Symptoms – what does seborrhoeic dermatitis look like?
Seborrhoeic dermatitis presents as red, slightly thickened skin covered with greasy, yellowish or white scales. The lesions most often itch or sting slightly, and the skin may feel tight. In people with darker skin tones, redness is less pronounced, and the lesions may be lighter or darker than the surrounding skin.
Dandruff that does not go away even with regular hair washing is usually noticed first on the scalp. On the face, redness and scaling are seen along the eyebrows, beside the nose and in the beard, and in some people on the eyelids. The symptoms fluctuate: periods of remission last for weeks or months, followed by a flare-up, most often in winter and during periods of stress.
Where does seborrhoeic dermatitis occur?
Changes occur in areas with the highest concentration of sebaceous glands: the scalp, the hairline on the forehead, the eyebrows, the space between the eyebrows, the folds beside the nose, the chin, behind and inside the ears, the upper part of the chest and the back, and less commonly the armpits and groin. In babies, it appears as cradle cap, that is, yellowish crusts on the crown of the head, and in the nappy area.
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Causes, triggers and course of seborrhoeic dermatitis
What causes seborrhoeic dermatitis?
The exact cause is not known. The fungus Malassezia, which normally lives on the skin and feeds on sebum, plays an important role. In individuals prone to seborrhoeic dermatitis, the skin reacts to it with inflammation, resulting in redness and flaking. Hereditary predisposition, increased sebum production and the state of the immune system also contribute.
What worsens seborrhoeic dermatitis?
The most common triggers are cold and dry weather, stress and lack of sleep, hormonal changes, infrequent hair and face washing, as well as aggressive products that dry out and irritate the skin. In some people, flare-ups occur after illness or during periods of extreme fatigue. In summer, with moderate sun exposure, symptoms are often milder.
Who most commonly gets seborrhoeic dermatitis?
It occurs in babies in the first months of life and in adults, most commonly between the ages of 20 and 50. It is more frequent in people with oily skin, people with psoriasis, certain neurological conditions, and a weakened immune system.
Seborrhoeic dermatitis in babies
In babies, it appears as cradle cap, namely yellowish, greasy crusts on the scalp, and sometimes redness in skin folds and the nappy area. It most commonly clears up on its own by the end of the first year. The crusts are softened with baby oil and gently removed with a soft brush, without scratching. If the condition spreads, becomes weeping or the baby seems distressed, a medical examination is required.
Is seborrhoeic dermatitis curable?
Seborrhoeic dermatitis is a chronic condition and the predisposition to it remains. With treatment, the lesions subside, and regular care and occasional application of preparations prevent frequent flare-ups. The aim of treatment is to keep the skin clear for as long as possible.
Have a question?
Frequently asked questions about seborrhoeic dermatitis
Is seborrhoeic dermatitis contagious?
No. It is not transmitted by touch, comb or towel, and is not the result of poor hygiene.
Seborrhoeic dermatitis or ordinary dandruff – what is the difference?
Ordinary dandruff is a mild form of seborrhoeic dermatitis: tiny, dry scales without redness. We speak of seborrhoeic dermatitis when scales are accompanied by redness, itching and greasy, yellowish deposits, and when the changes spread to the face, behind the ears or onto the chest.
Seborrhoeic dermatitis or psoriasis?
Both conditions cause redness and scaling on the scalp, so they are easily confused. In psoriasis the changes are thicker, clearly demarcated and covered with silvery scales, and they often exist on the elbows, knees and nails. In seborrhoeic dermatitis the scales are greasier and yellowish, and the borders are less sharp. In some people both conditions overlap, so the diagnosis is made by a dermatologist, if necessary with trichoscopic scalp examination.
How is seborrhoeic dermatitis treated?
Treatment depends on the location and severity of the lesions. The mainstay is shampoos and preparations with an antifungal action, which reduce the number of Malassezia fungi on the skin. When inflammation is pronounced, a dermatologist will briefly prescribe mild corticosteroid preparations, and for the face and sensitive regions, preparations that soothe inflammation without corticosteroids.
Once the skin settles, treatment is continued less frequently, for example with a shampoo once to twice a week, in order to prevent a recurrence. Corticosteroid preparations should not be used for a long time without a doctor's supervision.
What shampoo should be used for seborrhoeic dermatitis?
Shampoos with anti-fungal ingredients, zinc, selenium or salicylic acid are most commonly recommended. The shampoo should be left on the scalp for a few minutes before rinsing. The type of shampoo and frequency of washing are tailored by a dermatologist to the condition of the scalp and hair type.
How to care for the face with seborrhoeic dermatitis?
The face should be washed with a mild cleanser and cared for with a light, non-comedogenic cream that contains no alcohol or strong fragrances. Thick, greasy preparations and oils can make the blemishes worse. The beard and moustache trap flakes, so they should be washed regularly too.
Does diet affect seborrhoeic dermatitis?
There is no evidence that a specific food causes seborrhoeic dermatitis. A balanced diet, enough sleep and less stress help to make flare-ups less frequent.
How is seborrhoeic dermatitis treated in Imedic?
The treatment of seborrhoeic dermatitis is led by dermatologists Dr Marina Ćirović and Dr Sanja Kekić. During the examination, the scalp and skin are assessed, conditions resembling seborrhoeic dermatitis are ruled out, and a treatment and care plan is created.
Author: Dr Ivica Jeremić
PhD in Medical Sciences (Molecular Medicine and Immunology), rheumatology subspecialist, dermatology resident.
Updated:
Expert sources
- DermNet: Seborrhoeic dermatitis.
- American Academy of Dermatology Seborrhoeic dermatitis: Overview.
- Seborrheic Dermatitis. StatPearls, NCBI Bookshelf.
