Seborrheic dermatitis is a common skin condition that causes redness, scaly patches, and dandruff. Seborrheic dermatitis is a chronic form of eczema and most often affects the scalp, but can also develop in oily areas of the body, like the face, upper chest, and back.
When infants develop this condition, it’s known as crib cap. It typically develops within the first few weeks after birth and gradually disappears over several weeks or months.
In this article, we’ll talk more about what seborrheic dermatitis is, it’s symptoms, and how it’s treated.
The exact cause of seborrheic dermatitis isn’t known. But doctors believe there are two main factors that contribute to the development of the condition.
The first factor is the overproduction of oil. An excess amount of oil in the skin might act as an irritant, causing the skin to become red and greasy.
The second contributing factor is Malassezia, which is a type of yeast that’s naturally found in the skin’s oils. It can sometimes multiply abnormally, causing the skin to have an inflammatory response and secrete more oil than usual. The increased production of oil can lead to seborrheic dermatitis.
The condition might also develop in infants due to hormonal changes that occur in the mother during pregnancy. The fluctuating hormone levels are believed to stimulate the infant’s oil glands, leading to an overproduction of oil that may irritate the skin.
Seborrheic dermatitis is a long-term skin condition that requires ongoing treatment. But working with a doctor, developing a good skincare routine, and learning to recognize and eliminate triggers can help you manage the condition effectively.
Seborrheic dermatitis commonly affects the scalp and hairline, with symptoms ranging from mild dandruff to thick, dense patches of dried skin.
Dandruff is a common characteristic of seborrheic dermatitis and can appear as fine, powdery pieces of dead skin. It might be visible in your hair or on dark clothing.
If you have more severe seborrheic dermatitis, you may experience erythematous plaques, which are elevated, solid patches of thick-crusted skin on and around the scalp. If left untreated, the plaque could thicken and become yellow and greasy, and secondary infection could occur.
It’s a chronic inflammatory condition, so it can affect various parts of your body at the same time.
On the face, seborrheic dermatitis typically appears in places that have hair — like your eyebrows and eyelashes, as well as in mustaches and beards. It can also appear on your forehead, external ear canal, in the folds behind your ears, and around your mouth and nose.
Seborrheic dermatitis on the face may make the skin appear red, swollen, and greasy in appearance. White or yellow crusty scales may develop in more severe cases.
Trunk and abdomen
Seborrheic dermatitis may also appear on the trunk. It typically develops on and around folds of the body — including your navel, groin, and armpit as well as below the breasts, and in the skin folds around the genitals. Seborrhea is typically symmetrically distributed on the body.
Seborrheic dermatitis can also appear on the back and neck.
Your doctor will likely recommend that you try home remedies before considering medical treatments.
Dandruff shampoos are frequently used to treat seborrheic dermatitis on the scalp. They usually need to be used every day for optimal results. Make sure to follow all instructions on the bottle carefully.
Other home treatments that may help you manage seborrheic dermatitis include:
- using over-the-counter (OTC) antifungal and anti-itch creams
- using hypoallergenic soap and detergent
- thoroughly rinsing soap and shampoo off the skin and scalp
- shaving off a mustache or beard
- wearing loose cotton clothing to avoid skin irritation
If your symptoms don’t improve with the home remedies, talk with your doctor about trying the following treatments:
- Prescription-strength shampoos and ointments for seborrheic dermatitis contain hydrocortisone, fluocinolone, or desonide. These medications can be applied directly to the affected area. While these medications are very effective in treating seborrheic dermatitis, they may cause side effects when they’re used for an extended period.
- In some cases, an antifungal medication might be prescribed. But this drug usually isn’t recommended since it can cause serious side effects, including allergic reactions and liver problems.
- Metronidazole is another type of treatment that can relieve symptoms by fighting bacteria. It comes in both cream and gel forms. The medication can be applied to the skin once or twice daily until symptoms improve.
- Your doctor can use a combination of psoralen and light therapy to help manage your seborrheic dermatitis symptoms. Psoralen may be taken by mouth or applied directly onto the skin. After psoralen has been ingested or applied, the affected skin area is exposed to ultraviolet light for a short period.
Crib cap (or, cradle cap) usually doesn’t require medical treatment. It often goes away within 6 months. In the meantime, you can try the following daily routine to help manage your child’s symptoms:
- loosen scaly patches by massaging your baby’s scalp or using a soft-bristled brush
- wash your baby’s hair with a mild shampoo
- rinse the hair and scalp thoroughly
- brush your baby’s hair with a clean, soft-bristled brush
If it’s difficult to loosen and wash off scales, massage your baby’s scalp with olive oil before shampooing.
Make sure to check with your child’s doctor before using any OTC cortisone or antifungal creams. Some can be toxic for infants when they’re absorbed through the skin. Dandruff shampoos that contain salicylic acid aren’t usually recommended for infants either.
The symptoms of seborrheic dermatitis are often aggravated by various factors, including stress, change of seasons, and heavy alcohol use. The types of symptoms that develop can vary from person to person. It’s also possible for symptoms to occur in different parts of the body.
As mentioned, seborrheic dermatitis tends to develop in oily areas of the body. It most often affects the scalp, but it can also occur in the following areas:
- in and around the ears
- on the eyebrows
- on the nose
- on the back
- on the upper portion of the chest
Seborrheic dermatitis has a distinct appearance and set of symptoms:
- Skin develops scaly patches that flake off. The patches may be white or yellowish in color. This problem is commonly known as dandruff. It can occur in the scalp, hair, eyebrows, or beard.
- Skin develops erythematous plaques. These plaques are elevated, solid patches of thick-crusted skin that may turn yellow and greasy and occur in severe cases.
- Skin in the affected area tends to be greasy and oily.
- Skin in the affected area may be red.
- Skin in the affected area may be itchy.
- Hair loss may occur in the affected area.
Doctors aren’t exactly sure why some people develop seborrheic dermatitis while others don’t. But it does appear that your risk of developing the condition increases if a close family member has it.
Other factors thought to increase risk include:
- poor skin care
- environmental factors, like pollution
- the presence of other skin issues, like acne
- the use of certain skin care products, particularly those containing alcohol
- certain medical conditions, like HIV or Parkinson’s disease
- harsh detergents, soaps, chemicals
- cold, dry weather
- medications including psoralen, interferon, and lithium
- hormonal changes
|dandruff||White, oily, itchy flakes on the scalp that worsen during fall and winter months when air is dry.|
|psoriasis||Thick patches of dry, red, inflamed skin covered in silvery-white scales. Patches are often itchy.|
|atopic dermatitis (eczema)||Dry, itchy skin that turns into a red rash.|
|rosacea||Small, red, pus-filled bumps on the skin appearing in cycles of flare-ups.|
|tinea versicolor||Small, discolored, flaky patches of skin ranging in color from white to tan to brown to pink.|
To make an accurate diagnosis, your doctor will perform a physical examination and carefully inspect the affected areas. They’ll also ask you about your symptoms, including when they started and how often you experience them.
Your doctor may also want to perform a biopsy before making a diagnosis. During this procedure, your doctor will scrape off skin cells from the affected area.
These samples will then be sent to a laboratory for analysis. The results will help to rule out other conditions that may be causing your symptoms.
Not all cases of seborrheic dermatitis can be managed solely through the use of OTC dandruff shampoos. Oral medications, prescription shampoos, and medicinal creams or gels for the scalp and other areas of the body can be used for severe symptoms and more serious cases.
In general, you should reach out to your doctor if you:
- aren’t getting relief from a regular dandruff shampoo
- have areas that are extremely red
- have areas that are very painful
- have areas that are producing pus, draining fluid, or crusting
- are experiencing significant discomfort and believe medical intervention may be needed
You should also contact your child’s doctor if crib cap symptoms are severe or persist. They may recommend certain medicated shampoos or lotions.
Seborrheic dermatitis is a chronic condition, so you may need to cope with it on some level for the rest of your life. You may go through extended periods where there are little to no symptoms. You’ll also likely experience flare-ups, which are episodes when symptoms become more severe.
Over time, you can find a skincare routine that works for you and that minimizes the impact of the condition. Learning to recognize and eliminate triggers can also help you manage seborrheic dermatitis effectively. It doesn’t lead to any serious medical conditions or other complications.
Crib cap usually goes away without treatment within 6 months.