Seborrheic dermatitis (pronounced “seh-bah-ree-ick der-muh-tie-tis”) is a common skin condition that causes redness, scaly patches, and dandruff.
It is a chronic form of eczema that most often affects the scalp. It can also develop on oily areas of the body, like your face, upper chest, and back.
When infants develop this condition, doctors call it cradle cap. This typically develops within the first few weeks of birth and gradually disappears over several weeks or months.
In this article, we’ll talk more about what seborrheic dermatitis is, its symptoms, and how you can manage it.
Doctors don’t know the exact cause of seborrheic dermatitis. But they 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 your skin to become red and greasy. This may relate to hormone production.
The second contributing factor is Malassezia, a type of yeast that naturally occurs in the skin’s oils. It can sometimes multiply more than usual, causing an inflammatory response in the skin. This triggers increased oil production, and excessive oil can lead to seborrheic dermatitis.
The condition might also develop in infants due to hormonal changes that occur in the birthing parent during pregnancy. The fluctuating hormone levels might stimulate the infant’s oil glands, leading to an overproduction of oil that can irritate the skin.
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, and chemicals
- cold, dry weather
- medications including psoralen, interferon, and lithium
- hormonal changes
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. These 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. A secondary infection could also occur.
Your doctor will likely recommend that you try some home remedies before considering medical treatments.
People frequently use dandruff shampoos to treat seborrheic dermatitis on the scalp. Daily use is often necessary 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
Seborrheic dermatitis is a long-term skin condition that requires ongoing treatment. But you can manage the condition effectively by:
- working with a doctor
- developing a good skin care routine
- learning to recognize and eliminate triggers
If your symptoms don’t improve with these home remedies, talk with your doctor about trying the following treatments.
Prescription-strength shampoos and ointments for seborrheic dermatitis
These contain hydrocortisone, fluocinolone, or desonide.
You can apply these medications directly to the affected area. While they are very effective in treating seborrheic dermatitis, they may cause side effects when used for an extended period.
In rare instances, your doctor might prescribe an antifungal medication. But they don’t often recommend this drug, since it can cause serious side effects, including allergic reactions and liver problems.
The antifungal medication might be available in the form of a shampoo, topical solution, or cream that causes fewer side effects than oral treatment, according to the National Eczema Association.
Metronidazole is another type of treatment that can relieve symptoms by fighting bacteria. It comes in both cream and gel forms. Apply the medication to the skin once or twice daily until your symptoms improve.
Combination psoralen and light therapy
Your doctor can use a combination of psoralen and light therapy to help manage your seborrheic dermatitis symptoms.
You can take psoralen by mouth or apply it directly onto the skin. After ingesting or applying psoralen, your doctor exposes the affected skin area to ultraviolet light for a short period.
Treating cradle cap
Cradle cap usually doesn’t require medical treatment. It often resolves 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.
A caution about skin cream use for infants
Make sure to check with your child’s doctor before using any OTC cortisone or antifungal creams. Some can be toxic for infants after absorption through the skin. Dandruff shampoos that contain salicylic acid aren’t always safe for infants either.
The symptoms of seborrheic dermatitis are often aggravated by various factors, including:
- change of seasons
- 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.
The symptoms of seborrheic dermatitis are similar to those of other skin conditions, including rosacea and psoriasis.
|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 cradle 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 manage 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 skin care routine that works for you and 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 complications.
Cradle cap usually resolves without treatment within 6 months.