![Seborrheic dermatitis is a skin condition that that causes scaling, burning, and itching on the face, scalp, chest, back, legs, below the breasts, and in the groin area. Triggers for seborrheic dermatitis include hormonal changes, stress, illness, harsh detergents/solvents/chemicals/soaps, cold/dry weather, certain medications, certain neurological conditions, HIV/AIDS, and other medical conditions.](https://images.medicinenet.com/images/article/main_image/what-triggers-seborrheic-dermatitis.jpg?output-quality=75)
Seborrheic dermatitis is a condition that is considered a chronic form of eczema that affects the skin in areas where a lot of oil glands are located, including the face (often around the nose, on the eyelids, or behind the ears), scalp, chest, and back. It may also occur in skin folds under the arms and on the legs, below the breasts, and in the groin area, causing red, scaly, flaky skin, and sometimes itching.
Dandruff is an example of a mild type of seborrheic dermatitis. It also happens frequently in babies (“cradle cap”) causing redness and greasy, crusty, yellow or brown scales on the head, face, diaper area, and other parts of the body.
Seborrheic dermatitis is not contagious.
It is not known what causes seborrheic dermatitis but it is thought to be due to an inflammatory reaction to a type of yeast (Malassezia) that naturally lives on the skin. Genetics and hormones may also be a factor.
Risk factors and triggers for seborrheic dermatitis include:
- Hormonal changes
- Stress
- Illness
- Harsh detergents, solvents, chemicals, and soaps
- Cold, dry weather
- Certain medications including psoralen, interferon, and lithium
- Certain neurological conditions, such as Parkinson’s disease or epilepsy
- Certain diseases that affect the immune system, such as human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS)
- Other medical conditions, such as psoriasis, acne, rosacea, alcoholism, depression, eating disorders, and recovery from a stroke or heart attack
What Are Symptoms of Seborrheic Dermatitis?
Characteristics of the skin lesions include:
- Recurring episodes of active skin scaling, burning, and itching, alternating with inactive periods
- Active episodes occur more frequently when weather is cold and dry such as in winter and early spring, and remissions tend to happen during the summer
- In active phases, secondary infection can occur in areas where skin rubs together (such as the armpits)
- Stress can worsen the condition
- Candida overgrowth (a type of yeast)
- Generalized intense, widespread skin redness (seborrheic erythroderma) (rare)
Symptoms of seborrheic dermatitis include:
- Skin lesions that usually occur on the scalp, face, back, chest, in skin folds under the arms and on the legs, below the breasts, and in the groin area
- Redness, inflammation, scaling, oozing, or crusting of skin patches
- Scaly patches may look greasy or oily
- Mild, patchy scaling or thick, widespread crusts on the scalp
- Itching
- Loss of pigmentation (in dark-skinned patients)
- Eye redness
- Inflammation of the eyelids
- Crusty yellow material on the eyelashes
- White flakes or scales on the head or in the hair (dandruff)
- In infants: redness and greasy scales, usually on the scalp (“cradle cap”)
How Is Seborrheic Dermatitis Diagnosed?
A patient history and physical examination of the skin may be sufficient to diagnose seborrheic dermatitis. There is no specific test used to diagnose seborrheic dermatitis.
In some cases, a skin biopsy may be performed to help confirm the diagnoses or to help rule out other causes.
What Is the Treatment for Seborrheic Dermatitis?
Treatment for seborrheic dermatitis usually involves long-term management and may include:
- Topical corticosteroids (for short-term use only) for itching and redness
- Betamethasone (Valisone)
- Desonide (Tridesilon, Verdeso, Desonate)
- Topical antifungal creams and gels for itching and redness
- Ketoconazole (Xolegel, Nizoral)
- Naftifine (Naftin)
- Ciclopirox (Ciclodan, Loprox Kit, Loprox)
- Calcineurin inhibitors
- Pimecrolimus (Elidel)
- Tacrolimus (Protopic)]
- Sulfur or sulfonamide combinations
- Propylene glycol
- For acute flares, corticosteroid creams, lotions, or solutions
- For severe or unresponsive lesions, systemic fluconazole (Diflucan)
Treatment of dandruff includes:
- Use of shampoos with antifungal or antiseptic properties containing salicylic acid, tar, sulfur, or zinc; selenium sulfide (2.5%), ketoconazole, and ciclopirox
- Use of conditioner with zinc, 0.01% fluocinolone, and acetonide topical oil
- Applying tar, bath oil, Baker’s P&S solution, or Derma-Smoothe F/S oil overnight to loosen scales may be helpful
- Frequent shampooing or longer lathering
- Avoiding use of hair spray or hair pomades
Treatment for “cradle cap” in babies includes:
- Cleansing the scalp or affected areas with baby shampoo
- Using a fine-toothed comb or soft toothbrush to remove scaly skin
- Applying a small amount of oil (such as vegetable oil, mineral oil, baby oil, or petroleum jelly) on the baby's head and leaving it on overnight to loosen scaly skin.
- Once the oil loosens the scales, brush the baby's scalp gently with a soft brush to remove the scales
- Finally, wash the area with regular baby shampoo
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https://nationaleczema.org/eczema/types-of-eczema/seborrheic-dermatitis/