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What Is Seborrheic Dermatitis? Understanding the Skin Condition

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

Seborrheic dermatitis is a chronic (ongoing) type of eczema that causes greasy scales and itchy, flaky patches on the skin and scalp. Its name is based on the fact that it occurs on areas of the skin that have a lot of sebaceous glands (oil glands). Seborrheic dermatitis isn’t caused by a lack of personal hygiene, and it’s not contagious. There currently is no cure for seborrheic dermatitis, but with the right combination of treatments, symptoms and flares can be managed.

How Common Is Seborrheic Dermatitis?

Seborrheic dermatitis is a common condition, affecting around 11 percent of the general population. The condition occurs more often among men than women, according to an InformedHealth.org study. Seborrheic dermatitis tends to be more common in certain age groups as well — it’s usually seen in infants and in adults between the ages of 30 and 60.

What Causes Seborrheic Dermatitis?

Researchers aren’t exactly sure what causes seborrheic dermatitis, but several factors may play a role in its development. One possibility is that seborrheic dermatitis is an inflammatory reaction to a type of yeast called Malassezia. This yeast is present on everyone’s skin but thrives on areas of skin that tend to be affected by seborrheic dermatitis, leading researchers to wonder if there’s a connection. Some studies have explored whether an immune system reaction to Malassezia or its byproducts causes seborrheic dermatitis, but a direct relationship between yeast and the condition hasn’t yet been found.

Other factors that may have a role in seborrheic dermatitis include a family history of dermatitis, a higher level of androgen hormones, and a higher amount of certain skin lipids (natural fats). Because seborrheic dermatitis is chronic, factors such as the following may trigger or worsen symptoms:

  • Cold, dry weather
  • A history of other skin conditions, such as psoriasis, rosacea, and acne
  • Stress or recovery from a stressful event like a heart attack
  • Certain medications, including lithium, interferon, and psoralen
  • Irritating ingredients in products such as soaps, detergents, and chemicals

People with certain medical conditions or diseases have been found to be at a higher risk of developing seborrheic dermatitis. These conditions include human immunodeficiency virus (HIV), Parkinson’s disease, epilepsy, depression, alcoholism, and eating disorders.

How Is Seborrheic Dermatitis Diagnosed?

Seborrheic dermatitis looks similar to other skin diseases, such as atopic dermatitis (a more common form of eczema) and psoriasis, which can make it difficult to diagnose. Although seborrheic dermatitis usually is diagnosed based on a physical exam, your doctor or dermatologist may also do a skin biopsy (take a sample of body tissue) to look closely at your skin.

There are several other conditions that you may be diagnosed along with or instead of seborrheic dermatitis, such as:

  • Atopic dermatitis — Dry skin that’s inflamed and itchy
  • Contact dermatitis — An allergic reaction that causes an itchy rash
  • Rosacea — Facial redness or brownish discoloration, depending on your natural skin tone
  • Psoriasis — Scaly, dry patches of skin with a rash
  • Discoid lupus — Disclike rashes on the face and scalp
  • Nummular dermatitis — Pink, red, or brown coin-shaped rashes
  • Lichen simplex chronicus — Dry, itchy, thickened skin
  • Secondary syphilis — Red or reddish-brown rash on the soles of the feet and palms of the hands

Doctors will make a differential diagnosis by comparing your symptoms with those of other skin conditions. The location of lesions, plaques, and rashes can tell your doctor a lot about what condition you may have. They may also do tests such as a fungal culture or skin biopsy. Compared with other skin conditions, seborrheic dermatitis looks much different under a microscope.

Common Symptoms of Seborrheic Dermatitis

Sebaceous glands exist everywhere on your skin except the palms and soles. As a result, seborrheic dermatitis can be found on many parts of the body. It often affects the scalp and face, especially the:

  • Ears
  • Eyebrows and eyelids
  • Nose
  • Forehead
  • Beard area

On other parts of the body, you might notice symptoms where the skin rubs together and there isn’t much airflow, such as these areas:

  • Neck
  • Armpits
  • Under the breasts
  • Inside the elbows and behind the knees
  • Buttocks, groin, and genitals

Symptoms of seborrheic dermatitis include:

  • Itchy, flaky skin
  • Flakes of skin on the scalp, eyebrows, or facial hair (dandruff)
  • Yellow, greasy scales or crusts
  • Areas of discolored, thickened skin (plaques) on both sides of the face
  • Inflamed hair follicles on the face and chest
  • Irritating rashes in skin folds or creases
  • Scaly, inflamed eyelids (blepharitis)

The color of a rash associated with seborrheic dermatitis depends on your natural skin tone, appearing red in lighter skin and discolored (either darker or lighter than normal) in darker skin. People of color might also develop petaloid seborrheic dermatitis, a pink, round, flower petal-like rash around the cheeks and nose and in the eyebrows.

In infants, seborrheic dermatitis is known as cradle cap. Light-skinned babies with cradle cap usually have thick yellow crusts or plaques with some redness on the scalp. Black infants and those with darker skin tones may have lighter or pink patches or scaly, flaky skin.

Treatment Options for Seborrheic Dermatitis

Seborrheic dermatitis treatments focus on clearing the skin and controlling flare-ups. It’ll likely take some trial and error to find a combination of therapies that works best for you. You may also have to rotate treatments to keep them working effectively.

Treatments include a variety of shampoos, lotions, creams, and ointments that contain antifungal ingredients and steroids. Your doctor’s recommendations will depend on the severity and location of your symptoms.

Treatments for mild seborrheic dermatitis include:

  • Over-the-counter dandruff shampoos that contain coal tar, zinc pyrithione, selenium sulfide, or salicylic acid
  • Medicated shampoos that contain antifungals such as ciclopirox (Loprox) or ketoconazole
  • Gentle skin care to keep your skin clean and moist

Treatments for moderate to severe seborrheic dermatitis include:

  • Topical antifungals — Ciclopirox, ketoconazole, and sertaconazole nitrate (Ertaczo)
  • Topical corticosteroids for the scalp — Fluocinolone (Capex, Synalar), clobetasol (Clobex), and betamethasone valerate (Luxiq)
  • Topical corticosteroids for the body — Desonide (Desonate), hydrocortisone, fluocinolone, and betamethasone valerate
  • Topical calcineurin inhibitors — Tacrolimus (Protopic) and pimecrolimus (Elidel)
  • Oral antifungal medications — Fluconazole (Diflucan), terbinafine (Lamisil), and itraconazole (Sporanox)
  • Phototherapy using ultraviolet light

Conditions Related to Seborrheic Dermatitis

Seborrheic dermatitis often occurs alongside other health conditions. Known as comorbidities, these conditions include Parkinson’s disease, HIV, AIDS, and metabolic syndrome (conditions that raise the risk of stroke, diabetes, and heart disease). Comorbidities may make it harder to treat seborrheic dermatitis, but treating the other condition can help resolve the skin symptoms.

Seborrheic dermatitis is also associated with bacterial, fungal, and other skin conditions (in addition to atopic dermatitis, psoriasis, contact dermatitis, and rosacea, discussed above). These conditions include:

  • Acne vulgaris — Chronic acne caused by clogged hair follicles
  • Folliculitis — Inflamed hair follicles
  • Tinea — A group of contagious fungal infections
  • Extragenital warts — Noncancerous growths triggered by HPV infection
  • Onychomycosis — Fungal infection in fingernails and toenails
  • Pyoderma — Painful skin sores usually seen on the legs

Seborrheic dermatitis and its treatments can bring on several related complications. If left untreated, the condition can lead to fungal or bacterial infections. You may experience some unwanted side effects from topical corticosteroids or antifungal medications, including skin thinning, nausea, and other skin problems. Sometimes, people with seborrheic dermatitis also experience changes in their mood.

What Is the Prognosis of Seborrheic Dermatitis?

Seborrheic dermatitis is a chronic skin condition — symptoms come and go over the course of years — that is generally harmless but can be uncomfortable during flares. When symptoms worsen, they can be managed well with treatments. Although seborrheic dermatitis causes inflammation of the hair follicles, it doesn’t cause permanent hair loss.

If you begin to notice symptoms of seborrheic dermatitis, or if you have an underlying health condition that increases your risk, talk to your doctor or dermatologist. They can work with you to develop a treatment plan to help keep your symptoms under control, as well as treat any underlying conditions that may make your symptoms worse.

Talk With Others Who Understand

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

Have you been diagnosed with seborrheic dermatitis? What advice do you have for others living with the condition? Share your tips and experiences in a comment below or on your Activities page.

    All updates must be accompanied by text or a picture.
    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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