​​Seborrhoeic Dermatitis

As the weather starts to warm up, a variety of skin conditions flare up. Seborrheic Dermatitis is an uncomfortable skin condition that causes scaly patches and red skin, mainly on the scalp but also common on the face and body.  It is a form of eczema. Seborrheic dermatitis can occur in children and adults and is commonly known as “cradle cap” in babies.

In seborrhoeic dermatitis, the skin tends to have a reddish colour, a swollen and greasy appearance, and a white or yellowish crusty scale on the surface.  In people of colour, seborrhoeic dermatitis may actually lead to a lightening of the skin, which can be very distressing. This is because the yeast that causes seborrheic dermatitis produces a by-product that causes pigment cells to be under-active.

The terms seborrheic dermatitis and seborrhoeic dermatitis refer to the same eczematous skin condition and can be used interchangeably, being just US and UK spellings.

How Did I Get Seborrheic Dermatitis?

•  Seborrheic dermatitis does not have a definitive cause, but studies have indicated that there are many factors that work in combination to cause the condition.  These factors can include yeast that normally lives on our skin, genetics, living in a cold and dry climate, stress, and a person’s overall health.
• Seborrheic dermatitis is not caused by poor personal hygiene, or allergies and does not cause harm to the body.
• Seborrheic dermatitis can affect people of all colours and ages but infants three months of age and younger and adults between 30 and 60 years of age are most susceptible.

Seborrheic Dermatitis Treatment and Diagnosis

Seborrheic dermatitis can mimic many other skin conditions (psoriasis, eczema, or an allergic reaction). Therefore, it’s important to consult with a dermatologist for diagnosis and treatment.  A dermatologist will review your medical history and examine the rash to determine the diagnosis and treatment plan.

Seborrheic dermatitis has no absolute cure, but a treatment plan can help to reduce uncomfortable symptoms and signs and minimise flare-ups.

While seborrhoeic dermatitis rarely causes severe harm to the body, it can be uncomfortable to live with the constant itch, rash and other symptoms of seborrheic dermatitis. Fortunately, there are some effective treatment options, and seborrhoeic dermatitis can sometimes go away on its own or with the right shampoo and skincare routine.

Let’s dive into who gets seborrhoeic dermatitis, why it forms, common symptoms and treatment options.

What is seborrheic dermatitis? 

Considered a chronic form of eczema, seborrheic dermatitis appears on the body where there are a lot of oil-producing (sebaceous) glands like the upper back, nose and scalp. It can cause a variety of symptoms from dandruff to a rash on the affected area.

For many infants and some adults, seborrheic dermatitis goes away on its own. If symptoms don’t go away, there are many effective treatments to manage symptoms and stop seborrheic dermatitis flare-ups in the future.

What causes seborrheic dermatitis?

Seborrheic dermatitis is usually caused by a combination of genetic and environmental factors. Flare-ups of seborrheic dermatitis are often caused by “triggers”.

The trigger is usually an inflammatory reaction to excess yeast, sometimes called pityrosporum. This organism which normally lives on the skin’s surface is the likely cause of seborrheic dermatitis. The yeast overgrows, and the immune system seems to overreact to it, leading to a fungal infection that results in skin changes.

Certain medical conditions can increase people’s risk of developing seborrheic dermatitis, including psoriasis, HIV, acne, rosacea, Parkinson’s disease, epilepsy, alcoholism, depression, eating disorders and recovery from a stroke or heart attack.

Common triggers for seborrheic dermatitis include:

• stress
• recovery from a stressful life event, like losing a loved one or a heart attack
• hormonal changes or illness
• harsh detergents, solvents, chemicals and soaps
• cold, dry weather or a change in the season
• some medications, including psoralen, interferon and lithium
• certain medical conditions, such as HIV and Parkinson’s disease

Like all forms of eczema, seborrheic dermatitis is not contagious. You cannot “catch” it from another person. Instead, it’s the result of environmental and genetic factors.

What are the symptoms of seborrheic dermatitis?

Seborrheic dermatitis can be the culprit for a variety of symptoms depending on age, race, and the severity of a flare-up. Sometimes, symptoms will go away on their own or with changes in your skincare and hair regimens.

Seborrheic dermatitis and cradle cap in infants

Infants with seborrheic dermatitis often have a form called cradle cap, which appears on their scalps as scaly, greasy patches. Infants can also develop seborrheic dermatitis on their bottoms, which can be mistaken for diaper rash, a form of contact dermatitis.

Seborrheic dermatitis in adults and adolescents

When seborrheic dermatitis appears near the scalp in adults and adolescents, it’s often referred to as facial seborrheic dermatitis. Common symptoms of facial seborrheic dermatitis include inflamed skin and itching.

With this form, symptoms might also appear on the eyelids, on the sides of the nose, in and around the eyebrows and near the ears. Facial seborrheic dermatitis can also cause stubborn dandruff. But seborrheic dermatitis doesn’t just form on the face. It can appear in oily skin all over the body. In addition to the face, redness, swelling and greasy scaling can develop on the mid-chest, upper back and in the armpits, under the breasts and in the groin area.

Common symptoms

No matter where seborrheic dermatitis is on the body, there are common symptoms experienced by many with this condition.

These symptoms include:

• Flaking skin or dandruff;
• Patchy of flaky white or yellow scales on top of greasy skin;
• An irritable rash which looks dark in brown and black skin and lighter in white skin;
• Ring-shaped rash for those with petaloid seborrheic dermatitis;
• The affected skin sometimes crusts over and lesions containing sebum can form. Erythema, or redness of the skin caused by inflammation, may also be experienced.
• If the flare-ups occur in hairline creases, those who itch the affected areas too much may experience hair loss as well.
• Those with skin of colour might experience petaloid seborrheic dermatitis, a more severe form where lesions form around the hairline and skin discoloration happens. Usually, the discoloured skin manifests in a ring-shaped rash. When looking more generally at the relationship between eczema and skin of colour, itching due to eczema has been shown to have a greater impact in black patients, who are also more likely to have severe disease.

Symptoms of severe cases

More severe cases can lead to the immunodeficiency of affected skin and an increased risk for infections. Seborrheic dermatitis is not precancerous. If you have this form of eczema, it does not increase your chance of getting skin cancer.

Another common misconception is that seborrheic dermatitis leads to hair loss. This is completely false. Hair loss is not a symptom of seborrheic dermatitis and if you are experiencing hair loss, you probably have a different underlying condition.

Whether your severe symptoms are from seborrheic dermatitis or something else, it’s best to visit an experienced dermatologist. The dermatologist can help you get your severe symptoms under control so they stop disrupting your daily life.

How is seborrheic dermatitis treated?

Depending on the severity of the case, you might be able to treat this form of eczema with a shampoo swap—or seborrheic dermatitis might even go away without treatment. If symptoms persist for longer than two weeks, you probably want to consider talking to a dermatologist about over the counter and prescribed treatment options. Most adults with this condition will need a treatment plan to manage symptoms.

Lifestyle changes

Healthy lifestyle habits, like managing stress and getting plenty of sleep, can also improve skin. Stress relief is often the lifestyle change which will have the biggest impact on seborrheic dermatitis.

Some particularly effective stress relief techniques include:

• Perform light exercises, such as yoga or a gentle walk;
• Journal about stress and negative feelings;
• Develop a mediation or breathwork practice;
• Spend time in nature, even if it’s just five minutes.

There are many other ways you can reduce stress. What matters most is finding an enjoyable technique that allows you to slow down and devote time to self-care.

Dermatology at Clinica London

If you or your child may suffer from seborrhoeic dermatitis, we have a medical dermatologist who will assess and advise you or your baby.

As treatments are available, there is no need to suffer from embarrassing and uncomfortable seborrheic dermatitis. If your eyelids are also involved, then our ophthalmologists are also at hand to advise.