Seborrhoeic dermatitis, sometimes referred to as seborrhoeic dermatitis, is an inflammatory skin condition characterised by the appearance of red patches, primarily localised in sebum-rich areas. This is why it is frequently found on the scalp. What should be done in cases of seborrhoeic dermatitis? Which treatments are available? This article provides further information.
Scalp seborrhoeic dermatitis: how to treat it?
Summary
Published on August 22, 2023, updated on December 3, 2025, by Manon, Scientific Editor — 10 min of reading
Themes:
Scalp seborrhoeic dermatitis: what is it?
The seborrhoeic dermatitis of the scalp is a common chronic inflammatory condition, preferentially affecting sebum-rich areas. On the head, it causes scales and flaking of the scalp, leading to crusts in the hair that can be white or yellow. These deposits can easily detach during styling or showering, but, when inflammation is present, they become thicker and leave the scalp scaly, sometimes with papules and crusts on the scalp. Flares occur episodically, with itching, irritation and peeling of the scalp skin, which can impair quality of life. The condition is not contagious and the crusts affect adults and elderly people as well as children.
The exact origin of seborrhoeic dermatitis remains partially understood, but a key factor is the proliferation of the yeast Malassezia, which uses sebum to produce irritating fatty acids, triggering an inflammatory reaction. This interaction would account for the presence of redness, scales and crusts on the scalp, particularly in individuals with an irritated scalp. Various factors, such as hormonal influences (notably androgens), lifestyle and environment, appear to modulate individual susceptibility.
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What are the solutions for scalp seborrhoeic dermatitis?
Several treatments are available to slow the progression of seborrhoeic dermatitis of the scalp. Here is a non-exhaustive list of solutions.
Firstly, there are shampoos containing selenium sulphide (1 to 2.5%). This is an antifungal agent that limits the proliferation of the yeast Malassezia. However, its mechanism of action remains unknown. Selenium sulphide also exerts a cytostatic effect on epidermal keratinocytes, meaning it slows their renewal and thus prevents excessive scalp desquamation. This treatment should initially be applied daily, leaving it on for 5 to 10 minutes, and thereafter twice weekly. Selenium sulphide is a safe, non-toxic and effective solution.
Several studies have been conducted on selenium sulfide and its effects on seborrhoeic dermatitis and dandruff. One of these was conducted in 34 participants with scalp dandruff and evaluated the efficacy of a shampoo containing 2.5% selenium sulfide, applied every three days for four weeks. Of the 30 participants who completed the trial, the total dandruff score decreased significantly. Participants also reported a reduction in itching, reduced greasiness of the scalp and good tolerability of the product, while investigators rated the results "very good" or "excellent" in all subjects, with erythema resolved by the end of the study. Furthermore, no adverse effects were observed.
35.7%
Reduction in dandruff score after one week.
57.1%
Reduction in the dandruff score after two weeks.
78.3%
Reduction of the dandruff score after four weeks.
It is also possible to use shampoos containing salicylic acid. These can be effective in treating seborrhoeic dermatitis of the scalp. Salicylic acid is capable of penetrating the upper layers of the skin due to its lipid-soluble chemical structure. Once absorbed, it acts by dissolving the adhesive bonds between dead skin cells, thereby promoting their detachment and removal. Thanks to its keratolytic activity, salicylic acid can help to remove dead skin cells, thereby promoting cell renewal and the healing process of the scalp. Salicylic acid also participates in the inflammatory cascade and inhibits the synthesis of prostaglandin E2, the molecule responsible for redness. It thus soothes the scalp, alleviating the itching and irritation caused by seborrhoeic dermatitis. Shampoos containing salicylic acid should be used twice a week.
However, salicylic acid does not exhibit any antifungal activity. In seborrhoeic dermatitis of the scalp, it should therefore be combined with an antifungal agent, although its keratolytic properties make it a useful adjuvant.
A study conducted on 95 individuals with seborrhoeic dermatitis assessed the efficacy of a shampoo combining 1% selenium sulphide and 0.9% salicylic acid, used three times weekly for four weeks. The results demonstrate a clear improvement: cases of severe seborrhoeic dermatitis fell from 28.4% to just 3.2%, while 90.5% of participants exhibited only mild scaling or none at all. Scores for itching, irritation and flaking also showed significant reductions, and nearly nine out of ten participants expressed satisfaction with the product and would recommend it.
Effects of a salicylic acid and selenium sulphide shampoo on different parameters of seborrhoeic dermatitis.
Source: WEI A. & al. A study on dermatologists’ self-assessment of the efficacy of a 1% selenium disulfide – 0.9% salicylic acid -based shampoo for scalp seborrheic dermatitis. Archives of Dermatological Research (2025).
To combat the crusts on the scalp caused by seborrheic dermatitis, you can also turn to treatments containing ciclopirox olamine or piroctone olamine. These two antifungal agents are also commonly found in anti-dandruff products. Ciclopirox olamine acts by disrupting the cell membrane of Malassezia and has a notable anti-inflammatory activity to reduce redness and irritation of an inflamed or flaky scalp. Piroctone olamine, on the other hand, inhibits fungal growth by blocking iron metabolism, which is required for the survival of Malassezia, resulting in a gradual reduction of scaling and crusting in the hair. Often well tolerated, these agents can be formulated into shampoos or lotions and represent an appropriate option for relieving seborrheic dermatitis. Several clinical studies, some of which are presented below, attest to the efficacy of piroctone olamine and ciclopirox olamine.
| Study | Participants | Protocol | Results |
|---|---|---|---|
| ROSENMAN & al. (2000) | 82 individuals with seborrhoeic dermatitis. | Application twice weekly for four weeks of a shampoo containing 1% ciclopirox olamine or a placebo. | Resolution or significant improvement was achieved in 93% of participants in the control group, compared with 41% in the placebo group. |
| GOODE & al. (2002) | 154 individuals with dandruff, of whom 70 had seborrhoeic dermatitis. | Apply a shampoo containing 1.5% ciclopirox olamine and 3% salicylic acid, or a shampoo containing 2% ketoconazole, three times a week for four weeks. | Use of the ciclopirox olamine and salicylic acid shampoo resulted in a 22% reduction in dandruff and a 62.5% decrease in the area affected by seborrhoeic dermatitis, compared with a 26% reduction in dandruff and an 80.5% decrease in the dermatitis area with the ketoconazole shampoo. |
| SHARIFI-RAD & al. (2015) | 30 individuals with dandruff. | The shampoo containing plant extracts, 1% piroctone olamine and zinc PCA was used three times a week for five weeks within a two-month period. | Complete elimination of dandruff in 15 patients as early as the 2nd week, in 12 after 4 weeks, and in 3 by the end of the 5th week. |
| PI & al. (2025) | 20 individuals with moderate to severe seborrhoeic dermatitis. | Pre-application every 1–3 days of a gel containing salicylic acid, piroctone olamine and zinc PCA, and a cleansing lotion containing salicylic acid and piroctone olamine for 4 weeks, followed by use of the lotion alone for 12 weeks. | By four weeks, there was a significant reduction in dandruff scores (55.1%), itching (53.2%) and erythema (29%), which was maintained thereafter. Overall clinical improvement was 80%. |
The effects of ciclopirox olamine and piroctone olamine on seborrhoeic dermatitis.
Sources
BERESTON E. S. Use of selenium sulfide shampoo in seborheic dermatitis. Journal of the American Medical Association (1954).
ROSENMAN D. & al. A double-blind, placebo-controlled trial of a ciclopirox olamine 1% shampoo for the treatment of scalp seborrheic dermatitis. Journal of Dermatological Treatment (2000).
JOHNSON B. A. & al. Treatment of seborrheic dermatitis. American Family Physician (2000).
GOODE K. & al. A randomised, single-blind, single-centre clinical trial to evaluate comparative clinical efficacy of shampoos containing ciclopirox olamine (1.5%) and salicylic acid (3%), or ketoconazole (2%, Nizoral ) for the treatment of dandruff/seborrhoeic dermatitis. Journal of Dermatological Treatment (2002).
GUPTA A. K. & al. Seborrheic dermatitis. Journal of the European Academy of Dermatology and Venereology (2004).
SCHWARTZ R. A. & al. Seborrheic dermatitis: An overview. American Family Physician (2006).
SHARIFI-RAD J. & al. Preparation of strong Antidandruff Shampoousing medicinal plant Extracts: A clinical trial and chronic dandruff treatment. Jundishapur Journal of Natural Pharmaceutical Products (2015).
GODSE K. & al. Safety, efficacy and attributes of 2.5% selenium sulfide shampoo in the treatment of dandruff: A single-center study. Cureus (2024).
WEI A. & al. A study on dermatologists’ self-assessment of the efficacy of a 1% selenium disulfide – 0.9% salicylic acid -based shampoo for scalp seborrheic dermatitis. Archives of Dermatological Research (2025).
PI L. & al. A cohort clinical study on the efficacy of topical salicylic acid/piroctone olamine dandruff pre-gel and cleanser in improving symptoms of moderate to severe seborrheic dermatitis of the scalp. Journal of Cosmetic Dermatology (2025).
