Is seborrhoeic dermatitis contagious?

No. Seborrhoeic dermatitis is an inflammatory skin reaction to a normal skin yeast (Malassezia) — it is not an infection and cannot be passed from person to person. Sharing towels, pillows, hairbrushes or cosmetics with someone who has it carries no transmission risk.

Is it caused by poor hygiene?

No. Hygiene has nothing to do with developing seborrhoeic dermatitis. Some patients actually do better with slightly more frequent shampooing — not because hygiene is the problem, but because allowing oil and scale to build up between washes can worsen scalp symptoms. The condition affects clean and well-groomed people just as readily as anyone else.

Will it ever go away completely?

Seborrhoeic dermatitis is a chronic relapsing condition — it tends to come and go in cycles rather than disappearing permanently. The realistic goal is durable control with a maintenance schedule. Many patients keep it quiet for years on simple twice-weekly medicated shampoo plus an intermittent facial routine.

Do I need to wash my hair more often?

Often yes. Infrequent washing allows oil and scale to build up and worsens dandruff for many patients. The frequency depends on your hair type — daily for fine straight hair, two to three times per week for thick or coiled hair — but consistency with the medicated shampoo matters more than the absolute frequency.

Are topical steroid creams the best option for facial seborrhoeic dermatitis?

Topical steroids work quickly, but repeated use on the face and eyelids is not ideal because the skin in those areas is vulnerable to atrophy, telangiectasia and pigmentation changes from chronic steroid exposure. Steroid-sparing anti-inflammatory creams (pimecrolimus and tacrolimus) are usually preferred for ongoing control of facial seborrhoeic dermatitis, with topical antifungals during flares.

How can I tell the difference between seborrhoeic dermatitis and rosacea?

Both can produce facial redness and the two often overlap. Seborrhoeic dermatitis typically has fine flaking and scale in oily zones (around the nose, eyebrows, eyelids and along the hairline) and is worse in cold weather. Rosacea is dominated by persistent redness, episodic flushing and visible blood vessels across cheeks and central face, often without flaking. The facial flaking guide walks through how these are distinguished in clinic.

My scalp itches but I do not see flakes — could this still be seborrhoeic dermatitis?

Yes. Itch can precede visible flaking in some patients, and inflammation may be present even when scale is not obvious. Conversely, dandruff without itch is also common. The diagnosis is based on the overall pattern (oily-zone distribution, flare-and-settle cycle, response to medicated shampoo) rather than any single feature.

Do I need a referral?

No referral is required. You can book directly. A referral from your GP or treating clinician is welcome — it helps with collegial communication and continuity of care — but is not a barrier to accessing the service. Both clinics (Ivanhoe and Diamond Creek) operate the same pathway.

Inflammatory skin — flaking

Seborrhoeic Dermatitis

Name: Seborrhoeic Dermatitis Melbourne — Doctor-led Diagnosis
Published: 2026-06-06

Seborrhoeic dermatitis is a very common inflammatory condition causing flaky, red, irritated skin in oily areas — most often the scalp (dandruff), face (around the nose, eyebrows and eyelids), ears and sometimes the chest. It is not contagious and is not caused by poor hygiene. It tends to flare and settle in cycles, and most people can control it very well once they have a clear plan for scalp management (the "shampoo protocol") and facial maintenance (a simple, steroid-sparing plan).

By Dr Christopher Irwin, MBChB, FRACGP, MMed (Skin Cancer), FACAM, MSCCA

Last reviewed 2026-06-06 · Editorial policy

In brief

Seborrhoeic dermatitis is usually controlled with consistent maintenance, not one-off treatment.
For scalp, the biggest wins come from using medicated shampoos correctly — frequency, leave-on time and rotating actives.
For face and eyelids, steroid-sparing anti-inflammatory creams (pimecrolimus, tacrolimus) are usually preferred over repeated topical steroid use.
Seborrhoeic dermatitis overlaps with rosacea, peri-orificial dermatitis, contact dermatitis and psoriasis — diagnosis changes the plan.
In darker skin tones, redness may be subtle and pigment changes may surround affected areas.
Cradle cap in infants is the same condition and is usually harmless and self-limiting.
Parkinson's disease and HIV are well-described background associations — relevant in atypical or treatment-resistant presentations.
Itch can occur without visible flaking, and dandruff can occur without itch — diagnosis is based on the overall pattern.
Pure mineral sunscreens are usually better tolerated than chemical filters during a facial flare.

Quick definition

Seborrhoeic dermatitis is a very common inflammatory skin condition that produces flaky, red, irritated skin in oily areas — most often the scalp (dandruff), face (around the nose, eyebrows and eyelids), ears and sometimes the chest. It is an inflammatory reaction to a normal skin yeast (Malassezia) — not an infection and not caused by poor hygiene. It tends to flare and settle in cycles, particularly with cold weather, stress and fatigue. Most patients can control it well with a scalp protocol (medicated anti-dandruff shampoo) and a face protocol (antifungal plus steroid-sparing anti-inflammatory cream). Long-term success comes from a maintenance schedule rather than chasing one-off treatment.

Seborrhoeic dermatitis is a very common condition that causes flaky, red, irritated skin in oily areas — most often the scalp (dandruff), face (around the nose, eyebrows and eyelids), ears, and sometimes the chest. ^(1–4)

It is not contagious and is not caused by poor hygiene. It tends to flare and settle in cycles, and most patients can control it very well once they have a clear plan for scalp management (the shampoo protocol) and facial maintenance (a simple steroid-sparing plan). ^(1–4)

What is seborrhoeic dermatitis?

Seborrhoeic dermatitis is inflammation in areas with many oil glands. A normal skin yeast called Malassezia plays a major role — in susceptible people it triggers inflammation and scaling. ^(1–4)

It commonly affects:

scalp — dandruff or thicker scale
face — sides of the nose (nasolabial folds), eyebrows, eyelids, beard area
ears — behind ears and within ear folds
chest — centre of chest or sternum
skin folds — occasionally

Common symptoms and where it appears

Scalp (dandruff)

white flakes or greasy yellow scale
itch and tightness
worse with stress, winter and infrequent washing

Face

redness and flaking around the nose
eyebrow and eyelid scale
beard area scale in some men
behind ears and ear folds

Chest

red patches with fine scale on the sternum

Seborrhoeic dermatitis can look different across skin tones. In darker skin types, redness may be less obvious and there may be lighter or darker patches around affected areas. ^(2–4)

Why it flares (common triggers)

Most patients notice flare patterns with:

winter or dry weather
stress and fatigue
illness
oily skin
irritating skincare or hair products
infrequent scalp washing — scale builds up ^(1–4)

The goal is not to eliminate every trigger. It is to have a plan that keeps you stable when life happens.

The Scalp Protocol (dandruff shampoo plan)

For most adults, scalp control comes down to:

choosing a medicated anti-dandruff shampoo
using it 2 to 3 times per week initially
leaving it on for 3 to 5 minutes before rinsing
stepping down to a maintenance schedule once stable ^(2–4)

Common active ingredients include:

ketoconazole
zinc pyrithione
selenium sulfide
coal tar
salicylic acid plus sulfur
piroctone olamine ^(2–4)

For the step-by-step scalp plan, see the daily scalp routine for dandruff.

The Face Protocol (nose, eyebrows, eyelids)

Facial seborrhoeic dermatitis tends to respond best to:

an antifungal cream during flares
plus a steroid-sparing anti-inflammatory cream for sensitive areas (especially eyelids and face)
plus simple barrier-friendly skincare ^(2–4)

For the step-by-step facial plan, see the facial seborrhoeic dermatitis plan.

When it might not be seborrhoeic dermatitis

If you are not improving as expected, consider overlap or misdiagnosis:

if the main feature is flushing, burning or redness with triggers like heat, alcohol or spicy food, consider rosacea ⁽⁵⁾
if the rash is bumpy around the mouth, nose or eyes and steroids worsen it, consider peri-orificial dermatitis ^(6,7)

The treatment pathway differs — so it is worth checking rather than persisting with the wrong plan. The facial flaking guide walks through these differentials in detail.

Cradle cap (infants)

In babies, seborrhoeic dermatitis is called cradle cap. It looks like thick yellow or brown scale on the scalp and is usually harmless and not itchy. It often resolves with gentle care. ^(2–4)

For the at-home approach, see the cradle cap guide.

When to see a doctor

Book a review if:

you have used medicated shampoos correctly for 3 to 4 weeks with minimal improvement
facial or eyelid dermatitis is persistent, sore or recurrent
you are getting frequent flares requiring steroid cream
the diagnosis is uncertain — psoriasis, fungal infection, rosacea, peri-orificial dermatitis or contact allergy ^(2–7)

Seborrhoeic dermatitis toolkit

Deeper-dive patient articles covering specific facets of management:

If your main problem is facial redness or flushing, see rosacea. If your main problem is small bumps around the mouth, nose or eyes — especially if steroids made it worse — see peri-orificial dermatitis.

Book a seborrhoeic dermatitis appointment

If you are dealing with persistent dandruff, facial flaking or recurrent eyelid or eyebrow scaling, the booking panel in the sidebar takes you to an appointment with Dr Chris Irwin at Ivanhoe or Diamond Creek. Both clinics operate the same patient pathway:

Ivanhoe — Unit 1/1065 Heidelberg Road, Ivanhoe VIC 3079
Diamond Creek — Shop 12/67 Main Hurstbridge Road, Diamond Creek VIC 3089

Symptoms

Scalp — white or grey flakes (dandruff), or thicker yellow-greasy scale; itch and a tight feeling.
Face — redness and fine flaking on the sides of the nose (nasolabial folds), eyebrows, eyelids and along the hairline.
Beard area — scale and irritation through the moustache and beard in men with facial hair.
Ears — flaking and itch behind the ears and within the ear folds; occasionally in the external ear canal.
Chest — pink or red patches with fine scale across the centre of the chest (sternum).
Skin folds — occasionally affects the armpits, groin or under the breasts in some patients.
Worsens with cold weather, indoor heating, stress, fatigue and illness; often quieter in summer.
In darker Fitzpatrick skin types, redness may be subtle and lighter (hypopigmented) or darker (hyperpigmented) patches may surround affected areas.

Causes & contributors

Inflammation in areas with many oil glands (sebaceous-rich zones — scalp, face, chest).
Malassezia yeast (a normal skin organism) triggering inflammation in susceptible patients.
Cold, dry weather and indoor heating.
Stress, fatigue and illness — particularly during high-pressure periods.
Oily skin and high sebum production.
Irritating skincare or hair products (fragrances, alcohol-heavy formulations, harsh actives).
Infrequent scalp washing allowing scale and sebum to build up.
Background medical conditions and immunosuppression — Parkinson's disease and HIV are well-described associations.

Diagnosis

Seborrhoeic dermatitis is diagnosed clinically. Accurate diagnosis matters because it commonly overlaps with — or is mistaken for — rosacea, peri-orificial dermatitis, contact dermatitis and psoriasis, and the treatment pathway differs meaningfully between these conditions. If your face doesn't respond as expected to standard seborrhoeic dermatitis treatment, reassessment is worthwhile. The pattern (oily-zone distribution, dandruff history, flares with cold weather and stress) is usually distinctive enough on examination that biopsy is rarely required.

Treatment options

Scalp protocol — medicated shampoos

Choose a medicated anti-dandruff shampoo (ketoconazole, zinc pyrithione, selenium sulfide, coal tar, salicylic acid plus sulfur, or piroctone olamine), use it 2 to 3 times per week initially, leave on for 3 to 5 minutes before rinsing, then step down to a maintenance schedule once stable. Rotating between two active ingredients can help if response plateaus.

Facial protocol — antifungal cream

A topical antifungal cream during flares to address Malassezia overgrowth on the face. Typically applied once or twice daily during a flare, then reduced to intermittent maintenance use.

Facial protocol — steroid-sparing anti-inflammatory

Pimecrolimus or tacrolimus for sensitive sites (face and eyelids) rather than repeated topical steroid use. Important for long-term safety because facial skin and eyelid skin are vulnerable to atrophy and pigmentation changes from chronic steroid use.

Barrier-friendly skincare

Simple, fragrance-free skincare that supports the skin barrier and avoids irritants that perpetuate inflammation. Pure mineral sunscreens are often better tolerated than chemical filters during a flare.

Cradle cap care (infants)

In babies, seborrhoeic dermatitis is called cradle cap. Thick yellow or brown scale on the scalp, usually harmless and not itchy. Gentle softening with mineral or vegetable oil, then a soft brush, then a gentle baby shampoo is usually all that is required. Persistent or widespread involvement deserves review.

Maintenance plan

Most patients keep seborrhoeic dermatitis quiet with a maintenance schedule rather than one-off treatment. Consistency is what prevents relapse — typically twice-weekly medicated shampoo and intermittent topical maintenance on the face.

When to see a doctor

Book a review if you have used medicated shampoos correctly for 3 to 4 weeks with minimal improvement; if facial or eyelid dermatitis is persistent, sore or recurrent; if you are getting frequent flares requiring topical steroid cream; or if the diagnosis is uncertain — psoriasis, fungal infection, rosacea, peri-orificial dermatitis or contact allergy may mimic seborrhoeic dermatitis and the treatment pathway differs. Earlier review is also worth considering if eyelid involvement is prominent (blepharitis can coexist) or if there is widespread scalp or body involvement that has not responded to over-the-counter shampoos.

Frequently asked questions

Is seborrhoeic dermatitis contagious?

No. Seborrhoeic dermatitis is an inflammatory skin reaction to a normal skin yeast (Malassezia) — it is not an infection and cannot be passed from person to person. Sharing towels, pillows, hairbrushes or cosmetics with someone who has it carries no transmission risk.
Is it caused by poor hygiene?

No. Hygiene has nothing to do with developing seborrhoeic dermatitis. Some patients actually do better with slightly more frequent shampooing — not because hygiene is the problem, but because allowing oil and scale to build up between washes can worsen scalp symptoms. The condition affects clean and well-groomed people just as readily as anyone else.
Will it ever go away completely?

Seborrhoeic dermatitis is a chronic relapsing condition — it tends to come and go in cycles rather than disappearing permanently. The realistic goal is durable control with a maintenance schedule. Many patients keep it quiet for years on simple twice-weekly medicated shampoo plus an intermittent facial routine.
Do I need to wash my hair more often?

Often yes. Infrequent washing allows oil and scale to build up and worsens dandruff for many patients. The frequency depends on your hair type — daily for fine straight hair, two to three times per week for thick or coiled hair — but consistency with the medicated shampoo matters more than the absolute frequency.
Are topical steroid creams the best option for facial seborrhoeic dermatitis?

Topical steroids work quickly, but repeated use on the face and eyelids is not ideal because the skin in those areas is vulnerable to atrophy, telangiectasia and pigmentation changes from chronic steroid exposure. Steroid-sparing anti-inflammatory creams (pimecrolimus and tacrolimus) are usually preferred for ongoing control of facial seborrhoeic dermatitis, with topical antifungals during flares.
How can I tell the difference between seborrhoeic dermatitis and rosacea?

Both can produce facial redness and the two often overlap. Seborrhoeic dermatitis typically has fine flaking and scale in oily zones (around the nose, eyebrows, eyelids and along the hairline) and is worse in cold weather. Rosacea is dominated by persistent redness, episodic flushing and visible blood vessels across cheeks and central face, often without flaking. The facial flaking guide walks through how these are distinguished in clinic.
My scalp itches but I do not see flakes — could this still be seborrhoeic dermatitis?

Yes. Itch can precede visible flaking in some patients, and inflammation may be present even when scale is not obvious. Conversely, dandruff without itch is also common. The diagnosis is based on the overall pattern (oily-zone distribution, flare-and-settle cycle, response to medicated shampoo) rather than any single feature.
Do I need a referral?

No referral is required. You can book directly. A referral from your GP or treating clinician is welcome — it helps with collegial communication and continuity of care — but is not a barrier to accessing the service. Both clinics (Ivanhoe and Diamond Creek) operate the same pathway.

References

Related conditions

Medically reviewed by Dr Christopher Irwin, MBChB, FRACGP, MMed (Skin Cancer), FACAM, MSCCA · Last reviewed 2026-06-06 · Editorial policy