Persistent flaking, itching, and greasy red patches on your scalp, eyebrows, sides of the nose, or ears are almost always seborrheic dermatitis — a common, non-contagious condition driven by normal skin yeast. It can't be cured but is usually well controlled with medicated antifungal shampoo and, for facial patches, a short course of antifungal or anti-inflammatory cream. For typical adult cases, a licensed clinician can review your photos online and send the right prescription to your pharmacy.
Seek emergency care if: a rash spreads rapidly with fever, blistering, skin peeling, or the eye itself becomes red and painful — these point to something more serious than seborrheic dermatitis and need in-person care.
See a clinician nowWhat seborrheic dermatitis actually is
Seborrheic dermatitis is a chronic, relapsing skin condition that affects areas rich in oil glands — the scalp, eyebrows, the creases beside the nose, behind the ears, and sometimes the chest. On the scalp in its mildest form it's simply called dandruff. It produces flaky white or yellowish scale, often on a slightly red, greasy-looking base, and it can itch or burn.
It is linked to an overgrowth of Malassezia, a yeast that lives normally on everyone's skin, together with how your skin reacts to it. That means it is not caused by poor hygiene and is not contagious — it's a constitutional tendency that flares with stress, cold dry weather, and sometimes underlying health conditions.
What it looks like — common signs
If these describe what you're experiencing and you have no red flags, telehealth is a reasonable next step:
What to do right now
Most flares respond to a consistent routine you can start today:
- Use a medicated shampoo with ketoconazole, zinc pyrithione, selenium sulfide, or coal tar — lather, leave on the scalp for several minutes, then rinse.
- Use it regularly during a flare (often two to three times a week), then less often to maintain control.
- For facial patches, a gentle cleanser and a thin layer of an antifungal cream can help; avoid harsh scrubbing.
- Moisturize dry skin and avoid very hot water, which can worsen irritation.
- Manage triggers — stress and lack of sleep commonly set off flares.
It isn't about cleanliness — it's your skin reacting to normal yeast. The goal is steady control, not a one-time cure.
How a clinician can help online
For typical scalp and facial seborrheic dermatitis in adults, telehealth works well. A clinician reviews your symptoms and photos, confirms the pattern, and can prescribe a stronger antifungal shampoo, a topical antifungal cream (such as ketoconazole), or a brief course of a low-strength topical steroid or a non-steroidal anti-inflammatory cream to calm a stubborn flare. They'll also set up a simple maintenance plan so it stays controlled.
Telehealth is NOT the right path for: a rash that is rapidly spreading, blistering, or peeling; a painful red eye; signs of skin infection (increasing warmth, pus, fever); seborrheic dermatitis in an infant that isn't improving; or anyone who is immunocompromised — these need in-person evaluation.
How seborrheic dermatitis is treated
Treatment is aimed at reducing yeast and calming inflammation. Antifungal shampoos and creams (ketoconazole, ciclopirox, selenium sulfide, zinc pyrithione) are the backbone. Short courses of low-strength topical steroids or topical calcineurin inhibitors can quickly settle redness and itch, especially on the face, where strong steroids are avoided. Because the condition recurs, most plans include ongoing maintenance with intermittent medicated shampoo.
How long does it last?
A single flare usually improves within a couple of weeks of starting the right treatment. The condition itself is chronic and tends to recur, especially in winter or during stress, so the realistic goal is good long-term control with a simple maintenance routine rather than a permanent cure.
Frequently asked questions
Is seborrheic dermatitis the same as dandruff?
Dandruff is the mild, flaky scalp form. When flaking comes with redness, itching, or patches on the face, eyebrows, or ears, it's generally called seborrheic dermatitis. Both respond to the same treatments.
What causes it?
An overgrowth of Malassezia yeast that lives normally on skin, plus your skin's inflammatory response. It's not from poor hygiene and isn't contagious. Stress and cold, dry weather trigger flares.
Can it be treated online?
Yes. For typical adult cases, a clinician can review your symptoms and photos online and prescribe antifungal shampoo, a topical antifungal, or a short course of anti-inflammatory cream when appropriate.
Does it ever go away?
It's chronic and comes and goes. It can't be permanently cured, but most people keep it clear or nearly clear with intermittent treatment and a maintenance routine.
What shampoo helps?
OTC shampoos with ketoconazole, zinc pyrithione, selenium sulfide, or coal tar are first-line. If they aren't enough, a clinician can prescribe a stronger antifungal shampoo or anti-inflammatory.