- Risk Factors
- Signs & Symptoms
What is seborrheic dermatitis?
Seborrheic dermatitis (also known as seborrhea) is a chronic inflammation of the skin that typically waxes and wanes. It produces a red scaling, occasionally weepy, oozy eruption.
Seborrheic dermatitis commonly involves portions of the scalp, brows, mid-face, ears, mid-chest, and mid-back. It is not unusual for it to affect the skin of infants and young children where it often involves the scalp (cradle cap) and the diaper area.
Seborrheic dermatitis vs. psoriasis
Since both of these conditions can affect the scalp with an itchy scaling dermatitis, it can sometimes be difficult to distinguish one from the other. Aside from scalp involvement, psoriasis typically involves anatomically different areas of skin than seborrheic dermatitis. In addition, seborrheic dermatitis is eczematous dermatitis producing a weepy, oozing appearance.
Psoriasis produces papules and plaques of scaling red skin. A pathological examination of a skin biopsy is rarely necessary to distinguish these two conditions.
What causes seborrheic dermatitis?
Medical professionals have a poor understanding of the causes of seborrheic dermatitis. There are some newly recognized genetic influences in seborrheic dermatitis. Eleven gene mutations or protein deficiencies appear to be more common in individuals with seborrheic dermatitis. Most of the genes play a role either in the immune response or epidermal differentiation.
Since this condition tends to occur in areas of heavy sebum production, it is felt that oily skin may be a factor leading to seborrheic dermatitis. In addition, it seems that many patients with seborrheic dermatitis have an abundant growth of normal skin yeast (Pityrosporum or Malassezia) in the affected areas. The fact that topical antifungal medications are effective in controlling seborrheic dermatitis has led some to conclude fungi may play a role in causing this disease. Whether these normal members of the cutaneous microbiome play a causal role in seborrheic dermatitis remains to be determined.
Patients with severe central nervous system disease (dementia and traumatic brain injuries) seem to have more trouble with seborrheic dermatitis. It is unclear if the nervous system plays a role in causing seborrhea or if it is simply a lack of normal hygiene.
Is seborrheic dermatitis contagious?
Seborrheic dermatitis is not contagious.
What are risk factors for seborrheic dermatitis?
Although almost all patients with seborrheic dermatitis are generally healthy, there does seem to be an association between diseases of the central nervous system and AIDS (HIV).
What are symptoms and signs of seborrheic dermatitis?
The rash itself is characteristically red and scaling but occasionally can become weepy and oozy. The scaling can be extensive enough to produce significant dandruff, which is usually a patient's major complaint.
The distribution of this rash is often of great help in making the diagnosis. In adults, areas commonly involved include the scalp, the outer ear, and external auditory canal, the forehead, the eyebrows, the eyelids, the cheeks adjacent to the nose, including the folds that extend from the nose to the sides of the mouth, and less commonly the armpits, the mid-chest, and mid-back regions. In babies, the rash causes a scalp eruption commonly called "cradle cap." It can also be more extensive and involve the diaper area as well.
Although the rash may have no symptoms in both adults and children, it commonly causes itching, especially on the scalp.
What healthcare professionals diagnose and treat seborrheic dermatitis?
Most primary care physicians, pediatricians, internists, and family doctors can diagnose and treat seborrheic dermatitis. Occasionally, it may be necessary to refer patients to a dermatologist for a diagnosis.
How do healthcare professionals diagnose seborrheic dermatitis?
The diagnosis of seborrheic dermatitis is usually made clinically, meaning that the doctor recognizes it based on its appearance. Occasionally, a scraping of skin scales treated with potassium hydroxide is examined using a microscope to exclude fungal infection. A skin biopsy is rarely required for diagnosis.
What is the treatment for seborrheic dermatitis?
Treatment of hair-bearing areas, like the scalp, often includes the use of over-the-counter shampoos that may contain one or more of the following ingredients:
- Tar (DHS Tar, Neutrogena T/Gel)
- Ketoconazole (Nizoral requires a prescription)
- Zinc pyrithione (Head & Shoulders, Dermazinc)
- Selenium sulfide (Selsun Blue)
- Salicylic acid (Neutrogena T/Sal)
- 10% sodium sulfacetamide and 5% sulfur solution (Novacet, Sulfacet R lotion)
In addition, the application of a prescription-strength topical steroid lotion or solution of weak to moderate potency is effective such as desonide (Desonate, DesOwen, LoKara, Verdeso), clobetasol (Clobex, Cormax), betamethasone valerate (Valisone), fluocinolone (Capex, Synalar), hydrocortisone, and triamcinolone (Aristocort, Aristocort HP, Kenalog, Triderm).
For non-hair-bearing areas, the application of a weak to moderately potent topical steroid or topical antifungal cream is frequently effective. The use of topical calcineurin inhibitors, tacrolimus (Protopic) or pimecrolimus (Elidel) ointments, can be effective but is quite an expensive alternative. Patients may also use ketoconazole-containing creams for the treatment of seborrheic dermatitis.
It needs to be stressed that since this condition is incurable but easily controlled; if the disease is active and the treatment is stopped, one should expect seborrheic dermatitis to recur. One should also use effective medications just frequently enough to control the symptoms. Excessive treatment of apparently normal skin is economically wasteful as well as potentially risky.
- Alzheimer's Genes Might Also Raise Odds for Epilepsy
- Ketamine Beats Shock Therapy in Easing Tough-to-Treat Depression
- Most Americans Don't Know What 988 Suicide Crisis Hotline Is For: Poll
- Nowhere Safe to Play: 'Play Deserts' Keep Kids from Fun Physical Activity
- Hi-Tech Implant Helps Paralyzed Man Walk Naturally Again
- More Health News »
Are there home remedies for seborrheic dermatitis?
There is little compelling evidence that any of the following substances taken either orally or used topically are of any significant benefit in the control of seborrheic dermatitis: coconut oil, apple cider vinegar, tea tree oil, aloe vera, fish oil supplements, or biotin.
On the other hand, 1% hydrocortisone, which is inexpensive and easily available without a prescription, is likely to be very effective in controlling seborrhea. It can be helpful to apply olive oil or fluocinolone topical oil to the scalp to soften and loosen flaky or scaly patches; follow up by thoroughly brushing and washing your hair.
What is the prognosis of seborrheic dermatitis?
Since seborrheic dermatitis generally is not associated with any serious problems, one way of looking at the prognosis would be optimistic. On the other hand, although treatment almost always results in an excellent response, it is unlikely to result in any durable, permanent resolution of the disease.
What are complications of seborrheic dermatitis?
There are a few complications attributable to this condition. Most problems seem to be related to misdiagnosis or mistreatment. Rarely, certain superficial cutaneous (dermatophyte) fungal infections of the face and scalp can resemble seborrheic dermatitis.
- If dermatophyte infections are mistakenly treated with anti-inflammatory medications (topical steroids), more extensive involvement could be encouraged.
- The overuse of potent topical steroids in an ill-conceived attempt to cure this condition, especially on the face and armpits, can result in many undesirable skin changes including skin thinning.
- Severe seborrheic dermatitis can occasionally produce thinning or loss of hair, in great part probably related to excessive scratching. As the disease is controlled, regrowth is expected.
Health Solutions From Our Sponsors
Clark, Gary W., Sara M. Pope, and Khalid A. Jaboori. "Diagnosis and Treatment of Seborrheic Dermatitis." Am Fam Physician 91.3 (2015): 185-190.
Ijaz, N., and D. Fitzgerald. "Seborrheic Dermatitis." British Journal of Hospital Medicine 78.6 June 2017: C88-C91.
Okokon, E.O., J.H. Verbeek, J.H. Ruotsalainen, O.A. Ojo, and V.N. Bakhoya. "Topical Antifungals for Seborrheic Dermatitis (Review)." Cochrane Database of Systematic Reviews 5 May 2, 2015.
Stefanaki, I., and A. Katsambas. "Therapeutic Update on Seborrheic Dermatitis." Skin Therapy Lett. 15.5 May 2010: 1-4.
Top Seborrheic Dermatitis Related Articles
AIDS (Acquired Immunodeficiency Syndrome)AIDS is the advanced stage of HIV infection. Symptoms and signs of AIDS include pneumonia due to Pneumocystis jiroveci, tuberculosis, toxoplasmosis, seizures, weakness, meningitis, yeast infection of the esophagus, and Kaposi's sarcoma. Anti-retroviral therapy (HAART) is used in the treatment of AIDS.
Dandruff SlideshowDandruff is a common scalp condition. Learn about the causes of dandruff as well as treatments and remedies like dandruff shampoos. Find out how to get rid of dandruff.
EczemaEczema refers to skin inflammation. There are many different types of eczema that produce symptoms and signs that range from oozing blisters to crusty plaques of skin. Treatment varies depending upon the type of eczema the person has.
How Do You Get Rid of Dandruff?Learn what medical treatments can help ease your dandruff symptoms and reduce those pesky flakes for good.
Is Dandruff (Seborrhea) Contagious?Seborrheic dermatitis (dandruff) is a chronic condition in which skin on the scalp flakes and sheds. Dandruff is not contagious. Sunlight exposure and stress reduction can improve the symptoms and signs of dandruff.
Itching (Pruritus)Itching can be a common problem. Itches can be localized or generalized. There are many causes of itching including infection (jock itch, vaginal itch), disease (hyperthyroidism, liver or kidney), reactions to drugs, and skin infestations (pubic or body lice). Treatment for itching varies depending on the cause of the itch.
Skin RashThe word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Dandruff (Seborrhea)Dandruff (seborrhea) is a skin disorder that results from neither too much moisture nor too much oil. Dandruff can be treated with shampoos that contain tar, salicylic acid, zinc, selenium sulfide, or ketoconazole.
Skin BiopsyDuring a skin biopsy, a piece of skin is removed under a local anesthesia and examined using a microscope. The different types of skin biopsy include shave biopsy, punch biopsy, and excisional biopsy. Skin biopsies are performed to diagnose skin growths, skin conditions, and skin cancers.
Skin PictureThe skin is the largest organ of the body, with a total area of about 20 square feet. See a picture of the Skin and learn more about the health topic.
Skin Problems and Treatments: Guide to Seborrheic DermatitisGet to know the symptoms and treatments of seborrheic dermatitis, a common skin condition that often affects the scalp but can happen in other areas, too.
Skin QuizWhat's that all over you? Skin, of course! Test your knowledge of your most amazing organ with the Skin Quiz!
What Triggers Seborrheic Dermatitis?Seborrheic dermatitis is an inflammatory skin disease characterized by flaky, red, or yellowish scales that resemble dandruff. Sometimes, the scales may itch or even crust and ooze.
What Triggers Seborrheic Keratoses?Seborrheic keratoses are skin lesions that often appear on the skin as we age. Learn more about them, including what causes them and possible treatments.