What is Seborrheic Dermatitis?
Seborrheic dermatitis, or seborrheic eczema, is a common skin condition affecting up to one in ten people. The name tells you a lot; ‘seborrheic’ meaning it affects the sebaceous or oil-producing areas of the body (such as the face, scalp, chest or back) and ‘dermatitis’ describing red, flaky, itchy skin due to inflammation. Dandruff is seborrheic dermatitis on the scalp, and affects almost half of all adults, while seborrheic dermatitis can occur at any age; from newborn to adulthood. In babies it is commonly known as cradle cap.
What Causes Seborrheic Dermatitis?
There are multiple contributing factors, but one of the main culprits is a harmless yeast called Malassezia, which lives on everyone’s skin. In seborrheic dermatitis, this is found in higher amounts, and this Malassezia may be causing an inflammatory reaction in the skin. There is also an increased production of sebum (oil from skin) which plays a role.
There may be a genetic susceptibility to seborrheic dermatitis, and this combined with external factors such as tiredness, stress and weather changes (cold, dry conditions) can lead to flares. Seborrheic dermatitis is more common in people with a weakened immune system or in nervous system disorders like Parkinson’s Disease, but in most people it is not linked to any underlying illnesses.
Seborrheic dermatitis is not a contagious skin condition, but it does tend to come back again and again in adults.
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Seborrheic Dermatitis: Symptoms and Signs
Symptoms vary, but affected areas can be itchy, flaky and sensitive. The severity can also vary, and looks different in different skin types. Affected skin can appear red, darker or lighter than the surrounding skin and may have yellow, oily scales or flakes on the surface. The most common sites involved are those with a lot of oil-producing glands:
- The scalp and along the hairline, as flaky dandruff or as more inflamed skin with scale. Around the ears can sometimes be involved.
- The face, particularly around the eyebrows and the creases that run from the nostrils to the corners of the mouth. The eyelids can sometimes also be affected and become red, swollen and flaky.
- The front of the chest and the upper back, between the shoulder blades.
- The skin folds and moist areas such as under the breasts, under the arms, in the groin or in folds of skin on the abdomen. This skin can look pink and shiny, with cracks along the surface.
What Is the Treatment for Seborrheic Dermatitis?
There is no cure for seborrheic dermatitis, but treatment can improve or clear the skin. Unfortunately, it can flare up again once off treatment (although seborrheic dermatitis in babies does not need treatment and resolves itself within a few months). While it is a chronic condition, it may go away for a while, often during the summer, and return in winter or during periods of stress.
Self-Care Tips
- Use gentle soap-free washes and apply a light moisturiser to help the skin barrier afterwards.
- Choose non-comedogenic (non-oily, non-pore clogging) products, and ensure products are alcohol-free as this can trigger a flare-up.
- Soften thick scale in the scalp by applying coconut oil for an hour, then comb your hair and wash it out.
- Opt for cotton clothing, or loose fitting garments when seborrheic dermatitis is active to minimise irritation.
Treatment Options
- Scalp treatment:
- Thick areas of scale may be lifted with coconut oil or salicylic acid-containing products before washing your hair.
- Medicated anti-dandruff shampoos containing agents such as selenium sulphide or ketoconazole can be used regularly. For best results, leave for 5-10 minutes before rinsing.
- Body treatment:
- Washing affected areas with an antifungal shampoo may also help.
- Antifungal creams are often prescribed and they can safely be used on a long-term basis. Sometimes if the skin is inflamed, they are combined with a mild steroid cream for a short period.
- Rarely, a short course of antifungal tablets might be suggested by your doctor if the rash is widespread or resistant to other treatments.
Seek medical advice: It is important to visit your GP to confirm the diagnosis and receive appropriate treatment.
If you need guidance about seborrheic dermatitis or other skin disorders, contact the ISF Ask-a-Nurse Helpline here.
