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What Causes Seborrheic Dermatitis? Common Questions Answered

Medically reviewed by Kevin Berman, M.D., Ph.D.
Written by Emily Wagner, M.S.
Posted on November 22, 2022

Seborrheic dermatitis is a type of eczema that causes itchy patches, rashes, and dandruff on the face, scalp, and chest. There is no single known cause of the skin condition. Overgrowth of a type of yeast, known as Malassezia yeast, may contribute to inflammation and symptoms in seborrheic dermatitis.

Seborrheic dermatitis is associated with a few different risk factors, which increase a person’s likelihood of developing it. Some risk factors are inherited and others are environmental. Inherited risk factors are passed down through family members and can’t be controlled. Environmental risk factors include exposure to certain medications and complications from other skin conditions.

The Skin and Seborrheic Dermatitis

Researchers are still working to pinpoint the exact cause of seborrheic dermatitis. Currently, they believe it’s caused by a combination of factors. On almost every part of the skin (aside from the palms of the hands and soles of the feet), there are sebaceous glands. These glands produce sebum — an oil that helps keep the skin moisturized and protects it from bacteria and viruses. Seborrheic dermatitis symptoms tend to develop in areas with more sebaceous glands, such as the scalp, face, and chest.

Researchers have looked at the relationship between Malassezia yeast and seborrheic dermatitis. However, there isn’t enough evidence to say that an overgrowth of Malassezia yeast causes seborrheic dermatitis. Malassezia yeast grows on everyone’s skin, and it’s often found in the sebum on areas commonly affected by seborrheic dermatitis.

Some studies suggest that in people with seborrheic dermatitis, the immune system overreacts to Malassezia yeast and its byproducts. Others theorize that the yeast might irritate the skin, but doesn’t cause an immune reaction. Even still, doctors and dermatologists have found that antifungal medications, which decrease yeast growth, can help clear the skin of seborrheic dermatitis symptoms.

Can You Inherit Seborrheic Dermatitis?

Inherited risk factors are passed down from parents to children through their DNA. Researchers believe that some inherited gene changes may contribute to the development of seborrheic dermatitis. Having a family member with dermatitis or a general skin inflammation disorder increases your chances of developing seborrheic dermatitis.

Researchers have found 11 different gene changes and protein deficiencies associated with seborrheic dermatitis. These changes mainly affect the functioning of immune cells in the skin and prevent them from working properly. As a result, the skin can become infected or irritated more easily by factors like an overgrowth of Malassezia yeast, which could lead to chronic (ongoing) inflammation and changes in the skin.

One research study found that HLA proteins may contribute to an increased risk of seborrheic dermatitis. These proteins are found on the outside of your cells (except red blood cells), and they tell your immune system which cells belong to your body and which ones don’t. Another study looking at people with seborrheic dermatitis, acne, psoriasis, and eczema found that certain gene changes may be associated with the development of these conditions.

Age and Sex

According to the American Academy of Dermatology, people of all ages and skin colors can develop seborrheic dermatitis. However, the condition is much more likely to affect newborn infants up to 3 months old (called cradle cap) and adults between the ages of 30 to 60. Teenagers going through puberty may also develop seborrheic dermatitis. The condition tends to affect men more than women. Researchers believe that male sex hormones called androgens play a role.

Which Health Conditions Increase the Risk of Seborrheic Dermatitis?

Environmental risk factors and comorbidities can also increase a person’s chances of developing seborrheic dermatitis. These include underlying health conditions and medications, including those used to treat associated health conditions.

Other Skin Conditions

Seborrheic dermatitis is associated with skin inflammation and disruption of the protective skin barrier. Oftentimes, people will have other skin conditions in addition to seborrheic dermatitis. These may include:

  • Acne — Inflamed pores and hair follicles clogged with dead skin cells and oil
  • Psoriasis — Buildup of skin cells that causes itchy, scaly patches of skin and rashes
  • Rosacea — A condition that causes blushing or redness in the face
  • Folliculitis — Inflamed hair follicles
  • Tinea — A contagious fungal skin infection
  • Eczema — Inflamed, dry, itchy skin
  • Contact dermatitis — A rash from direct contact with something to which you are allergic
  • Blepharitis — Inflammation that causes redness and scaling along the edges of the eyelids
  • Pyoderma — A condition that causes painful skin sores
  • Intertriginous dermatitis — Inflamed rashes in the skin folds due to heat or friction
  • Onychomycosis — A fungal infection in the toenails or fingernails that causes thickening and discoloration
  • Extragenital warts — Noncancerous growths caused by infection with human papillomaviruses

Other Health Conditions

The risk of seborrheic dermatitis is higher if you have certain health conditions, including:

  • Conditions that suppress the immune system like human immunodeficiency virus (HIV), adult non-Hodgkin lymphoma, adult Hodgkin lymphoma, and organ transplants
  • Neurologic disorders like Parkinson’s disease, epilepsy, and tardive dyskinesia
  • Stroke or heart attack
  • Metabolic disease
  • Alcoholism

Seborrheic dermatitis is more common in people with an impaired immune system, including those with HIV or AIDS. Researchers estimate that around 35 percent of people with early HIV infection and 85 percent of those living with AIDS develop seborrheic dermatitis. The symptoms of seborrheic dermatitis also tend to be more severe in people with HIV/AIDS and may occur in parts of the body where they’re usually less common.

The American Parkinson Disease Association has found that people with neurological diseases, such as Parkinson’s disease, also experience seborrheic dermatitis more frequently. Parkinson’s disease causes dysfunction of the autonomic nervous system, which can affect functioning of the sebaceous glands. As a result, people with Parkinson’s disease tend to have more oily skin on the scalp and face, which can lead to seborrheic dermatitis symptoms.

Not everyone with these health conditions will develop seborrheic dermatitis. Oftentimes, treating these health conditions will help address seborrheic dermatitis symptoms. If you have seborrheic dermatitis in addition to other chronic health conditions, talk to your doctor or dermatologist about how to best treat all of your symptoms.

Mental Health Conditions

People with mental health conditions like anxiety, eating disorders, and depression are more prone to seborrheic dermatitis. Having seborrheic dermatitis can also make these mental health conditions worse. Stress is also a common trigger for the initial onset and flares of seborrheic dermatitis. Although stress and similar intense emotions may not directly cause seborrheic dermatitis, they may play a role in the development and flaring of symptoms.

Medications

Seborrheic dermatitis is a potential side effect of some medications. Examples include:

  • Dopamine antagonists, such as methyldopa, used to treat Parkinson’s disease
  • Lithium, which is used to treat mental health conditions
  • Immunosuppressants, which treat inflammatory diseases
  • Immunomodulators, like Interferon, which affect the immune system
  • Psoralen/psoralen and ultraviolet A (PUVA), which is used to treat psoriasis
  • Psychotropic medications like buspirone, haloperidol decanoate, and chlorpromazine

Can Seborrheic Dermatitis Be Prevented?

Seborrheic dermatitis can’t be prevented, and there currently is no cure. Sometimes, treating an underlying health condition may help treat seborrheic dermatitis, but it may not always resolve on its own. Seborrheic dermatitis is a chronic skin disease that has periods of flares and clear skin. There are steps you can take to prevent triggering flares and worsening symptoms. Treatments for seborrheic dermatitis include medicated shampoos to help with dandruff, antifungal medications, topical corticosteroids, and calcineurin inhibitors.

If you notice seborrheic dermatitis symptoms, talk to your doctor or dermatologist. They can prescribe you treatments to help manage the condition and clear your skin. Practicing good skin care and personal hygiene habits can also help keep some symptoms under control.

Talk With Others Who Understand

MySebDermTeam is the social network for people with seborrheic dermatitis and their loved ones. On MySebDermTeam, members come together to ask questions, give advice, and share their stories with others who understand.

What treatments have you tried for seborrheic dermatitis? What advice do you have for others living with the condition? Share your tips and experiences in a comment below or in your Activity feed.

    Posted on November 22, 2022
    All updates must be accompanied by text or a picture.

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    Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here
    Emily Wagner, M.S. holds a Master of Science in biomedical sciences with a focus in pharmacology. She is passionate about immunology, cancer biology, and molecular biology. Learn more about her here

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