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Seborrheic Dermatitis

What is Seborrheic Dermatitis?

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Considered a chronic form of eczema, seborrheic dermatitis appears on the body where there are a lot of oil-producing (sebaceous) glands like the upper back, nose and scalp. The exact cause of seborrheic dermatitis is unknown, although genes and hormones play a role. Microorganisms that live on the skin naturally can also contribute to seborrheic dermatitis.

People of any age can develop seborrheic dermatitis including infants (known as “cradle cap”). The triggers for seborrheic dermatitis include:

  • Stress
  • Hormonal changes or illness
  • Harsh detergents, solvents, chemicals and soaps
  • Cold, dry weather

In general, seborrheic dermatitis is slightly more common in men than in women. Patients with certain diseases that affect the immune system (such as HIV/AIDS) and the nervous system, such as Parkinson’s disease, are also at increased risk of developing seborrheic dermatitis.

Seborrheic dermatitis is not contagious.

What are the symptoms of seborrheic dermatitis?

Seborrheic dermatitis often appears on the scalp, where symptoms may range from dry flakes (dandruff) to yellow, greasy scales with reddened skin. Patients can also develop seborrheic dermatitis on other oily areas of their body, such as the face, upper chest and back.

Common symptoms of seborrheic dermatitis include:

  • Redness
  • Greasy, swollen skin
  • White or yellowish crusty flakes
  • Skin feels itchy or burns

How is seborrheic dermatitis diagnosed?

Seborrheic dermatitis can often look like — or even appear with — other skin conditions such as atopic dermatitis and psoriasis.

There is no test for diagnosing seborrheic dermatitis. Your doctor will ask about your medical history and also perform a physical examination of your skin. Sometimes, the doctor with scrape a bit of skin, mix it with a chemical and look at it under a microscope to determine if there is a fungal infection. Similarly, a skin biopsy (a procedure in which a small sample of skin is taken) may be required to rule out the other conditions that look like seborrheic dermatitis.

If you are experiencing symptoms, make an appointment with your doctor to get the correct diagnosis and treatment.

How are seborrheic dermatitis and atopic dermatitis different?

Atopic dermatitis and seborrheic dermatitis are both forms of eczema, a general term that describes inflammatory conditions that cause the skin to get red and itch. A person can be diagnosed with both seborrheic dermatitis and atopic dermatitis.

Atopic dermatitis (AD) nearly always causes itchy skin but seborrheic dermatitis does not. Atopic dermatitis most often affects the face, hands, feet, inside of the elbows and behind the knees. While seborrheic dermatitis affects places where there is oilier skin such as the nose and chest.

Another difference between the two conditions lies in the microorganisms that live on everyone’s skin. Considered to be from the yeast family, these an overgrowth of these fungi are known to contribute to seborrheic dermatitis.

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How do I treat seborrheic dermatitis?

In mild cases, a topical antifungal cream or medicated shampoo (such as ketoconazole, selenium sulfide, coal tar, and zinc pyrithione) may be enough to control symptoms.

In more severe cases, you may receive a prescription for a mild corticosteroid medication to calm the inflammation as well. Use topical corticosteroids only as directed—that is, when the seborrheic dermatitis is actively flaring.

In cases where corticosteroids are not appropriate, or when they have been used for a prolonged period, a non-corticosteroid topical medication such as tacrolimus (Protopic) or pimecrolimus (Elidel) may be prescribed. These medications are called topical calcineurin inhibitors (TCIs) and are approved for use by adults and children two years of age or older. Oral antifungal agents may be used in very severe cases.