Seborrheic dermatitis – also called seborrhea – is a non-contagious skin condition. It causes red patches and oily, scaly flakes to form, especially on facial skin and the scalp. These flakes only rarely itch. Experts believe that seborrheic dermatitis is made more likely by factors such as increased production of sebum (an oily substance) in the skin, fungi that affect the skin like yeast, and a weakened immune system.
If someone first has seborrheic dermatitis as a teenager or adult, it almost always comes back. Then it helps to apply antifungal medicines or steroid creams to the inflamed areas of skin.
The situation is very different in babies though: If seborrheic dermatitis occurs during the child’s first few months of life, it usually goes away on its own within one year.
Red patches covered with yellowish, shiny oily scales are the typical signs of seborrheic dermatitis. They don’t usually itch.
These patches appear most commonly on areas of skin that have a lot of sebaceous glands, which typically include
- the part of the scalp with hair and the hairline,
- under and between the eyebrows, and
- on the cheeks and particularly in the folds of skin that run from the nostrils down to the corners of the mouth.
Seborrheic dermatitis may also spread to other parts of the body, most commonly above the breastbone and on the back near the thoracic spine. Fold of skin may be affected too – for example, under the chest, or in the armpits or groin. In men, the patches may also occur in the genital region.
Seborrheic dermatitis: Parts of the body typically affected
Babies mostly develop yellowish, oily flakes on their scalp that don’t easily flake off. But as in adults, it can also spread to other parts of the body, such as the face, skin folds or the parts of the skin covered by a diaper.
Seborrheic dermatitis affecting a baby’s scalp
Causes and risk factors
It’s probably a combination of factors that cause these scaly, reddish patches of skin. For instance, increased sebum production and the yeast Malassezia furfur, which lives on the skin and is usually harmless, may contribute to the development of seborrheic dermatitis.
Bacteria, stress, genes, hormones, nervous system disorders like Parkinson’s or a weakened immune system could also play a role here. People with a weakened immune system – for example, due to AIDS – also have a higher risk of developing a more severe type of seborrheic dermatitis that spreads to the rest of the skin and is harder to treat.
Prevalence and outlook
Seborrheic dermatitis is common: About 3 to 10 out of 100 people are affected. It’s more common in men than in women. People usually get it for the first time when they are young adults or over the age of 50.
It’s chronic with symptoms that vary in their severity. These changes in the skin might also go away for a while – oftentimes in the summer. But they may return in the winter or during periods of stress.
Seborrheic dermatitis in babies usually clears up completely without any consequences.
Diagnosing seborrheic dermatitis is easy if scaly, non-itchy red patches of skin appear on the parts of the body typical for the condition. Usually it’s enough to have a detailed talk with the doctor and then a physical examination. The doctor will first try to rule out other skin conditions that are similar to seborrheic dermatitis, such as psoriasis or atopic dermatitis (also called atopic eczema). These conditions also cause changes in the skin, but usually on different parts of the body. In atopic dermatitis, the skin inflammations itch and are made up of red patches of skin with rough edges and some small blisters.
Only rarely are further examinations needed. A smear can also be tested in the laboratory to see whether it could be a bacterial skin infection such as impetigo. A sample of the tissue (biopsy) is usually not necessary.
Teenagers and adults can treat the inflamed patches of skin with medication to relieve the symptoms. Options include the following:
- Shampoos containing tar
- Creams that have salicylic acid as an ingredient
- Creams or shampoos with antifungal agents (antimycotics)
- Anti-inflammatory creams or gels containing steroids
It usually isn’t necessary to take any pills or tablets. Because sunlight can make seborrheic dermatitis improve, some people also try phototherapy with UV-B light.
There is no treatment that can clear up seborrheic dermatitis for good.
No treatment is usually needed for babies because if they have seborrheic dermatitis, it goes away on its own and doesn’t harm them. If you want to get some of the crust off your baby’s head, you can soften it overnight using olive oil and then wash it out the next day with baby shampoo. A zinc paste can help if there is discharge in the affected folds of skin, for example the skin covered by the baby’s diaper.
Although seborrheic dermatitis is harmless, it can still be distressing for teenagers and adults: The scaly patches of skin often occur on the face, making them visible to others. They can also remain for your entire life. If you feel very bad about your skin, you can talk with a doctor about ways of finding a better way to cope with the condition, like using behavioral therapy.
You should avoid always covering up the inflamed patches of skin with heavy make-up because this clogs the pores in the skin. But putting on light make-up now and then isn’t a problem. Mild, non-oily skin care products are well suited for skin care.
It’s not necessary to use special sun protection for seborrheic dermatitis. It’s enough to use appropriate protection from UV rays based on your skin type. Giving the skin sunlight and fresh air, for example by going to the beach, may instead even reduce the symptoms. Protective lotions with a low oil content are then more suitable than very greasy sun lotions.
When people are ill or need medical advice, they usually go to see their family doctor first. Read about how to find the right doctor, how to prepare for the appointment and what to remember.
Kastarinen H, Oksanen T, Okokon EO, Kiviniemi VV, Airola K, Jyrkkä J et al. Topical anti-inflammatory agents for seborrhoeic dermatitis of the face or scalp. Cochrane Database Syst Rev 2014; (5): CD009446.
Moll I. Duale Reihe Dermatologie. Stuttgart: Thieme; 2016.
Naldi L, Diphoorn J. Seborrhoeic dermatitis of the scalp. BMJ Clin Evid 2015: pii: 1713.
Okokon EO, Verbeek JH, Ruotsalainen JH, Ojo OA, Bakhoya VN. Topical antifungals for seborrhoeic dermatitis. Cochrane Database Syst Rev 2015; (5): CD008138.
Pschyrembel. Klinisches Wörterbuch. Berlin: De Gruyter; 2017.
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