What Is Seborrheic Dermatitis?

Seborrheic dermatitis is an inflammatory skin condition that causes dry, flaky skin patches on various body areas. On the scalp, mild seborrheic dermatitis is often referred to as dandruff, and in young infants, it is known as cradle cap. Seborrheic dermatitis can occur anywhere on the body but most commonly affects oil-prone areas like the scalp, face, neck, and chest.

This article will review symptoms, risk factors, diagnosis, and treatment of seborrheic dermatitis.

Symptoms of Seborrheic Dermatitis

Seborrheic dermatitis can look different on each individual. It can present as a red, pink, or violet raised rash on various parts of the body. Other symptoms of seborrheic dermatitis also include:

• Yellow or white scales, which can be dry or greasy
• Erythematous (red) plaques
• Greasy/oily patches of skin
• Itching or burning skin/scalp sensation
• Blepharitis (inflammation of the eyelids)

Areas Affected

Seborrheic dermatitis tends to affect parts of the body that are prone to increased oil production. Sebaceous glands are responsible for lubricating the skin and play an important role in overall health. Sometimes however, they can overproduce oil, which can lead to a variety of different skin conditions like acne and seborrheic dermatitis. Areas most prone to oil overproduction include:

• Scalp
• Forehead
• Eyebrows
• Eyelids
• Inside and behind the ears
• Sides of the nose
• Around the mouth and beard
• Back of the neck

In more severe cases of seborrheic dermatitis, rashes can develop in the armpits, skin folds, the groin, and under the breasts. In infants, seborrheic dermatitis is more likely to occur on the scalp, between skinfolds, and in the diaper region.

Can You Have Hair Loss With Seborrheic Dermatitis?

While not common, there are some cases in which seborrheic dermatitis can lead to minor hair loss. Increased oil production on the scalp can cause inflammation and irritation of the affected area. This, in turn, can cause an itchy or burning sensation. When a person scratches their scalp to alleviate the itchiness, they can damage the hair follicles and inadvertently cause hair loss.

Additionally, a yeast known as Malassezia can lead to seborrheic dermatitis of the scalp. If left untreated this type of yeast can also cause inflammation of the scalp, leading to damage of the hair follicles. It is important to note that hair loss associated with this condition is not permanent and can be reversed with proper treatment.

Who’s at Risk for Seborrheic Dermatitis?

Seborrheic dermatitis can affect anyone, but it is more common in males. It is also most common in infants younger than 3 months old (cradle cap) and adults between the ages of 30 and 60.

Other, additional risk factors for seborrheic dermatitis include:

• Fatigue
• Stress
• Genetics
• Cold environments/climates
• Infrequent hair washing
  
• Compromised immune system

Factors That Aggravate Seborrheic Dermatitis

Some factors which can aggravate seborrheic dermatitis include:

• Stress
• Cold, dry environments
• Harsh chemicals in soaps, shampoos, and detergents
• Medical conditions such as human immunodeficiency virus (HIV), Parkinson's disease, psoriasis, depression

Diagnosing Seborrheic Dermatitis

If symptoms are persistent and progressively worsening, it may be time to see a dermatologist or other healthcare providers. Different skin conditions can look similar to each other, like rosacea, atopic dermatitis, psoriasis, but a dermatologist will be able to make a specific diagnosis.

Although not usually necessary, a skin biopsy (removing a sample of skin for analysis in a lab) may be done to help confirm the diagnosis.

Seborrheic Dermatitis Treatment

Treatment for seborrheic dermatitis depends on the rash's severity and location. Over-the-counter (OTC) treatments like dandruff or medicated shampoos and baby oil can often manage flaky or dry patches on the scalp. Typically anti-dandruff products are massaged into the scalp and left in for a few minutes before being thoroughly washed out.

If OTC products are not improving seborrheic dermatitis, you may need to try other options, such as prescription shampoo, creams, and lotion options. These options can contain some of the following ingredients:

• Topical antifungals like ketoconazole 2% and ciclopirox 1%
• Corticosteroid cream
• Coal tar
• Topical immunosuppressant tacrolimus
  

How to Treat Cradle Cap in Infants

Cradle cap in infants tends to resolve on its own after a few months without any treatment, but there are some remedies that can help loosen and remove scales. Regular washing of a baby's scalp with a mild fragrance-free baby shampoo may be beneficial. If OTC shampoos are not effective, discuss prescription options with a pediatrician or dermatologist.

For scales that are more difficult to remove from the scalp, massaging baby oil into the scalp before bathing and shampooing may help. Combing the infant's hair during washing can also help remove scales.

Remember not to pick or scratch the affected areas—even if you have trouble removing scales or patches—as this can lead to infection and worsening rashes.

When to Seek Care for Severe Seborrheic Dermatitis

If skin or scalp symptoms are not responding to at-home or OTC therapies it is best to seek an evaluation from a dermatologist. In some cases, especially in immunocompromised individuals, a secondary bacterial or fungal infection can develop if the condition is left untreated.

Summary

Seborrheic dermatitis causes dry, flaky patches on the skin of various areas of the body. It's called dandruff when it appears on the scalp and cradle cap on infant scalps, but it can also affect the back of the neck, insides of the ears, sides of the nose, or other areas that produce oils. It can be treated with over-the-counter medications and creams, but it may require prescription-strength drugs if it's severe.

If left untreated, an infection may develop, so be sure to see a healthcare provider if you're experiencing symptoms.