Seborrheic Dermatitis

Seborrheic dermatitis can affect the upper chest and have round, red areas in addition to slight scaling.

Seborrheic dermatitis can affect the upper chest and have round, red areas in addition to slight scaling.

Seborrheic dermatitis is a common skin condition that is similar to eczema and sometimes occurs in patients with eczema. In babies, it tends to mostly affect the scalp and is known as “cradle cap”. Older children and adults can develop it on the scalp as well, which is similar to dandruff but tends to be more itchy and inflamed. It can also affect the face and upper chest in some cases, and can overlap with psoriasis.

The main symptoms of seborrheic dermatitis include one or more of the following:

  • Redness (erythema)
  • Itching
  • Dry and flaking skin


The cause of seborrheic dermatitis is thought to be due to an abnormal inflammatory response to a yeast normally found on the skin: Malassezia. Like eczema, many factors can aggravate seborrheic dermatitis including stress, change of seasons, illnesses, and heavy alcohol use, to name a few.

How is Seborrheic Dermatitis Treated?

Seborrheic Dermatitis - Image:

This image displays a black patient with temporary lightening of the skin due to widespread seborrheic dermatitis.

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

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 needed—that is, when the seborrheic dermatitis is actively flaring. Prolonged use of these drugs can cause thinning of the skin, and there are other side effects to consider as well.

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 agents, topical calcineurin inhibitors, are approved for use by adults and children two years of age or older, and they avoid many of the side effects of corticosteroids.  Oral antifungal agents are rarely necessary, but may be useful in very severe cases.

Will it Ever Go Away?

Seborrheic Dermatitis - Image:

Redness and scaling often wraps around the nose in people with severe seborrheic dermatitis.

Although seborrheic dermatitis is a chronic disease, many patients go through periods when it is worse and periods when it is better. Some patients do seem to “outgrow” it completely. Staying on top of it and treating flares before they become severe seems to make it much more manageable.

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