Medical dermatology

Hair & Scalp Disorders

Dandruff, seborrheic dermatitis of the scalp, scalp psoriasis, and more — expert diagnosis and treatment for a healthy scalp and hair.

Common Scalp Conditions We Treat

Seborrheic dermatitis / Dandruff — chronic, flaky, greasy scaling with itching; managed with antifungal shampoos and topical steroids
Scalp psoriasis — thick, silvery plaques with defined borders; often extends beyond the hairline
Tinea capitis (scalp ringworm) — fungal infection common in children; requires systemic antifungal (griseofulvin, terbinafine)
Folliculitis — infected or inflamed hair follicles; bacterial or fungal
Scalp acne (acne keloidalis nuchae) — papules and plaques at the nape of the neck, more common in men with coarse hair
Scalp pruritus — itchy scalp from multiple causes including neuropathic, contact, or inflammatory origins

Diagnostic Approach

History, dermatoscopy, and, when needed, skin scraping for KOH prep or culture to identify fungal organisms.

Treatment

Tailored to the specific diagnosis. Prescription-strength medicated shampoos, topical anti-inflammatories, intralesional corticosteroids, and oral antifungals or antibiotics as appropriate.

Frequently asked questions

What's the difference between dandruff and scalp psoriasis?

Dandruff (seborrheic dermatitis) produces fine, greasy flakes and mild redness without sharp borders. Scalp psoriasis causes thick, silvery-white plaques with well-defined edges, often extending onto the forehead and ears. A dermatologist can distinguish them clinically and with dermoscopy.

Most insurance plans cover medical dermatology procedures. Contact us to verify your benefits.

Trusted sources

AAD — Scalp conditions

This page is educational. Specific treatment decisions are made during your visit with Dr. Puyana.

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