expect.

01
Clinical Examination & Distribution Mapping
Dermatologist assesses characteristic distribution — scalp, nasolabial folds, eyebrows, ears, chest — and grades severity. Pattern recognition differentiates from psoriasis, rosacea, and contact dermatitis.
02
Dermoscopy
Trichoscopy of the scalp reveals arborising vessels, yellowish scales, and follicular plugging characteristic of seborrheic dermatitis — distinct from psoriasis's uniform white scales and red dots.
03
KOH Mount & Fungal Culture (if needed)
Potassium hydroxide preparation to confirm Malassezia density and rule out dermatophyte infection (tinea capitis/faciei), especially in refractory or atypical presentations.
04
Differential Diagnosis Workup
Psoriasis, rosacea, contact dermatitis, tinea, and lupus erythematosus are systematically excluded. HIV testing recommended for severe, extensive, or treatment-resistant cases.
05
Personalised Management Plan
A written protocol combining topical antifungals, anti-inflammatory agents, maintenance shampoo regimen, and trigger avoidance strategies — tailored to affected area, severity, and skin type.
Available at DermaVue

Seborrheic Dermatitis treatments we offer

All procedures by board-certified MD DVL dermatologists. US-FDA approved equipment. No technician-only protocols — ever.

Topical Antifungal Therapy
Ketoconazole, ciclopirox, or sertaconazole creams and shampoos target Malassezia directly. Applied to scalp, face, and body as appropriate. Shampoo formulations used 2–3 times weekly in the active phase, then weekly for maintenance.
First-line treatment for all severities
Topical Anti-Inflammatory Agents
Low-potency corticosteroids for short-term flare control, calcineurin inhibitors (tacrolimus, pimecrolimus) for steroid-free maintenance on the face, and lithium succinate for targeted anti-inflammatory action without steroid side effects.
Facial and eyelid involvement
Phototherapy (NB-UVB)
Narrowband UVB phototherapy reduces Malassezia colonisation and modulates the inflammatory response. Effective for widespread or recalcitrant disease that does not respond adequately to topical therapy alone.
Extensive or refractory seborrheic dermatitis
Chemical Peels
Salicylic acid peels exfoliate adherent scales, reduce sebum, and improve penetration of antifungal agents. Glycolic acid peels can address post-inflammatory hyperpigmentation in resolved lesions.
Scalp scaling & post-inflammatory marks
HydraFacial
Gentle vortex extraction removes scales and excess sebum without irritation, followed by targeted serum infusion to restore the skin barrier. Well-tolerated even on sensitised skin.
Facial seborrheic dermatitis maintenance
Maintenance Protocol
Long-term relapse prevention combining intermittent antifungal shampoo, barrier-repair moisturiser, trigger avoidance counselling, and scheduled dermatologist review every 3–6 months.
Long-term flare prevention
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Treatment Journey

Your Seborrheic Dermatitis treatment timeline

Results are gradual, progressive, and lasting with the right protocol.

Week 1
Consultation, clinical grading, and distribution mapping. Baseline photos taken. Differential diagnoses excluded.
Topical antifungal and anti-inflammatory prescription started. Medicated shampoo regimen initiated. Trigger avoidance counselled.
Week 2–3
Active scaling and erythema begin to reduce. Itching typically decreases within the first 7–10 days of treatment.
Second visit if facial involvement is significant. Calcineurin inhibitor may replace steroid for face maintenance.
Month 1–2
Visible clearance of scales and redness in most patients. Scalp pruritus substantially improved.
Transition to maintenance frequency for medicated shampoo (1–2 times weekly). Chemical peel or HydraFacial session if residual scaling or pigmentation.
Month 3–4
Stable remission in the majority of patients. Maintenance protocol established for long-term control.
Phototherapy course started if disease is refractory. Trigger diary reviewed and updated.
Month 6+
Sustained control with maintenance therapy. Flare intervals significantly extended compared to pre-treatment baseline.
Quarterly dermatologist review recommended. Regimen adjusted seasonally — monsoon and winter often require intensified maintenance.
FAQ

Frequently asked questions about Seborrheic Dermatitis

No, seborrheic dermatitis is not contagious. You cannot catch it from or spread it to another person. Malassezia yeast is part of the normal skin flora present on everyone's skin. The condition develops because of an individual's inflammatory response to the yeast, not because of infection or transmission.

Dandruff is the mildest form of seborrheic dermatitis, limited to scalp flaking without significant inflammation. When the condition progresses to include redness, greasy yellowish scales, and involvement beyond the scalp (face, ears, chest), it is classified as seborrheic dermatitis. Both share the same underlying Malassezia-driven mechanism.

Psoriasis produces thick, silvery-white, dry scales on well-demarcated plaques, often extending beyond the scalp to elbows, knees, and nails. Seborrheic dermatitis produces yellowish, greasy scales in sebum-rich areas — nasolabial folds, eyebrows, behind the ears. Some patients have overlap ("sebopsoriasis") requiring combined treatment. A dermatologist can differentiate using clinical examination and dermoscopy.

Seborrheic dermatitis is a chronic condition that tends to relapse. There is currently no permanent cure. However, it can be effectively controlled with maintenance antifungal therapy and trigger avoidance. Many patients achieve long periods of remission with the right dermatologist-guided protocol. The goal of treatment is sustained control and extended flare-free intervals — not a one-time fix.

DermaVue consultation fee is ₹300 at most branches. Medicated shampoos and topical antifungals are generally affordable prescription items. Chemical peel sessions range ₹1,500–3,500 per session. HydraFacial starts at ₹3,999. Phototherapy sessions are priced per session based on the area treated. Full treatment costs are discussed transparently at your first consultation — no hidden charges.

Kerala's tropical humidity creates warm, moist conditions on the skin surface that promote Malassezia yeast proliferation and can trigger or worsen flares. Sweat and environmental moisture disrupt the skin barrier in sebum-rich zones. DermaVue dermatologists factor in local climate when designing treatment plans, recommending appropriate cleansing frequency, antifungal maintenance schedules, and barrier-repair strategies suited to humid conditions.

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