Seborrheic dermatitis

At a glance

  • The typical symptoms of seborrheic dermatitis are scaly flakes of skin on your face and scalp.
  • It isn't contagious, but it does keep on coming back in adults.
  • Creams and shampoos can relieve the symptoms.
  • No treatment is needed in babies (where it is commonly known as cradle cap).

Introduction

Foto von jungem Mann
PantherMedia / AndreyPopov

Seborrheic dermatitis is a non-contagious skin condition. It leads to scaly patches of skin with oily, dandruff-like flakes, especially on your face and scalp. It is only rarely itchy. Experts believe that seborrheic dermatitis is made more likely by certain things. These include an increased production of sebum (an oily substance) in the skin, too much of a yeast (fungus) that lives on the skin, and a weakened .

If someone first has seborrheic dermatitis as a teenager or adult, it almost always tends to come back again and again. Then it helps to apply antifungal medicines or steroid creams to the inflamed areas of skin.

The situation is very different in babies, though: If seborrheic dermatitis occurs during the first few months of a child's life, it usually goes away on its own within one year and also doesn't come back. This is commonly known as cradle cap.

Symptoms

The typical symptoms of seborrheic dermatitis are patches of skin covered with yellowish, shiny, oily scales. These patches look reddish on light-colored skin, and lighter on darker skin. They don’t usually itch.

The patches occur most commonly on areas of skin that have a lot of sebaceous (oil-producing) glands. These typically include areas

  • along the hairline and on the part of the scalp covered with hair,
  • along and between the eyebrows,
  • on the cheeks and particularly in the folds of skin that run from the nostrils down to the corners of the mouth.

Seborrheic dermatitis may also spread to other parts of the body, most commonly above the breastbone and on the back near the thoracic spine. Fold of skin may be affected too – for example, under the breasts, or in the armpits or groin area. In men, the patches may also occur in the genital region.

Illustration: Seborrheic dermatitis: Parts of the body typically affected - as described in the article

Seborrheic dermatitis: Parts of the body typically affected

Seborrheic dermatitis looks a little different in babies and mostly affects their scalp.

Causes and risk factors

The scaly patches of skin are probably caused by various factors, such as an increased production of sebum (skin oil) and the usually harmless growth of the yeast Malassezia furfur on the skin.

Other factors that can play a role here include , stress, genes, , nervous system disorders like Parkinson’s disease, and a weakened immune system. People with a weakened also have a higher risk of developing a more severe type of seborrheic dermatitis that spreads to the rest of the skin and is harder to treat.

Prevalence and outlook

Seborrheic dermatitis is common: About 3 to 10 out of 100 people are affected. It’s more common in men than in women. People usually get it for the first time when they are young adults or over the age of 50.

It’s a chronic condition in adults and teenagers, with symptoms that vary in their severity over time. These skin symptoms might also go away for a while – often in the summer. But they may return in the winter or during periods of stress.

Diagnosis

It is easy to diagnose seborrheic dermatitis if scaly, non-itchy patches of skin appear on the parts of the body typical for the condition. Usually it’s enough to have a detailed talk with the doctor and then a physical examination. The doctor will first try to rule out other skin conditions that are similar to seborrheic dermatitis, such as psoriasis or eczema (also called atopic dermatitis). Like seborrheic dermatitis, these conditions cause changes in the skin, but usually on other parts of the body. In , the skin inflammations itch and are made up of patches of skin without clearly defined edges. Sometimes there are small blisters too.

Further examinations are only rarely needed. For instance, a swab test can be done and sent to a laboratory to find out whether it's a bacterial skin such as impetigo. It's usually not necessary to take a sample of the tissue (biopsy).

Treatment

In teenagers and adults, the symptoms can be relieved by applying certain medications to the inflamed patches of skin. The possible medications include the following:

  • Shampoos containing tar
  • Creams that have salicylic acid in them
  • Creams or shampoos with antifungal agents (antimycotics)
  • Anti-inflammatory creams or gels containing steroids

It usually isn’t necessary to take any pills or tablets. Because sunlight can make seborrheic dermatitis improve, some people also try phototherapy with UVB light.

There is no treatment that can clear up seborrheic dermatitis for good.

Babies don't usually need treatment for seborrheic dermatitis because it goes away on its own.

Everyday life

Although seborrheic dermatitis is harmless, it can still be distressing for teenagers and adults: The scaly patches of skin often occur on the face, making them visible to others. And they may never go away again. If you feel very bad about your skin, you can talk with a doctor about finding a way to better cope with the condition, for instance with the help of behavioral therapy.

You should avoid always covering up the inflamed patches of skin with a heavy foundation or concealer because that clogs the pores in the skin. But it's okay to use a light foundation every now and then. Mild, non-oily skin care products are well suited for skin care.

You don't need to use special sun protection for seborrheic dermatitis. Exposing the skin to sunlight and fresh air, for example by going to the beach, may even reduce the symptoms. It’s enough to use an appropriate sunscreen strength for your skin type. Less oily sun lotions are more suitable than very oily lotions.

Further information

When people are ill or need medical advice, they usually go to see their family doctor first. Read about how to find the right doctor, how to prepare for the appointment, and what to remember.

Elgash M, Dlova N, Ogunleye T, Taylor SC. Seborrheic Dermatitis in Skin of Color: Clinical Considerations. J Drugs Dermatol 2019; 18(1): 24-27.

Kastarinen H, Oksanen T, Okokon EO, Kiviniemi VV, Airola K, Jyrkkä J et al. Topical anti-inflammatory agents for seborrhoeic dermatitis of the face or scalp. Cochrane Database Syst Rev 2014; (5): CD009446.

Moll I. Duale Reihe Dermatologie. Stuttgart: Thieme; 2016.

Naldi L, Diphoorn J. Seborrhoeic dermatitis of the scalp. BMJ Clin Evid 2015: pii: 1713.

Okokon EO, Verbeek JH, Ruotsalainen JH, Ojo OA, Bakhoya VN. Topical antifungals for seborrhoeic dermatitis. Cochrane Database Syst Rev 2015; (5): CD008138.

Pschyrembel. Klinisches Wörterbuch. Berlin: De Gruyter; 2017.

Victoire A, Magin P, Coughlan J, van Driel ML. Interventions for infantile seborrhoeic dermatitis (including cradle cap). Cochrane Database Syst Rev 2019; (3): CD011380.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on June 18, 2020
Next planned update: 2023

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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