We don’t know what exactly causes seborrheic dermatitis. It seems to be a combination of things, including:
- Your genes
- A yeast that normally lives on skin
- Certain medical conditions and medicines
- Cold, dry weather
It doesn’t come from an allergy or being unclean.
Newborns and adults aged 30-60 are more likely to get seborrheic dermatitis. It’s more common in men than women and in people with oily skin.
Infantile seborrheic dermatitis
Infantile seborrhoeic dermatitis causes cradle cap (diffuse, greasy scaling on scalp). The rash may spread to affect armpit and groin folds (a type of napkin dermatitis).
- There are salmon-pink patches that may flake or peel.
- It is not especially itchy, so the baby often appears undisturbed by the rash, even when generalized.
Adult seborrheic dermatitis
Seborrheic dermatitis affects scalp, face (creases around the nose, behind ears, within eyebrows) and upper trunk.
Typical features include:
- Winter flares, improving in summer following sun exposure
- Minimal itch most of the time
- Combination oily and dry mid-facial skin
- Ill-defined localized scaly patches or diffuse scale in the scalp
- Blepharitis: scaly red eyelid margins
- Salmon-pink, thin, scaly, and ill-defined plaques in skin folds on both sides of the face
- Petal or ring-shaped flaky patches on hair-line and on anterior chest
- Rash in armpits, under the breasts, in the groin folds and genital creases
- Superficial folliculitis (inflamed hair follicles) on cheeks and upper trunk
What is the treatment for seborrheic dermatitis?
Treatment of seborrheic dermatitis often involves several of the following options.
- Keratolytics can be used to remove scale when necessary
- Topical antifungal agents are applied
- Mild topical corticosteroids are prescribed for 1–3 weeks to reduce the inflammation of an acute flare
- Topical calcineurin inhibitors are indicated if topical corticosteroids are often needed, as they have fewer adverse effects on facial skin.
- Medicated shampoos containing ketoconazole, ciclopirox, selenium sulfide, zinc pyrithione, coal tar, and salicylic acid, used twice weekly for at least a month and if necessary, indefinitely.
- Steroid scalp applications reduce itching, and should be applied daily for a few days every so often.
- Tar cream can be applied to scaling areas and removed several hours later by shampooing.
Face, ears, chest and back
- Cleanse the affected skin thoroughly once or twice each day using a non-soap cleanser.
- Apply ketoconazole or ciclopirox cream once daily for 2 to 4 weeks, repeated as necessary.
- Hydrocortisone cream can also be used, applied up to twice daily for 1 or 2 weeks. Occasionally a more potent topical steroid may be prescribed.
- Topical calcineurin inhibitors such as pimecrolimus cream or tacrolimus ointment may be used instead of topical steroids.