Seborrheic Dermatitis

Seborrheic Dermatitis

Seborrheic dermatitis (seb derm) is an extremely common skin condition affecting mostly the face and scalp. Think of this as being similar to dandruff, though it is more of a substantial rash with redness and increased symptoms, particularly itching. This can affect both adults and children. In babies, it is often called a “cradle cap.” At Advanced Dermatology of the Midlands, seborrheic dermatitis is a skin disease that we diagnose and treat quite often.

Seborrheic Dermatitis

What are the symptoms of seborrheic dermatitis?

If you are noticing a rough, flaky rash on your scalp, or certain areas of the face especially in the eyebrows, between the eyebrows, along the creases on the side of the nose, or on and around the ears, then odds are good that you have seborrheic dermatitis. It shares similarities with dandruff but presents as a more pronounced rash accompanied by redness and persistent itching.

The best dermatologists know that this condition can affect both men and women, although, it is more common in men. Seborrheic dermatitis can occur in both adults and children, with infants often experiencing it as “cradle cap.” Seb derm can be present year-round, however, it is generally worse during the transitional seasons such as the spring and fall.

The classic appearance of seborrheic dermatitis involves red scaling patches in areas of the body that have higher numbers of oil glands. This has to do with the underlying cause of the condition. Seb derm occurs when there is an overgrowth in a natural yeast organism on the skin. This is especially common in areas of high oil production. Our bodies develop a sensitivity allergic-like reaction to this yeast, resulting in a rash. Because testosterone increases our oil production, men tend to have this condition more often.

What Causes Seborrheic Dermatits?

Seborrheic dermatitis is typically caused by a combination of genetic and environmental factors. The condition is often triggered by an inflammatory reaction to an excess of Malassezia yeast, also known as pityrosporum, which naturally resides on the skin’s surface. The overgrowth of Malassezia can lead to a fungal infection, resulting in skin changes. It appears that the immune system may overreact to this yeast, contributing to the development of seborrheic dermatitis.

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

Various triggers can exacerbate seborrheic dermatitis including:

  • Stress
  • Recovering from a stressful life event (such as the loss of a loved one or a heart attack)
  • Hormonal changes or illness
  • Exposure to harsh detergents, solvents, chemicals, and soaps
  • Cold and dry weather or changes in seasons
  • Certain medications like psoralen, interferon, and lithium
  • Specific medical conditions such as HIV and Parkinson’s disease

It is important to note that seborrheic dermatitis, like all forms of eczema, is not contagious. This condition cannot be transmitted from one person to another. Instead, it is the result of a combination of environmental and genetic factors.

At Advanced Dermatology of the Midlands, we frequently diagnose and treat seborrheic dermatitis, offering effective solutions as part of a comprehensive treatment plan.

Diagnosis and Treatment of Seborrheic Dermatitis

To diagnose seborrheic dermatitis, you may need to have a small piece of skin removed (skin biopsy) for study in a lab. This test helps rule out other skin conditions.

There is some good news and there’s bad news when it comes to seborrheic dermatitis. The bad news, you cannot cure the condition, you can only treat the symptoms. People who have it tend to have it recur periodically. However, the good news is you can easily treat and control the condition long-term to prevent flare-ups and remove scales with little to no side effects.

Our dermatology providers are familiar with several different medications that can treat seborrheic dermatitis. In fact, there are also several things that can be done at home to improve seborrheic dermatitis.

Over the Counter Treatment Options

For more mild cases, these measures can be quite helpful. A good cleansing routine is very important, especially in oily areas of the body. If natural oil sits on the skin in areas where seborrheic dermatitis is present, the condition will worsen. In most cases washing the areas more often will help.

There are several skin and hair products including shampoos you can purchase over the counter for this condition such as those containing selenium sulfide. Nonprescription medicated shampoos such as Head & Shoulders, Selsun Blue, And Neutrogena T-gel are some examples. Before rinsing your hair or skin, we recommend leaving the shampoo on for 3-5 minutes.

Nonprescription medicated shampoos can be used on the scalp or even on the face as a facial cleanser. Speak with your doctor or dermatology provider first if using any of these for young children.

Prescription Treatment Options

For more severe or persistent cases, a dermatologist may recommend prescription-strength treatments several times a week for several weeks. These may include topical antifungal agents or calcineurin inhibitors, which help address the underlying fungal overgrowth and inflammation associated with seborrhoeic dermatitis. It’s important to follow the prescribed treatment plan and discuss any potential side effects with the healthcare provider.

For individuals with atopic dermatitis or darker skin, additional considerations may be necessary. Moisturizing the affected areas with products containing mineral oil can help alleviate dryness and irritation. In some cases, topical corticosteroids may be prescribed for short-term use to manage acute flare-ups, but long-term use should be avoided due to potential side effects.

Finally, hydrocortisone cream or ointment may help if applied to affected areas up to 10 days per month as needed.

Are seborrheic dermatitis and dandruff the same thing?

Seborrheic dermatitis and dandruff share similarities, with dandruff being considered the mildest form of seborrheic dermatitis. Both conditions can result in white-to-yellowish scales, which may be dry or greasy and accompanied by itchiness. While the treatment for both conditions can be similar, a dermatologist may recommend additional treatment for seborrheic dermatitis.

One distinguishing factor between seborrheic dermatitis and dandruff is the extent of their appearance. While dandruff primarily affects the scalp, seborrheic dermatitis can develop on other areas such as the ears, eyebrows, beard, or skin around the nostrils. In some cases, it can even occur on the chest, particularly in men.

Furthermore, seborrheic dermatitis causes inflammation, characterized by swelling and discolored skin, whereas dandruff typically does not involve such inflammatory changes.

Additional Information

How to relieve itchy skin (American Academy of Dermatology)

Seborrheic Dermatitis in Skin of Color: Clinical Considerations (National Library of Medicine)

Advanced Dermatology of the Midlands | Best Dermatologist Omaha & Council Bluffs, IA | Board Certified Dermatologists

At Advanced Dermatology the Midlands Our vision is to deliver the highest level of dermatological care, using the most advanced technology and evidence-based medicine in a personalized and compassionate environment.  Contact us to schedule a consultation to diagnose and treat seborrheic dermatitis.