Seborrheic dermatitis and dandruff: treatment in Tashkent

Other names: Перхоть, себорея, себорейная экзема

Seborrheic dermatitis is a chronic inflammation of the skin in areas rich in sebaceous glands: scalp, eyebrows, wings of the nose, nasolabial folds, behind the ears, chest and back. Its most famous manifestation is dandruff. A key role is played by the yeast-like fungus Malassezia, which normally lives on the skin, but when there is excess sebum, it multiplies and causes an inflammatory reaction. The disease is chronic and prone to relapse, but is well controlled - provided that treatment is not stopped the day the peeling disappears.

🧾 МКБ-10: L21 🏥 Where it is treated: 6 Not from an “unwashed head”Malassezia fungusMaintenance therapy needed

👨‍⚕️ Which doctor

Dermatologist, trichologist

🔬 Diagnostics

Examination, trichoscopy

💊 Treatment

Antifungal shampoos and creams

📈 Prognosis

Chronic, well controlled

⚠️ At risk

Stress, winter, HIV, Parkinson's disease

⏱ When to see a doctor

Planned

🚨 See a doctor urgently

With these signs do not wait for a scheduled appointment — the condition requires emergency care.

Тяжёлое распространённое течение, плохо отвечающее на лечение, — исключить ВИЧ
Себорейный дерматит с паркинсонизмом или после инсульта
Мокнутие, корки медового цвета — присоединилась бактериальная инфекция
Выраженное выпадение волос с рубцеванием
Резкое ухудшение с покраснением всей кожи
У младенца: распространённая сыпь с плохой прибавкой веса

How it manifests itself

On the head: white or yellowish greasy scales, itching, redness of the skin
On the face: redness and peeling at the wings of the nose, in the nasolabial folds, on the eyebrows and between them
Behind the ears and in the ear canal: peeling, cracking, itching
On the chest and back: round scaly spots in the center
In infants: “milk crusts” on the crown of the head - dense yellowish scales, usually without itching

Себорейный дерматит головы часто путают с псориазом. При псориазе чешуйки более плотные, серебристые, а бляшки выходят за линию роста волос на лоб и имеют очень чёткие границы.

Why does it occur

Excessive activity of the sebaceous glands and the proliferation of Malassezia fungus
Hereditary predisposition
Stress and lack of sleep are common triggers for exacerbations
Cold season, dry heating air
Immunodeficiency, including HIV - in case of severe persistent disease, examination is mandatory
Neurological diseases: Parkinson's disease, consequences of stroke
Abuse of aggressive shampoos and, conversely, infrequent hair washing

A common myth: dandruff is caused by “not washing your hair well.” In fact, the cause is inflammation and fungus; Moreover, too infrequent washing actually contributes to the accumulation of sebum and worsens the condition.

Treatment

Shampoos with ketoconazole, ciclopirox, selenium disulfide, zinc pyrithione - 2-3 times a week in the active phase
Keep the shampoo on the skin for 3-5 minutes before rinsing - otherwise the active ingredient does not have time to act
Creams with antifungal components for the face
Topical calcineurin inhibitors - for the face with severe inflammation, safe for a long time
Short courses of weak topical steroids - only for severe inflammation and not on an ongoing basis
Keratolytics (salicylic acid, urea) - for dense crusts
Maintenance therapy: medicated shampoo once every 1–2 weeks continuously

Основная ошибка — прекращать лечение, как только исчезла перхоть. Без поддерживающей терапии обострение возвращается через несколько недель.

In infants

“Milk crusts” on the head of children in the first months are a variant of seborrheic dermatitis. They do not bother the child and usually go away on their own by 6–12 months.

Apply baby or vegetable oil to the scabs 20–30 minutes before bathing
Gently comb out the softened scales with a soft brush
Wash your hair with mild baby shampoo
Do not peel off the crusts dry - you may injure the skin
If it spreads to the body and itching occurs, show the child to a doctor.

Frequently asked questions: Seborrheic dermatitis

Is dandruff due to the fact that I rarely wash my hair?+

No, the reason is inflammation and proliferation of the Malassezia fungus. But too infrequent washing contributes to the accumulation of sebum and worsens the course, so you need to wash your hair regularly.

How long to keep the medicated shampoo?+

3-5 minutes before rinsing. If you wash it off immediately, the active substance does not have time to act - this is the most common reason “the shampoo does not help.”

Can it be cured forever?+

This is a chronic condition with a tendency to relapse. But it is well controlled: an active course eliminates symptoms, and maintenance use of shampoo once every 1–2 weeks maintains remission.

How is it different from psoriasis?+

With psoriasis, the scales are dense, silvery, the boundaries of the plaques are very clear, and the rash extends beyond the hairline to the forehead. Seborrheic scales are fatty, yellowish, and the boundaries are blurred.

Are “milk crusts” dangerous for a baby?+

No, they do not bother the baby and usually go away by 6–12 months. Softening with oil before bathing and gentle combing helps. You cannot peel off the crusts dry.

The information on this page is for reference only and does not replace a doctor consultation. Only a qualified specialist can make a diagnosis and prescribe treatment after an in-person examination.