Seborrheic dermatitis: Overview

Seborrheic dermatitis

The rash usually develops on the scalp. On darker skin tones, the rash often looks pink, slightly purple, or lighter than the surrounding skin. People with lighter skin tones tend to have a red, raised rash.

Are seborrheic dermatitis and dandruff the same thing?

Dandruff may be considered the mildest form of seborrheic dermatitis. The two conditions are similar in that they both cause white-to-yellowish scale, which may be:

• Dry or greasy

• Itchy

Sometimes, both dandruff and seborrheic dermatitis are treated the same way. However, a dermatologist may add additional treatment for a patient who has seborrheic dermatitis.

Unlike dandruff, seborrheic dermatitis may develop on more than the scalp. It can appear on the ears, eyebrows, beard, or skin around the nostrils. Sometimes, it appears on the chest, especially in men.

Another difference between the two conditions is that seborrheic dermatitis causes inflammation (swelling and discolored skin), but dandruff does not.

Who gets seborrheic dermatitis?

This common skin condition develops in people of all ages and races. While it can appear at any time, it’s most likely to begin during one of these stages of life:

• Infancy: 2 to 12 months of age

• Adolescence

• Adulthood, usually beginning in a person’s 30 or later

When a baby has seborrheic dermatitis, it usually appears on the scalp and is called cradle cap. Babies can also develop seborrheic dermatitis in other areas like the folds of their skin, chest, back, or diaper area. No matter where seborrheic dermatitis appears on a baby’s body, it’s usually called cradle cap.

Seborrheic dermatitis is especially common in adults 50 years of age and older. Several studies have found that many adults 65 years of age and older live with this condition.

In the United States, Black people are most likely to develop seborrheic dermatitis. Men are also more likely than women to develop seborrheic dermatitis. The latter is true worldwide.

People who are living with an HIV infection or some neurologic disorders including Parkinson’s disease (affects the brain’s ability to control movement) also have a higher risk of getting seborrheic dermatitis than people who do not have one of these conditions. In children and adults who have AIDS, seborrheic dermatitis can cover much of the body and be difficult to treat.

If you have psoriasis or rosacea, you’re also more likely to develop seborrheic dermatitis. If you have both psoriasis and seborrheic dermatitis, the condition is called sebopsoriasis.

Does seborrheic dermatitis ever go away?

In babies, cradle cap goes away on its own, usually within a few months.

When a teenager or adult develops seborrheic dermatitis, it may go away without treatment. It’s also possible for a teen or adult to have the disease for life, experiencing flare-ups that may come and go.

Flare-ups are often seasonal, with most occurring during the winter and early spring. Seborrheic dermatitis may disappear during warm, humid weather.

Many people also experience flare-ups when they feel stressed.

Is there a cure for seborrheic dermatitis?

There isn’t a cure for seborrheic dermatitis, but treatment can alleviate symptoms like itch and lessen — and sometimes clear — the rash.

If you think you could have seborrheic dermatitis, the American Academy of Dermatology recommends seeing a board-certified dermatologist so that you get an accurate diagnosis. Many skin conditions cause an itchy rash, and it’s possible to have seborrheic dermatitis along with another condition like rosacea or psoriasis.

A board-certified dermatologist can give you an accurate diagnosis and create a treatment plan tailored to your needs.

Dermatologists recommend treating seborrheic dermatitis as soon as possible. Without treatment, the scale can thicken. Scratching the itchy rash can lead to an infection.

If you have a darker skin tone, seborrheic dermatitis can also cause dark spots and patches on your skin. These can be quite noticeable on the face. Early detection and treatment can prevent dark spots and patches.

Before seeing a dermatologist, it can be helpful to write down your symptoms and when they occur. That way you can tell your dermatologist what you’re experiencing. To learn more about the symptoms, go to Seborrheic dermatitis: Signs and symptoms.

Images
Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

References
Borda LJ, Wikramanayake TC. “Seborrheic dermatitis and dandruff: A comprehensive review.” J Clin Investig Dermatol. 2015 Dec;3(2):10.13188/2373-1044.

Elgash M, Dlova N, et. al. “Seborrheic dermatitis in skin of color: Clinical considerations.” J Drugs Dermatol. 2019 Jan 1;18(1):24-7.

Handler, MZ (author), James WD (chief editor). “Seborrheic dermatitis.” Medscape. Last updated 11/30/2020. Last accessed 10/6/2022.

Heath CR, Usatine RP, “Seborrheic dermatitis: DX across the skin color spectrum.” Cutis. 2021;108(5):297-8.

Pope E, Kowalski E, et al. “Topical ruxolitinib in the treatment of refractory facial seborrheic dermatitis.” JAAD Case Rep. 2022 Apr 23;24:59-60.

Reider N, Fritsch PO. “Other eczematous eruptions.” In: Bolognia JL, et al. Dermatology. (fourth edition). Mosby Elsevier, China, 2018: 228-30.

Sowell J, Pena SM, et. al. “Seborrheic dermatitis in older adults: Pathogenesis and treatment options.” Drugs Aging. 2022 May;39(5):315-21.

Whittington A, Kundu RV. “Seborrheic dermatitis.” In:Taylor and Kelly’s Dermatology for Skin of Color. (second edition). McGraw Hill, USA, 2016:142-8.

Written by:
Paula Ludmann, MS

Reviewed by:
Dara D. Spearman, MD, FAAD
Elaine T. Kaye, MD, FAAD
J. Klint Peebles, MD, FAAD

Last updated: 12/6/22