Why is my dandruff not cured?

Seborrheic dermatitis is a common skin condition characterized by redness, scaliness and sometimes itching of the skin, especially the scalp. It also classically occurs on the sides of the nose, eyebrows, ears and even the middle of the chest. Seborrheic dermatitis is easy to diagnose and treat, but it can recur. Thus, the treatment given may have to be repeated, as the condition is chronic.

Let’s get technical.. dandruff, seborrhea and seborrheic dermatitis are often used interchangeably. However, dandruff refers to scaling on the scalp, but redness is not present. Seborrhea means oily skin that can occur on the scalp and face, but there is no redness or scale. Seborrhea can become seborrheic dermatitis when redness and scaling become apparent.

Seborrheic dermatitis can occur in all age groups, with infants having it present most commonly on the scalp – “cradle cap”. In infants, it can clear with or without treatment usually by one year of age. When seborrheic dermatitis develops in teens and adults, the condition usually remains chronic.

Because of the possible evolution of dandruff and seborrhea to seborrheic dermatitis, the treatment options may vary based on the stage of the condition. For some, an anti-dandruff shampoos may be sufficient. When there is an abundance of oil present, this can stimulate yeast development, thus, anti -fungal medications can be beneficial. Finally, the presence of yeast can cause inflammation, which then creates irritation, flaking and redness. As a result, topical corticosteroids, often prescription strength, may have to be used.

Due to the chronic nature of seborrheic dermatitis and that some medications used long term can cause side effects, it is recommended that one see their dermatologist to get the condition under control and discuss a possible maintenance regimen.