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by Hellwig J
(Dandruff)

Definition

Seborrheic dermatitis is a chronic skin condition that causes a scaly, itchy rash. It can appear as a mild, white scaling, or a yellowish greasy, or reddish scaly rash. Most commonly affected areas are along the hairline, in and behind the ears, on the eyebrows, around the nose, and on the chest.

Dandruff is a type of seborrheic dermatitis where there is a scaling of the skin on the scalp. The area can be dry or oily, and is sometimes itchy.

Seborrheic Dermatitis
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Causes

The exact cause of seborrheic dermatitis is unknown. Common skin yeast organisms or genetic factors may play a role for some people.

Risk Factors

Factors that may increase the chances of seborrheic dermatitis:

  • Family members with seborrheic dermatitis
  • Chronic conditions, including disorders of the immune system such as HIV infection
  • Neurological conditions, such as Parkinson disease or, less commonly, stroke

Symptoms

The symptoms can vary from mild to severe. They include:

  • Dry or greasy, scaling of the scalp
  • Itchy scalp
  • Itchy, scaly rash with small pimples on nasal folds, eyebrows, anterior chest, upper back, arm pits, or genitals
  • Thickened, flaking skin
  • Reddened skin over the forehead and on either side of the nose

In babies less than 1 month old, seborrheic dermatitis may cause a thick, yellow, crusted scalp rash known as cradle cap.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. The diagnosis is made by the appearance of the rash.You may be referred to a doctor who specializes in skin disorders.

Treatment

Treatments for seborrheic dermatitis are usually applied directly to the skin in the form of shampoo or lotion. Treatment depends on the severity of your symptoms. Seborrheic dermatitis in infants will usually resolve on its own.

Medicated Products

Baby shampoo, mineral oil, and topical anti-fungal shampoos may be used for seborrheic dermatitis in infants

A variety of treatments are used for seborrheic dermatitis in children and adults, such as:

  • Prescription or over-the-counter shampoos containing 1 or more of the following ingredients:
    • Zinc pyrithione
    • Hydrocortisone or other cortisone (steroid) preparations
    • Selenium sulfide
    • Salicylic acid
    • Coal tar
    • Antifungal medications
  • Prescription or over-the-counter creams or lotions containing:
    • Hydrocortisone or other cortisone (steroid) preparations
    • Antifungal medications
    • Antibiotic medication
    • Pimecrolimus or tacrolimus
    • Lithium salt

Treatment can take several weeks or months and may need to be repeated if the condition returns.

Prevention

There are no current guidelines to prevent seborrheic dermatitis because the cause is unknown.

RESOURCES

American Academy of Dermatology  https://www.aad.org 

Family Doctor—American Academy of Family Physicians  https://familydoctor.org 

CANADIAN RESOURCES

Canadian Dermatology Association  https://www.dermatology.ca 

Health Canada  https://www.canada.ca 

References

Cunha PR. Pimecrolimus cream 1% is effective in seborrhoeic dermatitis refractory to treatment with topical corticosteroids. Acta Derm Venereol. 2006;86:69-70.

Schwartz RA, Janusz CA, Janniger CK. Seborrheic dermatitis: an overview. Am Fam Physician. 2006;74:125-130.

Seborrheic dermatitis. American Academy of Dermatology website. Available at: https://www.aad.org/public/diseases/scaly-skin/seborrheic-dermatitis. Accessed March 6, 2018.

Seborrheic dermatitis in children and adults. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T116636/Seborrheic-dermatitis-in-children-and-adults  . Updated February 27, 2018. Accessed March 6, 2018.

Seborrheic dermatitis in infants. EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T228754/Seborrheic-dermatitis-in-infants  . Updated March 31, 2015. Accessed March 6, 2018.

6/17/2014 DynaMed Plus Systematic Literature Surveillance  https://www.dynamed.com/topics/dmp~AN~T116636/Seborrheic-dermatitis-in-children-and-adults  : Kastarinen H, Oksanen T, Okokon EO, et al. Topical anti-inflammatory agents for seborrhoeic dermatitis of the face or scalp. Cochrane Database Syst Rev. 2014;(5):CD009446.p

3/12/2018 DynaMed Plus Systematic Literature Surveillance  https://www.dynamed.com/topics/dmp~AN~T116636/Seborrheic-dermatitis-in-children-and-adults  : Karakadze MA, Hirt PA, et al. The genetic basis of seborrhoeic dermatitis: a review. J Eur Acad Dermatol Venereol. 2017 Nov 20.

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