Symptoms of Seborrheic Dermatitis

Seborrheic dermatitis is a very common, chronic skin condition that causes red patches with overlying greasy, yellow scales to appear on the skin. These patches are believed to develop as a result of the body mounting an inflammatory response to Malassezia yeast on the skin. Dandruff is a mild form of seborrheic dermatitis.

When infants have seborrheic dermatitis on their scalps, it is referred to as "cradle cap."

Frequent Symptoms

Seborrheic dermatitis can develop at any age but most commonly develops in infants between 2 months to 12 months of age, and then later in adolescents and adults between the ages of 30 and 60.

Adult Symptoms

In adults, seborrheic dermatitis causes flaky, scaly patches on the skin that are itchy, moist, and yellowish in color. Underneath these scaly patches, the skin is generally red.

The patches of seborrheic dermatitis develop on areas of the skin that contain a large number of sebaceous (oil-producing) glands, such as the face (including the ears, eyebrows, and eyelids) and scalp.

Besides the scalp and face, other areas of the body that may be affected by seborrheic dermatitis include the upper chest and back, armpits, and groin.

Dandruff is probably the best-known form of seborrheic dermatitis, characterized by an itchy scalp and white skin flakes on hair and clothing. Dandruff treatments are designed to reduce oil and scale buildup and kill yeast that may be associated with development of the rash.

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Seborrheic dermatitis
Seborrheic dermatitis. DermNet / CC BY-NC-ND

Infant Symptoms

Many infants develop a type of seborrheic dermatitis called cradle cap, which causes redness and thick, scaly patches to form on the baby's scalp, ears, neck, or even in the diaper area. Like with adults, these patches are greasy and yellow to brown in color.

Unlike with adults, cradle cap usually does not itch.

While cradle cap is harmless and usually goes away on its own within a few months, the rash can be distressing to the parent.

Complications

Complications are uncommon with seborrheic dermatitis and usually involve skin infections or side effects of treatments.

Adult Complications

In adults (and usually with more severe cases), if seborrheic dermatitis is left untreated, a secondary bacterial infection or fungal infection may occur due to the skin being open or damaged. This can cause increased redness, tenderness, and oozing or weeping of the patch and the surrounding skin.

Another potential complication of seborrheic dermatitis is related to the side effects of treatment. In adults, seborrheic dermatitis is often a chronic condition that requires on-and-off treatment to reduce inflammation and symptoms.

While low-dose topical corticosteroid therapy is an effective medication for treating seborrheic dermatitis, long-term use can cause side effects like thinning of the skin and telangiectasias (dilated blood vessels).

This is why doctors generally prefer milder agents to start, such as antifungal creams or medicated shampoos. If those are not effective, they may write a prescription for a non-steroidal topical medication like Protopic (tacrolimus) or Elidel (pimecrolimus).

Another complication that is more likely with adolescents and adults is psychological distress and embarrassment, leading to low self-esteem.

Infant Complications

Infants do not usually develop complications from cradle cap, and it generally goes away on its own by 8 to 12 months of age.

When to See a Doctor

It's usually not necessary to see a doctor for mild seborrheic dermatitis, but severe or persistent symptoms are worth getting checked out. If the rash is persistent and doesn't improve with treatment, it may be a different condition.

When Adults Should See a Doctor

If you have any signs of a secondary infection, like increased pain, redness, drainage or fever, you should contact a doctor right away.

It is also sensible to see your doctor for any new rash, especially if it is not responding to over-the-counter treatments. This is because there are other common skin conditions that can cause symptoms similar to those seen in seborrheic dermatitis.

Some of these conditions include:

Less commonly, secondary syphilis can trigger a widespread rash that can mimic the patches of seborrheic dermatitis. Facial seborrheic dermatitis may also resemble the classic "butterfly rash" seen in systemic lupus erythematosus (SLE).

To differentiate among these conditions, in addition to a medical history and physical examination, a dermatologist may perform a skin scraping/KOH test or a skin biopsy.

When Infants Should See a Doctor

Infants should see a doctor if they have a widespread rash that isn't improving, or if they have any of the signs of infection, like pain, fever, drainage, or swelling.

In addition, the American Academy of Dermatology recommends that infants see a dermatologist for persistent rashes on the body or in the diaper area. It is important to distinguish seborrheic dermatitis from eczema, psoriasis, or allergies, as each of those requires a different treatment approach.

A Word From Verywell

If you think you or your child has symptoms of seborrheic dermatitis, please speak with your doctor. For babies with mild cradle cap, treatment may not be necessary. However, for babies with a more extensive rash, or for adults, prescription medication (in addition to self-care measures) may be warranted.

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