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Adeel Arshad

Authored on 24 January 2024 by Adeel Arshad,

Reviewed 24 January 2024 by Dr Ruch Karunadasa.

What is Seborrheic Dermatitis?

Seborrheic dermatitis is a common and easily treated skin disorder. This type of dermatitis causes itchy red areas on your skin as well as oily scales and white or yellow crusty or powdery flakes on your scalp.

Dandruff, cradle cap, seborrhoea and seborrheic eczema are all other names for this condition. It may resemble psoriasis, eczema, or an allergic reaction. It is most commonly found on the scalp but it can occur anywhere on the body. Common areas affected include the upper back and chest, behind the ears, in the eyebrows, the creases at the base of your nose, the face/forehead, under the breasts, in the navel (belly button), in the creases of your arms and legs and in the groin.

Seborrheic dermatitis is a chronic disorder that develops, resolves with therapy, and recurs occasionally.

Seborrheic dermatitis affects around 11% of the population. It is most common in newborns under three months old and people aged 30 to 60. It affects men more than women, and Caucasians are more affected than African Americans.

Signs and symptoms of seborrheic dermatitis may include:

  • Dandruff (skin flakes) on your scalp, hair, brows, beard, or moustache
  • Flaky white or yellow scales or crust on the scalp, face, sides of the nose, brows, ears, eyelids, chest, armpits, groin area, or under the breasts.
  • Red skin
  • Itching

If you are stressed, the indications and symptoms may be more severe, and they tend to worsen during cold, dry seasons.

Treatment of Seborrheic Dermatitis

General Measures

Proper education of the patients regarding skincare routines can help reduce the incidence of this disorder.

Identifying modifiable lifestyle factors, for example, a high fruit diet is related to reduced seborrheic dermatitis, but stress can cause flare-ups.

Specific Measures

Seborrheic dermatitis is frequently treated with a combination of the following methods.

  • Topical Anti-fungal Agents: Some anti-fungal creams can be used to eradicate the fungus causing the disease.
  • Keratolytic Agents: They can be used to remove scale when necessary. These include salicylic acid, lactic acid, urea, and propylene glycol.
  • Mild topical Corticosteroids: They should be used for 1–3 weeks to reduce the inflammation of an acute flare.
  • Topical Calcineurin Inhibitors: These include pimecrolimus cream and tacrolimus ointment and are indicated if topical corticosteroids must be used frequently, as they have fewer adverse effects on facial skin with long-term use.
  • Antibiotic and Other Therapies: Adults with resistant infections may benefit from oral anti-fungal treatments, tetracycline antibiotics, or phototherapy. Oral isotretinoin at low doses has also been shown to be effective but is only used in severe or resistant conditions.

Scalp Treatment

Shampoos containing, zinc pyrithione, ciclopirox, ketoconazole, coal tar, selenium sulfide, and salicylic acid can be used twice weekly for at least a month and indefinitely if necessary.

  • Steroid scalp treatments may relieve irritation and should be used regularly for a few days.
  • Steroid substitutes include calcineurin inhibitors such as tacrolimus.
  • Coal tar cream can be applied to scaling areas and then shampooed away several hours later.
  • Combination therapy is frequently recommended.
  • Tea tree oil shampoo and other alternative treatments may be used.

Face, Ears, Chest, and Back Treatment

  • Use a non-soap cleanser to thoroughly cleanse the afflicted skin once or twice each day.
  • Hydrocortisone cream used up to twice daily for 1 or 2 weeks, can also be used. A stronger topical steroid may be prescribed occasionally.
  • Instead of topical steroids, calcineurin inhibitors such as pimecrolimus cream or tacrolimus ointment may be used.
  • Apply ketoconazole or anti-fungal cream once daily for 2 to 4 weeks, as needed.
  • Although a variety of herbal medicines are routinely used, their usefulness is unclear.

Management in Infants

  • Regular scalp washing with baby shampoo or aqueous cream followed by gentle brushing may be used to remove the scales.
  • Depending on the severity of the rash, topical anti-fungal medications are frequently given.

Home Remedies

With lifestyle adjustments and home treatments, you may be able to control seborrheic dermatitis. Many of them are available without a prescription (over-the-counter) and could be considered if your doctor has previously diagnosed the condition. You may need to try different treatments or a mix of products before your condition improves.

  • Wash your skin regularly. Rinse the soap from your body and scalp thoroughly. Use a moisturiser instead of harsh soaps.
  • Soften your hair and remove scales. Massage your scalp with mineral oil or olive oil. Leave it in for about an hour. Then brush or comb your hair and wash it.
  • If you have a beard or moustache, shampoo it on a regular basis. Seborrheic dermatitis can be exacerbated under moustaches and beards. Shampoo with 1% ketoconazole every day until your symptoms improve. Then, once a week, shampoo your hair. Alternatively, shaving may help alleviate your problems.
  • Stay away from styling products. While you're treating the condition, avoid using hair sprays, gels, and other style products.
  • Put on a medicinal cream. If your condition has previously been diagnosed by your doctor, you could consider trying an anti-fungal cream.
  • Avoid using alcohol-containing skin and hair products. These can exacerbate the illness.
  • Gently cleanse your baby's scalp. If your baby has a cradle cap, wash the scalp once a day with non-medicated baby shampoo. Before washing off the shampoo, gently release the scales with gentle touch.
  • Clean your eyelids gently. If your eyelids are red or scaling, wash them with baby shampoo every night and wipe away scales with a cotton swab. Warm or hot compresses may also be beneficial.
  • Dress in cotton garments with a smooth touch. This keeps air circulating over your skin and helps to prevent irritation.

Alternative medicine

Many alternative remedies, such as those listed below, have assisted some people in managing their seborrheic dermatitis. However, the evidence regarding their usefulness is inconclusive. Before incorporating any alternative medicines into your self-care practice, always consult with your doctor.

  • Tea tree oil. Tea tree oil, either alone or in shampoo, can be applied directly to the affected area. However, tea tree oil has been shown to cause an allergic reaction.
  • Aloe vera. Apply aloe vera gel to the affected area, either in a product or straight from a cut leaf of the plant to help treat this condition.
  • Fish oil supplements. These supplements include omega-3 fatty acids.

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Skin consultation £19.99

Our simple consultation first process enables you to complete a consultation with a doctor, submitting photos of the affected skin and answering a set of questions that will enable a diagnosis where possible.

Common skin conditions can even include:

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Frequently asked questions about Seborrheic Dermatitis

  • Who is at risk of developing Seborrheic Dermatitis?

    Although newborns are more prone to developing seborrheic dermatitis, adults aged 30-60 are equally at risk. As an adult, several risk factors that can increase your risk include:

    • Oily skin
    • Psoriasis
    • Acne
    • Depression
    • Alcoholism
    • AIDS
    • Rosacea
  • What are the complications of Seborrheic Dermatitis?

    Major complications a patient with Seborrheic Dermatitis might encounter include;

    • Skin thinning, dilated blood vessels, and steroid-induced telangiectasia
    • Secondary bacterial or fungal infection
    • Psychosocial impact due to appearance of skin
  • What causes Seborrheic Dermatitis?

    The cause is not completely understood.

    Hormone levels, fungal infections, nutritional deficiencies, and neurogenic variables are all linked to the illness.

    The proliferation of the Malassezia yeast genus is believed to play a role. Malassezia, a saprophyte of normal skin, produces lipases and phospholipases that cleave free fatty acids from triglycerides in sebum. This could cause inflammation. Individual presentations may be explained by differences in skin barrier lipid composition and function.

  • How can I reduce my risk of Seborrheic Dermatitis?

    There is not much that can be done to avoid seborrheic dermatitis. However, simple healthy things you can do to lower your risk include; getting enough rest, managing your emotional stress, and getting a daily little dose of sunlight (UV light). Stay out of the midday sun.

    When using medicated shampoos and skin treatments, always follow the directions provided by your healthcare professional. Under or incorrect treatment can cause flare-ups of your ailment and warrant additional visits to your healthcare provider.

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