Seborrheic Dermatitis of the Scalp: A Review (2015–2025)

AbstractSeborrheic dermatitis of the scalp (SSD) is a chronic, relapsing inflammatory skin disorder characterized by erythema, greasy scaling, and pruritus, which considerably affects patients’ quality of life due to its visibility. Its pathogenesis is multifactorial, involving Malassezia overgrowth, scalp microbiome dysbiosis, impaired skin barrier function, and both immunogenetic and environmental factors. This review comprehensively summarizes current knowledge (2015–2025) regarding the pathogenesis, established therapeutic approaches, and emerging treatment strategies for SSD, based on a systematic analysis of clinical studies. A systematic literature search was conducted in the PubMed database using MeSH terms “Dermatitis, Seborrheic,” “Scalp,” “Malassezia,” “Disease Management,” and “Treatment Outcome.” Only full-text English-language articles published between October 2015 and January 2025 were included, focusing on adult patients diagnosed with scalp seborrheic dermatitis in interventional or observational studies assessing clinical outcomes such as erythema, scaling, pruritus, and microbiological changes. Eleven studies met the inclusion criteria. The analyzed research evaluated interventions including traditional antifungals (e.g., ketoconazole, selenium disulfide), anti-inflammatory agents (e.g., glycyrrhetinic acid, statins), keratolytics, botanical formulations, and microbiome-modulating products. Most treatments resulted in significant symptom improvement with minimal adverse effects. Reported mechanisms included reduction of Malassezia species, attenuation of inflammatory pathways, restoration of epidermal barrier integrity, and rebalancing of the scalp microbiota. Effective SSD management requires a multimodal approach: while topical antifungals and corticosteroids remain foundational, emerging therapies such as microbiome modulation, corticosteroid-sparing regimens, and biomarker-guided strategies show promise for long-term control. Future research should prioritize personalized treatment plans that integrate patient preferences, microbiological profiling, and objective biomarkers of therapeutic response. Keywords—Dermatitis, Seborrheic, Scalp, Disease Management, Treatment Outcome