Seborrheic dermatitis

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.

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

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 bacteria, stress, genes, hormones, nervous system disorders like Parkinson’s disease, and a weakened immune system. People with a weakened immune system 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.

Seborrheic dermatitis is common: About 3 to 10 out of 100 people are affected. It is 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.

Seborrheic dermatitis is 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.

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 eczema, 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 infection such as impetigo. It is usually not necessary to take a sample of the tissue (biopsy).

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.

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.

It is not a good idea to cover 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 is enough to use an appropriate sunscreen strength for your skin type. Less oily sun lotions are more suitable than very oily lotions.

When people are ill or need medical advice, they usually go to see their family doctor first. You can read about how to find the right doctor in our topic "Health care in Germany" – and our list of questions can help you to prepare for your appointment.