Seborrheic Dermatitis: What It Is, Causes, Symptoms, and Treatment

Seborrheic dermatitis is a skin disease that causes flaking and dandruff on areas like the scalp, face, chest, and body folds. The condition can occur in both adults and infants. In some cases, it may improve without treatment. However, symptoms can be severe and negatively impact daily life, necessitating treatment in such instances.

What is Seborrheic Dermatitis?

Seborrheic dermatitis is a skin condition that primarily affects the scalp. It causes redness, flaking, and dandruff on the skin. In addition to the scalp, it can also appear in areas with active sebaceous (oil) glands, such as the eyebrows, sides of the nose, chest, upper back, ears, and body folds. In infants, it is known as cradle cap, which appears on the scalp. Also known as seborrheic eczema, this condition may improve on its own without treatment. However, recurring treatments may be necessary for some individuals to alleviate symptoms. Regular washing of the affected areas with appropriate shampoos can help reduce symptoms.

Symptoms of Seborrheic Dermatitis

Symptoms of seborrheic dermatitis may vary from person to person. The most common symptoms include:

Dandruff on the scalp, eyebrows, or beard
Yellowish or whitish scaling on the scalp, face, armpits, chest, and under the breasts
Redness of the skin
Itching

These symptoms may worsen due to factors such as stress, seasonal changes, and cold or dry weather.

In infants, seborrheic dermatitis may cause a condition known as cradle cap, characterized by yellow-brown scaling on the scalp. Most babies recover from cradle cap by the age of one, but in some cases, it can persist until adolescence.

For many patients, symptoms may not cause significant discomfort. However, if symptoms interfere with daily life or if the patient is bothered by dandruff or skin lesions, it is important to consult a dermatologist. Additionally, if an infection develops on the skin, medical attention is necessary. If home remedies do not adequately address skin issues, consulting a specialist is recommended.

Causes of Seborrheic Dermatitis

The exact causes of seborrheic dermatitis are not fully understood. However, there are some factors that experts believe may contribute to the development of the condition. One of these is the presence of a fungus called Malassezia furfur, which affects the parts of the skin responsible for oil production. This fungus is normally present on healthy skin but may cause problems in individuals prone to oily skin or in those with a weakened immune system, allowing it to spread and lead to skin issues.

Other factors thought to play a role in the development of seborrheic dermatitis include immune response disturbances (immunosuppression), Parkinson's disease, facial nerve paralysis, and nutritional deficiencies (such as zinc, niacin, and pyridoxine deficiency).

Risk Factors for Seborrheic Dermatitis

There are various factors that increase the risk of seborrheic dermatitis, including:

Conditions that weaken the immune system, such as AIDS, certain types of cancer, and the use of immunosuppressive drugs
Major medical events like heart attack or stroke
Psychiatric and neurological conditions like Parkinson's disease and depression
Certain medications

Seborrheic dermatitis is most commonly seen in infants and adults between the ages of 20-50. It is more common in men than in women and is also more prevalent in individuals with oily skin types.

Diagnosis of Seborrheic Dermatitis

The diagnosis of seborrheic dermatitis is made through a skin examination performed by a doctor. Since seborrheic dermatitis can be confused with other skin diseases, a skin biopsy may be required in rare cases for diagnosis. Skin conditions that are often confused with seborrheic dermatitis include:

Psoriasis: Psoriasis also causes redness and flaking of the skin. Unlike seborrheic dermatitis, flaking is more pronounced, and lesions appear silver-gray-white and are thicker.
Atopic Dermatitis: This condition causes itching and redness on the back of the knees, the front of the elbows, and the neck folds. In most patients, eczema tends to recur.
Tinea Versicolor: In this disease, skin rashes typically appear on the back and chest. These rashes are usually not as red or itchy as those in seborrheic dermatitis.
Rosacea: This disease usually causes redness and acne-like rashes on the face. In addition, flaking is less common. However, rosacea can coexist with seborrheic dermatitis.

Treatment of Seborrheic Dermatitis

The primary treatment for seborrheic dermatitis includes medical shampoos, creams, and lotions. Various at-home applications can also help alleviate the symptoms of the disease.

Medications Used in Seborrheic Dermatitis Treatment:

Shampoos, creams, and ointments that reduce inflammation: Products containing corticosteroids can be applied to the scalp. These are easy-to-use products; however, it’s important to use them at the minimum effective dose. Prolonged and uninterrupted use of these products can lead to side effects such as skin thinning and persistent redness. Creams containing tacrolimus and pimecrolimus, which belong to the calcineurin inhibitor drug group, may also be used in treating seborrheic dermatitis. The side effects of these products are generally fewer than those of corticosteroid-containing products and may include tolerable reactions such as burning, redness, and sensitivity.
Antifungal creams and shampoos: Depending on the severity of the symptoms, a doctor may prescribe creams and shampoos containing ketoconazole, an antifungal (anti-yeast) ingredient.
Antifungal tablets: If symptoms do not improve with other treatments, oral antifungal medications may be used under the supervision of a dermatologist.

Seborrheic dermatitis can be managed with simple home remedies and lifestyle changes. These approaches can help alleviate symptoms associated with the condition. For home remedies to be effective, the patient should understand their skin type and the severity of their condition. Applications made with this knowledge in mind will yield better results.

Patients can use anti-dandruff shampoos to prevent dandruff formation on the scalp. Shampoos containing zinc pyrithione, selenium sulfide, ketoconazole, tar, or salicylic acid can be beneficial for combating dandruff. Patients can try these products in sequence to find the one that best suits them, typically using the chosen product three to four times a week.

Other Useful Applications in Seborrheic Dermatitis Treatment:

Applying mineral oil or olive oil to the scalp and leaving it on for a few hours before washing the hair can soften the scalp. Then, gently combing the hair can help remove dandruff and flaking from the scalp.
Regular washing of the face and scalp with a mild soap can be effective against seborrheic dermatitis. After washing, it’s important to moisturize the skin with suitable moisturizers to prevent dryness.
Low-dose corticosteroid creams may be applied to skin lesions. If these creams are not effective, other formulations may be considered.
It is recommended to pause the use of hair styling creams, sprays, and gels until the seborrheic dermatitis treatment is completed.
People who experience issues in areas like the eyebrows, sides of the nose, and beard/mustache areas should cleanse their faces with appropriate cleansers to remove excess oil and follow up with suitable moisturizers. Low-dose corticosteroid creams, creams with calcineurin inhibitors, and tea tree oil-based cleansing soaps can be among the products used for this purpose.
If seborrheic dermatitis causes flaking on the eyelashes, they can be washed with baby shampoo or eye cleansers containing tea tree oil. In addition to regular washing, flakes on the eyelashes can be gently cleaned with cotton swabs (such as ear swabs).
For babies with cradle cap, non-medicated shampoos should be used. After softening the scalp with olive oil, the baby’s hair can be combed with a soft brush to remove the flakes.
Spicy foods may also trigger seborrheic dermatitis, so reducing spicy food intake can help reduce flare-ups.

Individuals with skin lesions resembling seborrheic dermatitis who cannot resolve these issues with home remedies should consult a healthcare center. Through a detailed examination, the cause of the lesions can be identified.

Last Updated Date: 06 May 2021

Publication Date: 28 April 2021

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