Scalp Rosacea: Current Evidence

Scalp rosacea, or red scalp disease, is an underrecognized inflammatory condition characterized by diffuse scalp erythema, dry scaling, and inflammatory papules or pustules, often with pruritus or burning sensations. It predominantly affects middle-aged men and is linked to androgenetic alopecia, possibly due to increased UV exposure. The condition involves genetic susceptibility, immune dysregulation, neurovascular changes, and environmental triggers, with Demodex folliculorum potentially contributing to its persistence. Diagnosis is aided by trichoscopy, which reveals specific vascular patterns, and histopathology confirms its non-scarring nature. Treatment is based on therapies for facial rosacea, with oral tetracyclines as the first-line option. The prognosis is generally favorable, as it does not progress to scarring alopecia. This review aims to enhance recognition and management of scalp rosacea by summarizing current evidence on its pathogenesis, clinical features, and treatment strategies.