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What’s the Difference Between Psoriasis and Seborrheic Dermatitis Scalp?

Psoriasis vs Seborrheic Dermatitis What's the Difference_AROMSE_scalp treatment


I am Dr. Chou, President and Director of Sincere Dermatology Clinic. With 15 years of experience as a dermatologist, I specialize in trichology and addressing various skin concerns. I have compassionately cared for patients with scalp conditions like psoriasis and seborrheic dermatitis, providing effective management strategies to alleviate symptoms and improve their well-being.


How to distinguish scalp psoriasis from seborrheic dermatitis?

Scalp seborrheic dermatitis and psoriasis can be difficult to distinguish clinically. If the diagnosis is difficult, a “sebopsoriasis” diagnosis may be made temporarily, with dermatologists waiting to see if more typical lesions develop on other sites later on.

Seborrheic Dermatitis Psoriasis
Thickness of the scales Thinner Thicker
Scales appearance Greasy Dry
Range of lesions Within the hairline Beyond the hairline
Color Yellow or white Silvery white
Other lesion locations Face (glabellar area, nasolabial folds),
ears, anterior chest
Everywhere of the skin, nails
Risk for arthritis None 3 folds
The visual depiction of
the specimen when observed
under a microscope.
Arborizing vessels Dotted


Glomerular vessels


Under Microscope: What do the symptoms of Psoriasis & Seborrheic Dermatitis scalp look like?

Psoriasis vs Seborrheic Dermatitis What's the Difference_under microscope_AROMSE



How to diagnose psoriasis? 

The detective spirit: Don’t forget to check the hairline, ears, genital area, umbilicus, intergluteal folds, and nails.

The job of a dermatologist is similar to that of a detective, requiring the use of challenging diagnostic methods.

  • Medical history
  • Clinical findings

Clinically, differential diagnosis between psoriasis and many diseases such as seborrheic dermatitis or chronic dermatitis is required. However, psoriasis is much like a clumsy robber who leaves many clues waiting for the dermatologists to uncover.

Plaque-type psoriasis typically manifests in specific areas of the body. The scalp, extremities (which are susceptible to injury or friction), and lower back are the primary distribution sites (marked in blue). However, if no psoriatic lesions are observed in these areas, we can look for signs of psoriasis in the hairline, ears, genital area, umbilicus, intergluteal folds, and nails (indicated by a red color).

Nail manifestations

Nail manifestations are subdivided into two categories:

  • Nail matrix lesions: red spots in lunula, leukonychia, pitting, or nail plate crumbing
  • Nail bed lesions : onycholysis, subungual hyperkeratosis, splinter hemorrhages, or oil drops.

Pathologic examination shows the incomplete keratinization (parakeratosis) of the stratum corneum, when we use the wooden end of a swab to scrape a lesion, it is like scraping a candle where silvery white dander continues to fall off (candle sign). Additionally, due to the dilated capillaries of the papillary dermis and the thin epidermis layer above it, as we continue to scrape harder, we will see punctate bleeding spots (Auspitz signs). This is why when patients suspected of having psoriasis arrive in my clinic, I will take a cotton swab for scrapping.

Another special part about psoriasis is that it is found on a skin injury site. When it is difficult to determine clinically, the dermatologist’s ultimate secret weapon is skin biopsy.

The picture on the left shows a sunburned psoriasis patient with visible psoriasis lesions on uncovered skin, while the picture on the right shows a patient with a dry sore at the site of a skin biopsy.



It’s a journey, not a destination.

While there is no definitive cure for psoriasis or dermatitis, many of my patients have found effective ways to alleviate symptoms and manage their condition. If you are unsure whether you are experiencing psoriasis or seborrheic dermatitis, it is crucial to seek professional medical advice for accurate diagnosis and appropriate treatment.


3 Steps Treatment for Psoriasis scalp

Calm your psoriasis scalp: Psoriasis Scalp Care 3 Steps Solution
What’s included: scalp deep cleanser + daily shampoo+ scalp tonic

Psoriasis-Solution-for-dry-and-itchy-scalp-AROMASE_beauty award-20


3 Steps Treatment for Dermatitis scalp

Calm your psoriasis scalp: Oily Dandruff 3 Steps Solution ( Ideal for Dermatitis)
What’s included: scalp deep cleanser + daily shampoo+ herbal cooling scalp spray




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  • psoriasis forum, SPRING 2012 Vol. 18, No. 1
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  • President and Director of Sincere Dermatology Clinic
  • Vice President of the Lou Shou Qi Dermatology Clinic
  • Director of AHDC Dermatology Clinic

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