Clinical Dermatology
Medical management of dandruff and seborrheic dermatitis — from mild flaking to severe scalp inflammation. Evidence-based protocols, not just shampoos.
Dandruff (seborrheic dermatitis of the scalp) is one of the most common conditions seen in dermatology clinics. While mild dandruff is a cosmetic nuisance, moderate to severe seborrheic dermatitis involves significant scalp inflammation, itching, and can contribute to hair thinning.
The difference between dandruff and seborrheic dermatitis:
Mild dandruff is simply increased desquamation (skin flaking) of the scalp. Seborrheic dermatitis is an inflammatory condition driven by the Malassezia yeast, sebaceous gland activity, and individual immune response. The distinction matters because treatment approach differs significantly.
Vernon's diagnostic approach:
1. Trichoscopy: A dermoscopic examination of the scalp reveals the pattern and severity of inflammation, differentiates seborrheic dermatitis from psoriasis or other scalp conditions, and identifies any associated hair loss.
2. Identifying triggers: Stress, diet, weather changes, hormonal fluctuations, and incorrect hair products can trigger or worsen dandruff. Our dermatologists address these systematically.
Treatment protocol by severity:
Mild: Medical-grade anti-fungal shampoos (ketoconazole 2%, ciclopirox), correct washing frequency guidance, scalp care routine.
Moderate: Topical antifungal lotions, low-potency topical steroids for flare management, calcineurin inhibitors for steroid-sparing maintenance.
Severe / Resistant: Oral antifungal therapy, phototherapy, scalp PRP for associated hair thinning, nutritional optimization (zinc, B-complex, omega-3).
The hair loss connection: Chronic untreated seborrheic dermatitis can cause telogen effluvium — a diffuse hair shedding response to ongoing scalp inflammation. Controlling dandruff is often the first step in managing associated hair thinning.
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