Usually beginning on the scalp as oily,
waxy patches, this common type of eczema sometimes spreads to the
face and beyond. A severe case, while rare, produces widespread
lesions. Like most types of eczema, seborrheic dermatitis tends to
flare in cold, dry weather.
Seborrheic dermatitis often
appears in and around the ears.
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Signs and Symptoms
Signs and symptoms can vary from day to day and include:
Oily, waxy appearance to the skin
Flaking skin with scale that ranges
in color from white to yellowish brown
Reddish, somewhat swollen patches of
skin — often resembling atopic dermatitis (another type of eczema)
Patches can appear on these areas of
the body: scalp, hairline, upper lip, beneath the eyebrows, inside
and behind the ears, eyelids, creases near the mouth, around the
nose, armpits, groin, navel, buttocks, underneath the breasts, and
upper back. These areas contain oil-producing glands called
Skin may itch constantly. Itching and
burning are most common when a skin infection develops. When the
skin is infected, skin becomes extremely inflamed and itchy.
If severe, widespread patches
Develops in all races
Tends to begin during infancy
(newborn to 6 months), puberty, or between 40 and 70 years of age.
After 6 months of age, the condition rarely appears before
puberty. When seborrheic dermatitis begins during infancy, it
usually clears by 9 to 12 months of age.
While the exact cause is not known, researchers believe that a
number of factors interact to cause seborrheic dermatitis. These
factors include the genes we inherit, yeast that normally live on
human skin, stress, climate, and overall general health.
The following tend to increase the likelihood of developing
A family history of eczema
Having oily skin or hair
Cold, dry climate
Gender: Males tend to develop more
often and have more severe cases
Injury to the skin, such as an
abrasion or scratch
Using lotions or other topicals that
Having acne, rosacea, psoriasis, or
blepharitis (inflammation of the eyelid)
Some medical conditions (Parkinson’s
disease, human immunodeficiency virus (HIV), and recovering from a
stroke or heart attack) increases the risk significantly.
Estimates indicate that as many as 90% of HIV-infected individuals
develop seborrheic dermatitis.
Taking certain medications, including
interferon-α, lithium, and psoralen, significantly increases one’s
Infants. The condition usually
clears on its own over a period of weeks or months but may return
Adults. Seborrheic dermatitis
is often chronic, flaring periodically and without warning.
Visual examination of the skin and
complete medical history. These are usually all that is needed
to diagnose seborrheic dermatitis. It is best to see a
dermatologist because seborrheic dermatitis can resemble many
other skin conditions, including atopic dermatitis, psoriasis, and
rosacea. In infants, seborrheic dermatitis may develop only in the
diaper area and be mistaken for diaper rash. Effective treatment
requires an accurate diagnosis.
Skin biopsy or other laboratory
testing. This may be necessary to eliminate the possibility of
another medical condition.
While seborrheic dermatitis cannot be cured, most cases
respond quickly to proper treatment. The goals of treatment are to
loosen and remove scales and crusts, prevent skin infections, as
well as reduce the inflammation and itch.
Treatment varies by age and area of the body to be treated:
Infants (scalp). Cradle cap,
which only develops in infants, can usually be controlled by
shampooing more frequently with a baby shampoo and by softly
brushing away the scales. A dermatologist also may prescribe a
mild corticosteroid or anti-fungal medication.
Infants (beyond the scalp).
When the condition spreads beyond the scalp in infants,
dermatologists usually prescribe a topical medication, such as a
mild corticosteroid or anti-fungal cream.
Adolescents and adults (scalp).
African-American patients often get relief by shampooing once a
week with a product recommended by a dermatologist.
Caucasian patients with seborrheic dermatitis may find that
shampooing more frequently than usual and leaving the lather on
the scalp for a longer time clears the condition. Shampoos
specially formulated for dandruff relief are often effective.
Sometimes getting results requires alternating dandruff shampoos
so that a different shampoo is used every few days. A
dermatologist can explain this process and recommend which
shampoos a patient should use and when. To effectively treat the
scalp, a dermatologist also may prescribe a topical corticosteroid
or antifungal medication.
A word of caution: While tar shampoos can effectively reduce skin
cell buildup, they also tend to discolor blond and gray hair.
Adolescents and adults (beyond the
scalp). Medicated dandruff shampoos often provide relief
beyond the scalp. A dermatologist can explain how to use shampoo
to treat other affected areas. A topical corticosteroid or
antifungal medication also may be prescribed. A severe case may
require the addition of an oral antifungal medication or
Clark RAF et al. “The Other Eczemas.” In: Moschella SL et al.
Dermatology. (Third edition.) WB Saunders Co.: Philadelphia,
Johnson BA et al. “Treatment of Seborrheic Dermatitis.”
American Family Physician. 2000. May1;61(9):2703-2710.
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have the human immunodeficiency virus (HIV), Parkinson’s disease, or
congestive heart failure often develop seborrheic dermatitis.