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Scalp Eczema, Scalp Psoriasis, Seborrheic Dermatitis, Contact Dermatitis – What's the Difference?
Blog January 19, 2025

Scalp Eczema, Scalp Psoriasis, Seborrheic Dermatitis, Contact Dermatitis – What's the Difference?

Dr. Yeonseung Choe
Dr. Yeonseung Choe
Chief Director

This illustrates the patterns of scalp psoriasis and scalp atopic dermatitis. The left side presents scalp psoriasis, while the right side shows scalp atopic eczema. Scalp psoriasis is characterized by more distinct borders, accompanied by scaling and flaking. In contrast, with atopic dermatitis, eczema can extend to the face and ear areas. The less defined and more 'messy' borders can also be a key differentiating factor.

Psoriasis und Ekzeme am Capillitium

In cases of seborrheic dermatitis of the scalp, dandruff and scaling are characteristically observed.

Atopic Scalp Eczema

In cases of atopy, as it can appear in other areas besides the scalp, please check the skin condition of other body parts as well.

Allergic Contact Dermatitis

The pattern of allergic contact dermatitis looks slightly different.

This is a table comparing scalp psoriasis, seborrheic dermatitis of the scalp, atopic scalp eczema, and contact dermatitis of the scalp, presented alongside the photos above. I was able to find some German resources regarding scalp symptoms.

References

Sticherling, M. (2017). Psoriasis capitis und seborrhoisches Ekzem der Kopfhaut. Der Hautarzt, 68(6), 457–465.

This material was also excerpted from a German resource. This shows the pattern of scalp psoriasis, which is characterized by relatively distinct borders.

Seborrheic Scalp Dermatitis

In seborrheic scalp dermatitis, yellow scales, dandruff flakes, or crusts are observed. It is difficult to consider itching a distinguishing symptom among scalp eczema, scalp psoriasis, and seborrheic scalp dermatitis.

Tinea Capitis

It is accompanied by hair loss. Since chronic scalp inflammation can be a cause of hair loss, it is important to receive appropriate treatment.

Clinical Diagnosis of Common Scalp Disorders

This study summarizes various skin symptoms commonly observed on the scalp. Representative symptoms include dandruff, seborrheic scalp dermatitis, tinea capitis, and scalp psoriasis. It will be necessary to differentiate by checking various factors such as age, Wood's lamp examination, itching, scaling, inflammation, and hair loss.

Scalp skin diseases are often quite challenging to treat, and the course of treatment can be prolonged. Furthermore, hair loss due to chronic inflammation can cause significant stress for patients, making it essential to ensure consistent and appropriate treatment.

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Dr. Yeonseung Choe

Dr. Yeonseung Choe Chief Director

I have met many patients who came after visiting multiple medical institutions and departments for persistent or recurrent conditions. Symptoms normally handled by different specialties—such as abdominal pain, headaches, palpitations, dizziness, and insomnia—may overlap in one person. Sometimes there is no clear improvement despite taking medication for each symptom, and being unwell gradually becomes part of daily life. In these cases, I look beyond individual diagnoses and examine how the symptoms connect and change together. Asking only about the most uncomfortable symptom today does not reveal the full course. I look at when the body first began to change and what happened after illness, surgery, childbirth, or starting and stopping medication. I also review changes in weight, diet, and sleep, then trace which symptoms improved with previous treatment and which remained. Test results, diagnoses, and the course of previous treatment are important for understanding the current condition. Clinical research in modern Korean medicine, physiological and pathological research in modern medicine, and observations recorded in classical Korean medicine texts offer different perspectives on the same body. Rather than fitting a patient into one perspective, I consider what each can and cannot explain and look for clues that connect symptoms and treatment histories that were previously considered separately.

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