Seborrhoeic dermatitis and hair transplants: Dr Úbeda answers

Seborrhoeic dermatitis raises many questions among those considering a hair transplant or who have already undergone one: it is neither alopecia nor an infection, but its presence on the scalp can affect both the planning of the procedure and post-operative care.

We spoke with Dr. José María Úbeda, from Clínica Alpha, to understand exactly what this condition is, how it is diagnosed, how it relates to hair transplants, and the role of daily care for transplanted hair when there is a history of seborrhoeic dermatitis.

In summary:

• Seborrhoeic dermatitis does not usually cause scarring alopecia; the hair loss associated with it is typically temporary.
• If it is active when evaluating a transplant, the standard practice is to control it before planning the procedure.
• It is a chronic condition: it can reappear after the transplant, and the goal of treatment is to manage it, not to eliminate it forever.

What is seborrhoeic dermatitis and what does it look like on the scalp?

It is a chronic inflammation of the skin that appears mainly in areas with higher sebaceous gland activity: the scalp, the sides of the nose, the eyebrows, or the area behind the ears. On the scalp, it usually causes redness, itching and greasy or yellowish flakes.

Its origin is multifactorial and not fully understood. It is linked to the activity of yeasts of the Malassezia genus, which are naturally present on the skin, along with the composition of sebum, the function of the skin barrier, and each person's specific inflammatory response. Factors such as stress can trigger or intensify certain flare-ups. It usually follows a chronic and relapsing course: periods of improvement alternating with phases of higher activity.

Is it the same as dandruff?

Dandruff and seborrhoeic dermatitis are related, but they are not exactly the same clinical presentation. Dandruff is usually considered the mildest form of the same spectrum: it produces scalp scaling without significant visible inflammation. In seborrhoeic dermatitis, redness, itching, and whitish or yellowish scales on inflamed skin are more common.

If your question is specifically about dandruff after a transplant, at FOLIC we have a dedicated guide: dandruff after a hair transplant.

How do I know if it is seborrhoeic dermatitis and not another scalp disease?

The diagnosis of seborrhoeic dermatitis is usually clinical, based on the appearance and distribution of the lesions. However, other scalp conditions—such as psoriasis, contact dermatitis, or certain inflammatory alopecias—can produce similar redness, scaling, or itching.

In a patient considering a hair transplant, correctly distinguishing seborrhoeic dermatitis from other conditions is especially important, as its implications for the transplant can be very different. If the diagnosis is unclear, investigations such as trichoscopy and, exceptionally, a biopsy may be needed.

Can I get a hair transplant if I have seborrhoeic dermatitis?

When there is an active flare-up or significant scalp inflammation, the usual practice is to bring the dermatitis under control first, then reassess whether a transplant is appropriate. The surgeon must assess the condition of the donor and recipient areas, the intensity of the inflammation, and the dermatological diagnosis before scheduling the procedure.

If it appears after the transplant, does it affect the survival of the grafts?

Seborrhoeic dermatitis, on its own, usually has a limited impact on graft survival compared to other inflammatory scalp conditions, such as lichen planus^[1].

When associated with increased hair loss, this is usually non-scarring and potentially reversible once the inflammation is controlled. However, if there is persistent density loss, it is important to rule out other causes of alopecia.

If you are concerned about transplanted hair loss in the first few weeks, you may also be interested in our content on shock loss after a hair transplant, a different and also temporary cause.

Can seborrhoeic dermatitis reappear after a hair transplant?

Yes. As it is a chronic and recurrent disease, having had a hair transplant does not prevent new flare-ups from appearing. The goal of treatment is to keep it under control and reduce the frequency and intensity of relapses, rather than to remove the underlying tendency permanently.

How is seborrhoeic dermatitis treated?

Treatment depends on the intensity and location of the flare-up and should be individualised and supervised by a specialist; the goal is not to cure it definitively, but to control the flare-ups. Among the most widely used topical treatments are antifungal shampoos or preparations—ketoconazole and ciclopirox have significant support in clinical studies—and, when there is significant inflammation, anti-inflammatory treatments prescribed by a doctor.

As a general measure, it is also advisable to identify factors that may trigger flare-ups, including stress in some patients, and to avoid scratching the affected area.

How is the treatment adapted after a hair transplant?

During the first few days after the procedure, any treatment for seborrhoeic dermatitis must be adapted to the post-operative care protocol indicated by the clinic, as the initial priority is to protect the grafts. Do not restart any treatment on your own during this phase. Once this initial phase is over, care can return to normal within a routine suited to a sensitive scalp.

For your shampoo routine after the initial phase, read our guide to which shampoo to use after a hair transplant.

When should you consult a specialist?

It is advisable to seek a medical evaluation if the following appear:

• intense or persistent scaling;
• highly inflamed or painful plaques;
• crusts, discharge, or signs of infection;
• localised or progressive hair loss;
• inflammation around the follicles;
• symptoms that do not respond to regular care;
• a major flare-up before or after a hair transplant.

If any of these signs occur, it is best to go to the clinic or a dermatologist before attempting to resolve the issue with cosmetic products alone.

Frequently asked questions about seborrhoeic dermatitis and hair transplants

Can I get a hair transplant if I have seborrhoeic dermatitis?

It depends on whether it is active or controlled at the time of evaluation. It is standard to stabilise it before planning the procedure to perform the transplant under the best possible conditions.

Does seborrhoeic dermatitis affect the transplanted follicles?

On its own, it usually has a limited impact on the survival of the grafts compared to other inflammatory scalp conditions.

Can seborrhoeic dermatitis appear after a hair transplant?

Yes. It is a chronic and recurrent disease, so the transplant does not prevent new flare-ups from appearing.

Does seborrhoeic dermatitis cause hair loss?

Not directly. It can be associated with increased hair loss, which is usually non-scarring and potentially reversible when the inflammation is controlled. If the loss of density persists, it is important to rule out other causes.

Is dandruff the same as seborrhoeic dermatitis?

They are related but not identical: dandruff is usually the milder form, without significant visible inflammation.

Which shampoos are used for seborrhoeic dermatitis?

Usually antifungal shampoos containing ingredients such as ketoconazole or ciclopirox, recommended by a specialist according to the individual case.

When should I seek medical advice about flaking after a transplant?

When it is persistent, intense, accompanied by localised hair loss, or does not improve with regular care.

Does FOLIC treat seborrhoeic dermatitis?

No. FOLIC is a dermocosmetic shampoo formulated for regular care for sensitive scalps and transplanted hair, with a physiological pH. It does not contain active ingredients intended to treat seborrhoeic dermatitis and is not a substitute for medical treatment, which should be indicated by a dermatologist or your hair clinic.

Cosmetic care, not medical treatment

If you have a history of seborrhoeic dermatitis and transplanted hair, daily cosmetic care plays a different role than medical treatment: keeping the scalp in the best possible condition without interfering with treatment.

FOLIC is formulated for regular care for sensitive scalps and transplanted hair. It does not contain active ingredients intended to treat seborrhoeic dermatitis.

• Physiological pH.
• No harsh surfactants.
• Specific formulation for sensitive scalps and transplanted hair.

Discover the FOLIC hair transplant shampoo →

This article has been prepared based on responses from Dr. José María Úbeda Pereda. FOLIC has made editorial adjustments for structure, clarity, and format for its publication.

Dr. José María Úbeda Pereda is the medical director and co-founder of Clínica Alpha (Madrid). He holds a degree in Medicine from CEU Cardenal Herrera University, has a Master's degree in Trichology and Hair Micrografting (AMIR), and is trained as an Expert in Integrated Medicine from CEU Cardenal Herrera University.

He is trained in FUE technique—incisions, manual and monitored extraction—, hair transplant design and counselling (hair, beard, and eyebrows), and trichological diagnosis. Before founding Clínica Alpha, he worked as a doctor specialising in hair medicine in clinics in Madrid and Zaragoza.

Dr. José María Úbeda Pereda
Medical Director · Clínica Alpha · Madrid

Other medical sources consulted:
[1] Álvarez Suriaca X, Pedraz Muñoz J. Dermatitis seborreica y liquen plano en el trasplante capilar. Un diagnóstico diferencial crucial. Revista SEME, 2024.
[2] A comprehensive literature review and an international expert consensus on the management of scalp seborrhoeic dermatitis in adults. Eur J Dermatol. 2024;34(S1):4-16.