When you aren’t sure whether you have scalp psoriasis or a related condition called seborrheic dermatitis, you might have sebopsoriasis — which is essentially the overlap of the two conditions with symptoms from both. A doctor may initially diagnose you with sebopsoriasis, then change the diagnosis to psoriasis or seborrheic dermatitis, depending on how your symptoms evolve.

Members of MyPsoriasisTeam wonder about sebopsoriasis. “Need help and information on the treatment of sebopsoriasis,” wrote one member. “I think, from reading about pustular psoriasis, that some of that is also beginning on my scalp. Dermatology treatments do not really help a lot, and it continues to get worse.”

Another member shared, “I was diagnosed with sebopsoriasis in June. I get scalp psoriasis on my scalp and neck in the winters. I get large red plaques on my neck that I still have scars from. … It occurs near my hairline, my two temples, near my sideburns, to my ears, under my jaw, and to my neck. It gets so patchy and itchy, it’s the worst. Then it peels, and I get relief until the next morning. It gets red and looks like round areas. It’s very scaly but does not look like typical psoriasis.”

If you relate to these anecdotes, you might be curious to learn more about sebopsoriasis. Having a mix of recognizable and unrecognizable symptoms can be confusing. The following points can help you better understand sebopsoriasis and how it is related to both scalp psoriasis and seborrheic dermatitis.

What Is Sebopsoriasis?

Sebopsoriasis is often a transitional condition between scalp psoriasis and seborrheic dermatitis, rather than a distinct condition. A doctor may initially diagnose you with sebopsoriasis, then watch how your symptoms develop and respond to different treatments.

Characterizing features of sebopsoriasis, according to DermNet, include:

• Yellowish, greasy scales behind the ears and on the scalp, nasolabial folds (the lines from your nose down to each side of your mouth), eyebrows, and sternum
• Thicker scales than those commonly seen in seborrheic dermatitis, with darker red, more defined margins
• Scales that appear less silver than is typical in psoriasis

Sebopsoriasis is most common either in children and adolescents or in people ages 50 and older. Men typically get the condition more often than women, according to DermNet.

What Are Common Symptoms of Sebopsoriasis?

Symptoms of sebopsoriasis are a combination of those from psoriasis and seborrheic dermatitis. Symptoms that may indicate sebopsoriasis, beyond those mentioned above, include:

• Inflamed skin
• Crusty patches
• Flakes that are both white and silver — Dandruff from seborrheic dermatitis tends to be white, while the flaking from psoriasis tends to appear silver. Thus, seeing a mix of both could indicate sebopsoriasis.
• Scales or flakes on both your scalp and back
• Itching

A person may also have symptoms that indicate a higher likelihood of scalp psoriasis or seborrheic dermatitis. Skin patches that appear oily suggest scalp psoriasis. On the other hand, dandruff alone may point to seborrheic dermatitis instead of scalp psoriasis.

Additionally, flakes that are only white could indicate seborrheic dermatitis, while silvery scales suggest psoriasis.

How Is Sebopsoriasis Diagnosed?

Your doctor should be able to determine whether you have scalp psoriasis, seborrheic dermatitis, or sebopsoriasis just by examining your skin. They likely won’t need to perform a biopsy (remove a skin sample to look at under a microscope) or other more invasive procedures.

Your doctor might also check whether your symptoms have spread beyond your scalp. Psoriasis tends to extend beyond the hairline to the face or the rest of your body — especially areas that have skin folds causing friction.

Seborrheic dermatitis, however, can also develop on the chest, under the breasts, or in the armpits and groin area.

Your doctor might also look for changes in your nails, like pitting, which can be symptoms of psoriasis.

A diagnosis of sebopsoriasis may be changed to psoriasis or seborrheic dermatitis if you develop more distinct symptoms of one or the other.

How Is Sebropsoriasis Treated and Managed?

Medicated shampoos are used to treat both plaque psoriasis and seborrheic dermatitis, so they can make good treatments for people with sebopsoriasis.

One MyPsoriasisTeam member wrote, “Just starting and my scalp is driving me nuts. Losing bits of hair from the scaly stuff on my scalp. Been using Head & Shoulders anti-itch and T/Gel.”

Some ingredients to look for in medicated shampoos are:

• Coal tar
• Salicylic acid
• Zinc pyrithione
• Ketoconazole (an antifungal)
• Selenium sulfide
• Coconut oil

Over-the-counter ointments can also help. Ointment ingredients to look for include:

• Salicylic acid
• Hydrocortisone
• Coal tar

Topical corticosteroid lotions can also bring relief, though applying them to the scalp can be difficult if hair gets in the way. Corticosteroids are usually applied in small amounts locally to the affected skin. On the scalp, apply topical corticosteroids in the direction your hair grows.

When buying shampoos or topical treatments over the counter, look for products with the National Psoriasis Foundation Seal of Recognition. This indicates that they’re generally safe for use by people with psoriasis and related skin conditions.

If your symptoms are particularly severe, your doctor might try a stronger treatment, such as biologic drugs, which target certain cells in your immune system. Depending on your condition, they may prescribe topical calcineurin inhibitors, such as tacrolimus (Protopic) and pimecrolimus (Elidel), or systemic medications like methotrexate (Otrexup, Rasuvo, or Trexall). Getting additional vitamin D through phototherapy or a drug like calcipotriene (Dovonex) may also help.

“I started Taltz 6 weeks ago — starting to get a little change for better with the scalp🤨,” shared one member.

Whatever treatment you try, make sure to update your health care provider about your symptoms so that they can tailor your care as best they can.

Advice From MyPsoriasisTeam Members

Some home remedies may help relieve certain symptoms, like itchiness. One member wrote about how they manage symptoms beyond using Wild Naturals hair products and body wash and Head & Shoulders shampoo. “I try to stay hydrated and use moisturizer on my skin. I have found that stress and chocolate make my psoriasis flare. You might find different foods cause a trigger.”

Other MyPsoriasisTeam members have shared their skin care strategies, such as these:

• “I use coconut oil, but my scalp’s so bad, I have to keep reapplying for about 2 days and keep combing it through. Only clears for about a week, though.”
• “I use T/Gel tar shampoo! It helps some!”
• “I’m trying not to pick scales. They are covering most of my scalp. I’m using salicylic acid and tea tree oil shampoos.”

Talk to a dermatologist to determine the best treatment options for you. Whether you’re dealing with scalp psoriasis, seborrheic dermatitis, or a mix of both, flare-ups can be tough and life-disrupting. Know that you aren’t alone.

Talk With Others Who Understand

MyPsoriasisTeam is the social network for people with psoriasis. It’s home to more than 116,000 members who come together to discuss how they cope with the skin disease and give each other advice for psoriasis treatment. Join today to share your story, ask questions, give advice, and discuss daily life with others who understand.

Have you dealt with sebopsoriasis? What strategies have you found to treat or manage it? Let us know in the comments below or start a conversation by posting on your Activities page.