Seborrheic dermatitis causes, symptoms & treatment

What is seborrheic dermatitis?

Seborrheic (seb-o-REE-ik) dermatitis is stubborn dandruff, a common skin condition. It’s also known as seborrheic eczema, seborrheic psoriasis, and in infants, as cradle cap. It mainly affects the scalp with flaky, scaly patches. It can also cause red, scaly patches on oily parts of the body such as face, nose, eyebrows, ears, eyelids and chest. It may go away on its own, but return later. Stubborn cases may require treatments over several months to control. It does not harm the body, and is caused by a complex combination of factors.

What causes seborrheic dermatitis?

Although the exact cause is unknown, researchers believe it is caused by a complex combination of factors. Seborrheic dermatitis is influenced by yeast (fungus) that normally lives on skin, your genes, living in a cold and dry climate, stress, irregular immune system response, and your overall health. Seborrheic dermatitis is not caused by poor personal hygiene, nor is it an allergy.

Anyone of any age or race can get it, but your risk is higher if you:

Are younger than 3 months of age
Are between ages 30 and 60
Have Parkinson’s disease
Have HIV AIDS (85% of AIDS patients will develop it)
Have acne, rosacea or psoriasis
Have epilepsy
Are recovering from a stroke or heart attack
Are alcoholic
Have depression or an eating disorder
Have a weakened immune system (organ transplant or cancer patients)
Are taking these medications: Lithium, Interferon, Psoralen

What are the symptoms of seborrheic dermatitis?

Adults and adolescents may have these symptoms:

Scaly skin patches that flake off, flakes are yellowish to white
Skin patches can look oily or moist
Reddish skin under the scales
Itchy skin, scalp, and in the ear canal
Men can have it in their beard or mustache
Burning sensation on skin
Scaly patches can form on the scalp, ears, eyebrow skin, eyelids, nose, armpits, upper chest and back, under breasts, or on genitals

Infants with seborrheic dermatitis, or cradle cap, may have a yellowish to brownish, greasy scale or crust on the scalp. It can become flaky and easily rubs off. Infants may also develop it on the face, eyelids, around the nose or ears, and in the diaper area.

Symptoms are often worse when the weather is dry and cold, or if you are experiencing a lot of stress.

How is seborrheic dermatitis diagnosed?

Diagnosis is made after examining your skin. Your dermatologist may scrape off some skin cells to examine. This can rule out similar conditions such as psoriasis, eczema, rosacea, allergy or tinea versicolor.

How is seborrheic dermatitis treated?

Adult seborrheic dermatitis occasionally goes away without treatment. However, most people have it for years, during which it may flare up and clear, only to flare again. Treatment is usually needed to control it in most people. It’s important to watch for symptoms and start treating it as soon as symptoms first occur.

Regularly washing with a mild soap and water will often help the oily places on your skin that are itching and flaking. Using a dandruff shampoo regularly can also improve the condition. However, if you are so uncomfortable that it’s interfering with normal activities or you’re embarrassed by it, see your dermatologist. While treatment cannot cure seborrheic dermatitis, it can help loosen and remove the scales, reduce swelling and itching, and prevent a skin infection.

If over-the-counter shampoos and lotions aren’t helping, you may need a prescription treatment such as:

Inflammation controlling shampoos, creams or ointments include prescription-strength hydrocortisone, fluocinolone, clobetasol, and desonide. While these corticosteroid preparations are effective, if they are used for many weeks or months without a break, they can cause thinning skin or lines on the skin.
Creams or lotions with calcineurin inhibitors are also effective, and have fewer side effects. However, they are more expensive, and may be linked to cancer.
Antifungal shampoos, gels and creams (ketoconazole and ciclopirox) may be prescribed to be used alternately.
Antifungal oral medications may be prescribed if you’re not getting better. They are not the first choice for treatment because of drug interactions and other side effects.

Cradle cap on infants usually goes away without treatment within six months to a year. You can use a baby shampoo on the baby’s scalp daily, or gently brush it away with a washcloth or baby hairbrush. It will also go away if it’s on the baby’s skin.

These home-care methods can help keep it under control:

Wash your scalp daily with dandruff shampoo until symptoms start to lessen. Then use it one to three times a week as long as you have symptoms. If your shampoo stops working effectively, alternate between two or more brands of dandruff shampoo. These shampoos may also be rubbed gently on the face, ears and chest if you’re having symptoms on your skin. Be sure to rinse it off completely.
Mineral or olive oil, applied to the scalp, will soften the scales. Leave it on for at least an hour and then comb out loose scales and wash your hair and scalp.
Shampoo beard and mustache daily until symptoms lessen. Shaving facial hair can also reduce symptoms.
Try an antifungal cream with ketoconazole if corticosteroids don’t work.
Don’t use hair styling products (especially those with alcohol) while treating seborrheic dermatitis.
Wear cotton clothing to keep air circulating around your skin.
If eyelids are affected, wash gently with baby shampoo and wipe away scales; rinse completely. Warm compresses may help.

Mayo Clinic. (April 2020). Seborrheic Dermatitis. Retrieved 10-4-21, {https://www.mayoclinic.org/diseases-conditions/seborrheic-dermatitis/symptoms-causes/syc-20352710}

Mayo Clinic. (April 2020). Seborrheic Dermatitis: Diagnosis and Treatment. Retrieved 10-4-21, {https://www.mayoclinic.org/diseases-conditions/seborrheic-dermatitis/diagnosis-treatment/drc-20352714}

American Academy of Dermatology Associates. (n.d.) Seborrheic Dermatitis: Signs and Symptoms. Retrieved 10-4-21, {https://www.aad.org/public/diseases/a-z/seborrheic-dermatitis-symptoms}

American Academy of Dermatology Associates. (n.d.) Seborrheic Dermatitis: Who Gets and Causes. Retrieved 10-4-21, {https://www.aad.org/public/diseases/a-z/seborrheic-dermatitis-causes}

American Academy of Dermatology Associates. (n.d.) Seborrheic Dermatitis: Diagnosis and Treatment. Retrieved 10-4-21, {https://www.aad.org/public/diseases/a-z/seborrheic-dermatitis-treatment}

Medically reviewed by:

Dr. Javeed Siddiqui, MD, MPH

Dr. Siddiqui is the Chief Medical Officer at TeleMed2U responsible for clinical and technical program development as well as maintaining a thriving telemedicine practice in infectious diseases which includes specialized care of Hepatitis and HIV.

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Seborrheic Dermatitis