Does seborrheic dermatitis cause hair loss?

What else could explain the hair loss?

Seborrheic dermatitis usually produces scaly patches on the scalp. Dandruff is its form without underlying inflammation. A red or silver scalp rash with patchy hair loss can instead be tinea capitis, a fungal infection also called scalp ringworm. Psoriasis and reactions to hair products can also resemble dandruff, so flakes alone do not identify the problem.13

Hair loss can also come from inherited pattern hair loss, thyroid disease, low iron or protein intake, hormonal changes, medicines, or tightly pulled hairstyles. Rapid shedding can begin a few months after physical or emotional stress. Bleaching can damage hair shafts and cause breakage, which is different from shedding hair from the scalp.24

How should you care for the scalp?

1. 1Choose a medicated shampoo labelled for dandruff or seborrheic dermatitis. Ketoconazole targets yeast; salicylic acid helps loosen scale. A pharmacist can help you choose and explain how to use it.
2. 2Follow the shampoo's label instructions. A common scalp treatment schedule is twice weekly for at least a month, but use the directions for your particular product rather than assuming every shampoo has the same schedule.
3. 3Reduce products that irritate the scalp. Avoid fragranced products and essential oils, and check for sodium lauryl sulphate if shampoos worsen your scalp eczema. If most shampoos irritate, an emollient lotion can be used for washing, though it can leave hair greasy.
4. 4Reduce gels, sprays and setting lotions, then reintroduce them individually to identify irritation. Keep your hairdryer on a low or warm setting rather than hot.
5. 5Assess the scalp symptoms after four weeks. See a doctor if dandruff persists, is severe, or comes with marked itching, redness or swelling. Have the hair loss assessed separately rather than waiting for shampoo to solve both problems.

Shampoo can clean hair without a large lather, despite the bubbles' impressive public relations.4

Will the hair grow back?

Regrowth depends on the cause of the hair loss: some types are temporary and others are permanent. A clinician can examine the scalp, review medicines and family history, and check iron levels or thyroid function when needed. Correcting an underlying problem is often enough to help stop hair loss.2

Adult seborrheic dermatitis often comes and goes, so scalp treatment can require ongoing maintenance. More severe inflammation sometimes needs prescribed treatment, including a short course of a steroid scalp preparation. Styling products are optional, even if the bathroom shelf has promoted them to essential staff.14

When should you see a doctor?

Contact a doctor for excessive daily shedding, sudden loss of large amounts of hair, or loss affecting the body as well as the scalp. Seek assessment for patches that drain fluid or pus, form crusts, or become very red or painful. These changes can signal a secondary infection.25

What causes seborrheic dermatitis?

The exact cause is not fully understood. Oil gland activity, Malassezia yeast that normally lives on skin, skin barrier changes and genes are involved. The yeast breaks down skin oils into fatty acids that may trigger inflammation. Stress, fatigue and weather extremes can contribute to flares. Dandruff is not caused by poor hygiene.135

What causes seborrheic dermatitis on the face?

Facial seborrheic dermatitis involves the same factors and favours areas rich in oil glands, including the eyebrows, nose creases, beard and ears. Redness and flaking can resemble other conditions, including rosacea or psoriasis. A clinician can distinguish them by examining the appearance and location of the rash.156