Does Seborrhiec Dermatitis (Dandruff) Spread?

Ask dermatologist and skin care blogger dr baileyHello Dr. Bailey,

I am curious about the potential of seborrheic dermatitis (dandruff) to spread.  If it does spread then can you tell me how this happens?  Also, if someone has it in one place, is it likely they will get it in another?

Thank you,  Rebecca B

Hello Rebecca,

Seborrheic dermatitis (aka dandruff) spreads out from its areas of initial involvement, but it’s not because of contagion. Like many rashes, dandruff starts small and gets bigger.  We don’t know what causes seborrheic dermatitis and so we don’t know why it does what it does when it does it….. it’s just what it does.  We do know that it’s more likely to do it now in the winter though.

Dandruff usually occurs on the scalp where it’s important to differentiate it from ‘ring worm’ of the scalp (fungus infection), psoriasis and other more ‘exotic’ scalp rashes. For my patients with scalp seborrhea I start treatment with my zinc pyrithione shampoo and body cleanser called OTB SKIN Medicated Cleanser #2.

OTB SKIN Medicated Cleanser #2

professional strength dandruff shampoo

This is a great professional strength, medicated shampoo as well as a back and chest acne cleanser.  If the medicated pyrithione zinc alone doesn’t do the trick then we rotate through 3 different medicated shampoo ingredients as I outlined in my scalp dandruff treatment post titled Remedies For The Dry Itchy Scalp Of Seborrheic Dermatitis. In that post I also explain how to use medicated shampoos most effectively for successful dandruff treatment.  It’s worth having a look at that post if you have scalp dandruff.

On the face, dandruff usually starts around the nose, eyebrows and chin. It works out from there to the forehead, mid cheeks and in front of the ears.  It’s often mistaken as skin dryness because of the flaking.  People tend to put gobs of moisturizer on the rash, to no avail.  Treatment needs to target the rash and my favorite way to do this is with the products in my Facial Redness Relief Kit.

Facial Redness Relief Kit

Skin Care for Facial redness relief

I have additional skin care suggestions for facial dandruff and you can find them in my post titled Dr. Cynthia Bailey’s Tips For Facial Seborrheic Dermatitis Control.

Dandruff can also involve the mid chest and back and even the skin folds.  For chest and back treatment I usually recommend the same OTB Medicated Cleanser/Shampoo #2 treatment applied with a Body Buf Puf Sponge with Handle.

Buf Puf Body Sponge

As for the evolution of a typical case of dandruff (seborrheic dermatitis), in most cases the rash starts as dryness and itch on the scalp, then the face jumps in, then the back and chest.  I rarely see it in the body folds though.  Even though it seems like the rash is ‘spreading’ it’s really just the rash getting worse and ‘evolving’.

I hope that helps your understanding of this common and frustrating skin problem.  I also hope it gives you some ideas about the treatment approaches that I recommend to my dermatology patients who have dandruff.

Warm Regards,

Cynthia Bailey MD, Dermatologist

If you have questions about skin care or skin health please send them to me using the Contact Dr. Bailey button at the top of the page.

Disclaimer: Please realize that availing yourself of the opportunity to submit and receive answers to your questions from Dr. Bailey does not confer a doctor/patient relationship with Dr. Bailey. The information provided by Dr. Bailey is general health information inspired by your question. It should not be a substitute for obtaining medical advice from your physician and is not intended to diagnose or treat any specific medical problem (and is not an extension of the care Dr. Bailey has provided in her office for existing patients of her practice). Never ignore your own doctor’s advice because of something you read here; this information is for general informational purpose only

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2 Responses to “Does Seborrhiec Dermatitis (Dandruff) Spread?”

  1. Ginger Smith December 27, 2011 at 8:12 am #

    Thanks again for all the information. I will read and digest it for some time to come. I have seborrheic dermatitis everywhere possible, and have found putting a dab of vitamin E oil gently across my eyelids before bed really helps break up the crusting and replenishes some of the oils that are lost. Do this only before bed as vision will be blurry for awhile. I had been using this oil for years on my face, and tried it one night on my eyelids. I DO NOT put this in the eyes, just on the lashes. I was very pleased with the results!

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