Seborrheic Dermatitis

What is seborrheic dermatitis?

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.

Who gets seborrheic dermatitis and why?

Seborrheic dermatitis can affect people of any age, though it’s most common in infants and adults between the ages of 30 and 60. Among adults and teens, the condition is more common in males.

In infants, the condition usually clears on its own and doesn’t come back. In adults, however, seborrheic dermatitis usually follows a pattern of flaring and clearing that can last for years.

An inflammatory reaction to excess Malassezia yeast, an organism that normally lives on the skin’s surface, is the likely cause of seborrheic dermatitis. The Malessezia overgrows and the immune system seems to overreact to it, leading to an inflammatory response that results in skin changes.

Certain medical conditions can increase people’s risk of developing seborrheic dermatitis, including psoriasis, HIV, acne, rosacea, Parkinson’s disease, epilepsy, alcoholism, depression, eating disorders and recovery from a stroke or heart attack.

Common triggers for seborrheic dermatitis include:

  • stress
  • hormonal changes or illness
  • harsh detergents, solvents, chemicals and soaps
  • cold, dry weather
  • some medications, including psoralen, interferon and lithium

What are the symptoms of seborrheic dermatitis?

Infants with seborrheic dermatitis most often have a form called cradle cap, which appears on their scalps as scaly, greasy patches. They can also develop seborrheic dermatitis on their bottoms, where it can be mistaken for diaper rash, a form of contact dermatitis.

In teens and adults, seborrheic dermatitis forms where skin is oilier. In addition to the scalp, redness, swelling and greasy scaling can develop on the sides of the nose and in and around the eyebrows, on the mid-chest, upper back and in the armpits and groin area.

How is seborrheic dermatitis treated?

Following a skincare routine can help keep symptoms under control. Wash affected areas daily with a gentle, zinc-containing cleanser (2% zinc pyrithione) and follow up with a moisturizer. Healthy lifestyle habits, like managing stress and getting plenty of sleep, can also improve skin.

Treatment for seborrheic dermatitis is aimed at removing scales, reducing itch and calming the inflammation that’s causing redness and swelling.

In infants, using an emollient such as mineral oil or petroleum jelly to gently loosen scales is usually all that’s needed. Care can be more complicated for adults, who often need ongoing treatment and self-care to help prevent flare-ups.

Dermatologists usually begin treating mild cases with a topical antifungal cream or medicated shampoo, such as a prescription anti-fungal shampoo or over-the-counter dandruff product.

If the condition is more severe, intermittent use of a topical corticosteroid or calcineurin inhibitor may be required.

What do the ecz-perts have to say?

“Seborrheic dermatitis isn’t contagious and is not an allergy, although some allergies can mimic it,” said Dr. Peter Lio, clinical assistant professor of dermatology and pediatrics at Northwestern University’s Feinberg School of Medicine. A correct diagnosis, he added, requires careful evaluation by a dermatologist.

Seborrheic dermatitis can also overlap with atopic dermatitis, especially in infants. “We see this overlap in young adults, as well, usually in those with more severe atopic dermatitis,” Lio said. They can develop a condition that some call head and neck dermatitis that seems to be very closely related to seborrheic dermatitis and is treated similarly.”