Find out what you can do to treat this flaky skin condition that can cause scaly skin and stubborn, itchy dandruff.
Seborrheic (seb-o-REE-ik) dermatitis is a common skin condition that mainly affects your scalp. It causes scaly patches, inflamed skin and stubborn dandruff. It usually affects oily areas of the body, such as the face, sides of the nose, eyebrows, ears, eyelids and chest. This condition can be irritating but it's not contagious, and it doesn't cause permanent hair loss.
Seborrheic dermatitis may go away without treatment. Or you may need to use medicated shampoo or other products long term to clear up symptoms and prevent flare-ups.
Seborrheic dermatitis is also called dandruff, seborrheic eczema and seborrheic psoriasis. When it occurs in infants, it's called cradle cap.
Seborrheic dermatitis causes a rash of oily patches with yellow or white scales. The rash may look darker or lighter in people with brown or Black skin and redder in those with white skin.
Seborrheic dermatitis signs and symptoms may include:
The signs and symptoms of seborrheic dermatitis tend to flare with stress, fatigue or a change of season.
See your health care provider if:
The exact cause of seborrheic dermatitis isn't clear. It may be due to the yeast Malassezia, excess oil in the skin or a problem in the immune system.
Risk factors for seborrheic dermatitis include:
To diagnose seborrheic dermatitis, your health care provider will likely talk with you about your symptoms and look at your skin. You may need to have a small piece of skin removed (biopsied) for study in a lab. This test helps rule out other conditions.
For adolescents and adults, the main treatments for seborrheic dermatitis are medicated shampoos, creams and lotions. If nonprescription products and self-care habits don't help, your health care provider might suggest that you try one or more of these treatments:
Antifungal gels, creams, lotions, foams or shampoos alternated with another medication. Your health care provider might suggest you try a product with 2% ketoconazole or 1% ciclopirox (Loprox). Or you might rotate between two or more products. Ketoconzole can worsen the dryness of tightly coiled or chemically treated hair and increase the risk of breakage. To ease this effect, use it only once a week with a moisturizing conditioner.
How often you shampoo or apply other antifungal products will depend on your hair-grooming practices and symptoms. Medicated shampoos can be used once a day or 2 to 3 times a week for several weeks. Let the product sit on your scalp for a few minutes — see package directions — so it has time to work. Then rinse. After your symptoms clear up, use a medicated shampoo just once a week or once every two weeks. This will help prevent a relapse.
Creams, lotions, shampoos or ointments that control inflammation. Your health care provider might prescribe a prescription-strength corticosteroid you apply to the scalp or other affected area. These include hydrocortisone, fluocinolone (Capex, Synalar), clobetasol (Clobex, Temovate) and desonide (Desowen, Desonate). They are effective and easy to use. And use them only until symptoms clear up. If used for many weeks or months without a break, they can cause side effects. These include loss of skin color, thinning skin, and skin showing streaks or lines.
Creams or ointments with a calcineurin inhibitor such as tacrolimus (Protopic) or pimecrolimus (Elidel) may be effective. Another benefit is that they have fewer side effects than corticosteroids do. But they are not first-choice treatments because the Food and Drug Administration has concerns about a possible association with cancer. In addition, tacrolimus and pimecrolimus cost more than mild corticosteroid medications.
You may be able to control seborrheic dermatitis with lifestyle changes and home remedies. Many of these are sold in nonprescription forms. You may need to try different products or a combination of products before your condition improves.
The best approach for you depends on your skin type, hair-grooming practices and your symptoms. But even if your condition clears up, it's likely to come back at some point. Watch for the symptoms and resume treating the condition when it recurs. Or use nonprescription antidandruff products in your self-care routine to prevent flare-ups.
If regular shampoo doesn't help with dandruff, try nonprescription dandruff shampoos. They are classified according to the active ingredient they contain:
How often you shampoo or apply other antifungal products will depend on your hair-grooming practices and symptoms. Medicated shampoos can be used once a day or 2 to 3 times a week for several weeks. After your symptoms clear up, use a medicated shampoo just once a week or once every two weeks. This will help prevent a relapse. Shampoo that contains tar or selenium sulfide can discolor light-colored hair.
Sometimes a shampoo that has helped loses its effectiveness over time. If that's the case, try alternating between two or more types. Be sure to leave your shampoo on for the full recommended time — this allows its ingredients to work. Then rinse. These shampoos may be rubbed gently on the face, ears and chest and rinsed off well.
The following nonprescription treatments and self-care tips may help you control seborrheic dermatitis:
Many alternative therapies, including those listed below, have helped some people manage their seborrheic dermatitis. But evidence for their effectiveness isn't proved. It's always a good idea to check with your health care provider before adding any alternative medicines to your self-care routine.
If you're considering dietary supplements or other alternative therapies, talk with your health care provider about their pros and cons.
You'll probably first visit your primary care provider. Or you may see a doctor who specializes in the diagnosis and treatment of skin conditions (dermatologist).
Here's some information to help you get ready for your appointment.
Before your appointment, list your answers to the following questions:
Your health care provider is likely to ask you a few questions. Being ready to answer them may free up time to go over any points you want to spend more time on. Your health care provider might ask:
A nonprescription antifungal cream or anti-itch cream can be helpful. If your scalp is affected, a nonprescription antifungal shampoo, foam or other product may ease your symptoms. Try not to scratch or pick at the affected area. This increases your risk of infection.