What is seborrheic dermatitis? Symptoms and treatment options

“Seborrheic dermatitis” might be tough to say ten times fast, but it is less difficult to define. The word “seborrheic” refers to the sebaceous glands, which create an oily substance called sebum. “Derm” means skin. Put the two together and out comes a common skin condition. The disease causes an itchy, inflamed rash in adults that appears on oily parts of the body, like the face or scalp.

Learn more about seborrheic dermatitis below. Find details on causes, symptoms and treatment options.

In this article:

What causes seborrheic dermatitis?

Seborrheic dermatitis is one of the seven forms of eczema. Some people might know it as dandruff, but this is just a milder form of the disease. Seborrheic dermatitis in infants is called cradle cap.

Experts aren’t exactly sure what causes it. They think it stems from a combination of factors, including extra oil on the skin, genetics, stress and too much yeast on the skin.

Seborrheic dermatitis is also a long-lasting condition. Those affected can expect flare-ups from time to time. It is not contagious, so there is no need to worry about catching it from someone else. As of today, there is no cure. But there are treatments to help manage symptoms and stop breakouts.

Who does seborrheic dermatitis affect?

This type of eczema is more common in Black people than in others. Experts say 3 to 5 percent of the general population has seborrheic dermatitis. But that number jumps to 6.5 percent in Black communities. Men also develop seborrheic dermatitis more often than women.

The conversation doesn’t end with whom it might affect, either. It’s also about when symptoms might show up. Seborrheic dermatitis usually appears at certain stages of life. The first occurs during infancy, from when babies are three weeks to a couple months old. Flare-ups are also common during puberty, when the sebaceous glands are changing, and in adults ages 30 through 60.

Certain illnesses can also increase the odds of developing seborrheic dermatitis:

• Alcoholism
• Depression
• Eating disorders
• Epilepsy
• HIV
• Parkinson’s disease
• Psoriasis
• Rosacea
• Stroke or heart attack

What triggers a seborrheic dermatitis flare-up?

Outbreaks can happen anytime. But certain triggers can make symptoms of seborrheic dermatitis more likely to appear:

• Cold, dry weather
• Harsh chemicals, hair-styling products, detergents and soaps
• Hormonal changes
• Illness
• Medications like psoralen, interferon and lithium
• Seasonal changes
• Stress

Where does seborrheic dermatitis show up?

Seborrheic dermatitis usually shows up on oily skin, and oily skin tends to appear on areas of the body with lots of sebaceous glands. These tiny structures produce an oily substance called sebum to help moisturize the skin. There are thousands of sebaceous glands throughout the body, but the face and scalp contain the most, which is why these areas are hot spots for seborrheic dermatitis.

That, however, doesn’t mean it can’t pop up on other parts of the body. The condition can also appear on the chest, back of the neck or where the skin folds (such as the armpits, belly button and groin).

Symptoms of seborrheic dermatitis

The following symptoms are often linked to seborrheic dermatitis:

• Burning sensation
• Flaky skin
• Itchiness
• Pink, purple, white or red scaly rash (how the rash looks on skin can vary based on skin tone)
• The rash may be dry, have greasy scales or both

How is seborrheic dermatitis diagnosed?

It’s recommended that patients talk to a health care provider if they have symptoms for two weeks or longer, and they should always speak with a provider before starting or stopping any therapy. Health care providers usually diagnose seborrheic dermatitis through a physical exam. But other skin conditions can cause similar symptoms, so it's important to rule things out like allergies, rosacea or psoriasis. A medical expert might use the following tests to pinpoint a patient’s condition:

• Biopsy: A procedure whereby doctors scrape or cut off a sample of skin to look at under a microscope.
• Blood or urine test: A test to help doctors rule out other conditions. It also checks for underlying causes, which can be either acquired or inherited.
• Skin scraping: A procedure used to detect fungal infections of the skin. It is also known as a potassium hydroxide (KOH) test.

Seborrheic dermatitis treatment options

Some patients experience more severe symptoms than others, so treatment plans will vary. People with mild cases can try over-the-counter (OTC) solutions for relief support, as recommended by their health care provider. Adults with more severe forms of seborrheic dermatitis may need to consider prescription options.

Scalp treatments

Cradle cap usually goes away on its own in a few weeks to months. The U.S. Food and Drug Administration (FDA) has not approved any drugs for treating seborrheic dermatitis in children under the age of two. Dandruff shampoo is not recommended for treating cradle cap in infants, so scalp treatments are the best option for addressing cradle cap in babies. Apply mineral oil to soften the affected areas and use a cotton swab or soft cloth to remove the scales. Health care providers may also recommend shampooing the scalp every other day.

Over-the-counter treatments

OTC dandruff shampoos can help control mild symptoms of seborrheic dermatitis. These products can have antifungal agents, which target the species of yeast that is believed to be associated with seborrheic dermatitis. Others, like coal tar and salicylic acid, help to control scalp buildup. As a reminder, speak with a health care provider before starting or stopping any therapy. Health care providers may recommend products that contain:

• Coal tar 
• Ketoconazole
• Selenium sulfide
• Salicylic acid
• Tea tree oil
• Zinc pyrithione

Prescription medications

If OTC treatments don’t help, a health care provider may suggest prescription options like roflumilast or ciclopirox. Other treatment options include antifungal shampoos, lotions, foams or gels.

Lifestyle changes

Lifestyle changes can help people manage their symptoms, as well. This includes avoiding stressors and using fragrance-free soaps. Moderate amounts of sunlight can also help improve the condition. There are no official dietary guidelines for seborrheic dermatitis. However, some studies suggest citrus fruits and vegetables can help ease symptoms.

Key takeaways

Seborrheic dermatitis is a common form of eczema. It can lead to a rash, flaking and itchiness. This condition often affects oily areas of the body, like the face and scalp. Experts don't know exactly what causes it, but it seems to be a mix of things like genes and a yeast that lives on the skin. Shampoos, creams and some self-care can help keep symptoms in check and under control.