Seborrheic Dermatitis

What is seborrheic dermatitis?

Seborrheic dermatitis is a common chronic, inflammatory skin condition that causes a patchy rash that is itchy and scaly. In adults, it affects the skin anywhere there is hair with sebaceous (oil) glands including the upper back, scalp, and oily skin areas on the face. It typically affects adults age 30-60, but it can occur at any age, even in babies. When an adult develops seborrheic dermatitis, it can be long-lasting. Symptoms come and go but can increase with stress or changes in a person’s overall health. Seborrheic dermatitis also tends to increase in the winter and early spring.

In newborns and babies up to 3 months, it is known as cradle cap causing a diffuse scaly scalp. Seborrheic dermatitis may also affect the armpits and be mistaken for diaper rash when it appears in groin folds. By age one, the condition typically disappears.

What are the symptoms of seborrheic dermatitis?

Seborrheic dermatitis appears as an itchy rash with red inflamed areas and yellow powdery or greasy scales on the scalp, face and trunk. It particularly manifests in the creases around the nose, around the external ear canals, behind the ears, within the eyebrows and eyelashes, mustache and beard, and along the hair line. It can cause blepharitis – inflammation of the eyelids and crusting.

Seborrheic dermatitis on the scalp is dandruff that causes scalp itching.  On the face it may burn. If untreated it can become a thick, yellow, greasy scale that can lead to a secondary infection.

What causes seborrheic dermatitis?

The cause is not known but a mix of genes and hormones play a role. The normal flora on the skin includes a specific type of yeast that may contribute to the symptoms of seborrheic dermatitis. It is not caused by poor hygiene.

Seborrheic dermatitis is more common in men and people with immune system diseases like diabetes and rosacea, and in people with central nervous system disorders like Parkinson’s.  Common triggers are stress, hormones, illness, harsh detergents, cold dry weather and some medications.

How is seborrheic dermatitis diagnosed?

It can be confused with dermatitis and psoriasis. There is no test. Diagnosis is based on clinical findings, history and a physical exam.

How is seborrheic dermatitis treated?

In some cases, seborrheic dermatitis may resolve without treatment, but it can flare over a lifetime.  Typically, seborrheic dermatitis waxes and wanes.  It is a chronic condition which can be managed. Treatment is focused on loosening the scales, reducing inflammation and swelling, and stopping the itch.

For cases on the scalp, prescription medicated dandruff shampoo that contains a topical antifungal such as ketoconazole, along with topical steroids, may provide sufficient treatment. On the body, a medicated body wash followed by a prescription topical steroid can help to control an outbreak.

When over-the-counter dandruff shampoos aren’t working, or if you think you may have seborrheic dermatitis, book an appointment with Dr. Heather Higgins for an exam. They can prescribe the best combination of treatments including prescription medications.