Seborrheic dermatitis

Seborrheic dermatitis is a common inflammatory skin condition. It causes flaky, white to yellowish scales to form on oily areas such as the scalp, face, or inside the ear. It can occur with or without reddened skin.

Scales

Scales are a visible peeling or flaking of outer skin layers. These layers are called the stratum corneum.

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Cradle cap is the term used when seborrheic dermatitis affects the scalp of infants.

Causes

The exact cause of seborrheic dermatitis is unknown. It may be due to a combination of factors:

• Oil gland activity
• Yeasts called Malassezia, which live on the skin, mainly in areas with more oil glands
• Changes in skin barrier function
• Your genes

Risk factors include:

• Stress or fatigue
• Weather extremes
• Oily skin, or skin problems such as acne
• Heavy alcohol use, or using lotions that contain alcohol
• Obesity
• Nervous system disorders, including Parkinson disease, traumatic brain injury, or stroke

  Parkinson disease

  Parkinson disease results from certain brain cells dying. These cells help control movement and coordination. The disease leads to shaking (tremors...

  

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  Stroke

  A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...

  

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• Having HIV/AIDS

  HIV/AIDS

  Human immunodeficiency virus (HIV) is the virus that causes acquired immunodeficiency syndrome (AIDS). When a person becomes infected with HIV, the ...

  

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Symptoms

Seborrheic dermatitis can occur on several body areas. It often forms where the skin is oily or greasy. Common areas include the scalp, eyebrows, eyelids, creases of the nose, lips, behind the ears, in the outer ear, and middle of the chest.

In general, symptoms of seborrheic dermatitis include:

• Skin lesions with scales

  Skin lesions

  Rashes involve changes in the color, feeling or texture of your skin.

  

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• Plaques over large area

  Plaques

  A patch is a flat area of color change in the skin that is 1 cm or more wide.

  

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• Greasy, oily areas of skin
• Skin scales -- white and flaking, or yellowish, oily, and sticky dandruff
• Itching -- may become more itchy if infected
• Mild redness

Exams and Tests

Diagnosis is based on the appearance and location of the skin lesions. Further tests, such as skin biopsy, are rarely needed.

Skin biopsy

A skin lesion biopsy is when a small amount of skin is removed so it can be examined under a microscope. The skin is tested to look for skin conditi...

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Treatment

Flaking and dryness can be treated with over-the-counter dandruff or medicated shampoos. You can buy these at the drugstore without a prescription. Look for a product that says on the label it treats seborrheic dermatitis or dandruff. Such products contain ingredients such as salicylic acid, coal tar, zinc, resorcinol, ketoconazole, or selenium sulfide. Use the shampoo according to label instructions.

For severe cases, your health care provider will likely prescribe a shampoo, cream, ointment, or lotion containing either a stronger dose of the above medicines or containing any of the following medicines:

• Ketoconazole
• Ciclopirox
• Sodium sulfacetamide
• A corticosteroid
• Tacrolimus or pimecrolimus (medicines that suppress the immune system)

Phototherapy, a medical procedure in which your skin is carefully exposed to ultraviolet light, may be needed.

Sunlight may improve seborrheic dermatitis. In some people, the condition gets better in the summer, especially after outdoor activities.

Outlook (Prognosis)

Seborrheic dermatitis is a chronic (life-long) condition that comes and goes, but it can be controlled with treatment.

Severity of seborrheic dermatitis can be lessened by controlling risk factors and paying careful attention to skin care.

Possible Complications

The condition may result in:

• Psychological distress, low self-esteem, embarrassment
• Secondary bacterial or fungal infections

When to Contact a Medical Professional

Call for an appointment with your provider if your symptoms don't respond to self-care or over-the-counter treatments.

Also call if patches of seborrheic dermatitis drain fluid or pus, form crusts, or become very red or painful.