• image.alt
  • With Mayo Clinic dermatologist

    Lawrence E. Gibson, M.D.

    read biography

Mayo Clinic Health Manager

Get free personalized health guidance for you and your family.

Get Started

Free

E-Newsletter

Subscribe to receive the latest updates on health topics. About our newsletters

  • Housecall
  • Alzheimer's caregiving
  • Living with cancer

Question

Scalp psoriasis vs. seborrheic dermatitis: What's the difference?

How does a doctor tell the difference between scalp psoriasis and seborrheic dermatitis of the scalp?

Answer

from Lawrence E. Gibson, M.D.

Scalp psoriasis and seborrheic dermatitis of the scalp can be difficult to differentiate. Both are common conditions that affect the scalp. In addition, they share similar signs and symptoms, such as itchy, red, scaly skin.

Most often, the scales of psoriasis are thicker and somewhat drier in appearance than are the scales of seborrheic dermatitis. In addition, psoriasis usually affects more than one area of the body. If you have scalp psoriasis, you may also have mild psoriasis on your elbows, knees, hands or feet or may notice subtle nail changes.

Compare signs and symptoms
Scalp psoriasisSeborrheic dermatitis of the scalp
  • Red patches of skin covered with silvery scales
  • Silvery white scales that may attach to the hair shaft.
  • Patchy scaling or thick crust on the scalp that may bleed when removed
  • Patches may extend beyond hairline
  • Itching or soreness
  • Red, greasy skin covered with flaky white or yellow scales
  • Yellow or white scales that may attach to the hair shaft
  • Patchy scaling or thick crust on the scalp that may be easily removed
  • Patches usually confined by hairline
  • Itching, which may be severe

No single test confirms a diagnosis of psoriasis or seborrheic dermatitis. Your doctor usually makes a diagnosis with a visual examination of the affected skin. Fortunately, scalp psoriasis and seborrheic dermatitis of the scalp share some similar treatments, including:

  • Over-the-counter medicated shampoos, such as those containing ketoconazole, tar or salicylic acid
  • Ointment, gel or foam preparations, such as those containing tar products, corticosteroids or vitamin D analogues
  • Mineral oil or an oil-based preparation applied to the scalp at night — and covered with a shower cap — to loosen scales and reduce inflammation

Scalp psoriasis is often persistent and more difficult to treat than seborrheic dermatitis. For stubborn cases of scalp psoriasis, your doctor may prescribe oral medications, such as methotrexate or cyclosporine, or combine stronger medications with medicated creams and ointments.

Next question
White patch on skin: A cause for concern?
References
  1. Habif TP. Psoriasis and other papulosquamous diseases. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 4th ed. Philadelphia, Pa.: Mosby; 2004. http://www.mdconsult.com/das/book/body/151181644-3/0/1195/45.html?tocnode=51440575&fromURL=45.html#4-u1.0-B0-323-01319-8..50010-8_728. Accessed July 23, 2009.
  2. Plewig G, et al. Seborrheic dermatitis. In: Wolff K, et al. Fitzpatrick's Dermatology in General Medicine. 7th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2951940. Accessed July 8, 2009.
  3. Naldi L, et al. Seborrheic dermatitis. New England Journal of Medicine. 2009;360:387.

AN01177

Oct. 20, 2009

© 1998-2009 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Reliable tools for healthier lives," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

Print Share Reprints

Text Size: smaller largerlarger