Seborrheic dermatitis: Signs and symptoms

Where does seborrheic dermatitis appear on the body?

Seborrheic dermatitis is a common skin condition that causes a scaly rash. This rash can develop on any area of the body except the palms and soles.

In adults, this rash often appears on one or more oily areas of the body like the:

• Scalp

• Forehead

• Eyebrows (between and underneath)

• Eyelids

• Ears (behind and inside)

• Nose (sides)

• Mouth (around) and beard area

• Back of the head and neck

• Chest

If you have extensive seborrheic dermatitis, the scaly rash can also develop on your armpits, belly button, groin, buttocks, or under the breasts. Occasionally, seborrheic dermatitis is so extensive that it covers much of the body.

When babies get seborrheic dermatitis, it’s called cradle cap and is usually found on one or more of these areas:

• Scalp (most common)

• Skin folds

• Diaper area (less common)

What are the signs and symptoms of seborrheic dermatitis?

What you see on your skin tends to vary with your age, skin tone, and whether you have another medical condition like Parkinson’s disease or HIV/AIDS.

Common signs and symptoms of seborrheic dermatitis and cradle cap (seborrheic dermatitis in babies) include the following:

Dry, flaky skin

This can develop on any part of your body that has seborrheic dermatitis, including the scalp, face, or chest. The flakes are more noticeable where you have a rash or hair, as shown here.

Rash on scalp

This rash can be dry, have greasy scales, or both. If you have a darker skin tone, the rash tends to look pink (A), slightly purple, or lighter than your natural skin tone. Some people with darker skin tones develop white spots on their scalp. In lighter skin tones, the rash is usually red and raised (B).

Rash on the face

On darker skin tones, you’ll likely see a rash that’s darker than your natural skin tone (A) or light spots (B). In lighter skin tones, the rash is often red. The skin tends to be oily in some areas and dry in others. Some people develop thin, scaly plaques (raised patches) on their face.

Burning or itching

The itch is usually mild, but it can be intense, especially on the scalp. With effective treatment for seborrheic dermatitis, the itch and burning go away.

Rash on your eyelids (blepharitis)

Your eyelids contain oil glands. When these oil glands become inflamed, it’s called blepharitis. The skin on the eyelids can become scaly, swollen, discolored, irritated, and itchy. Some people develop yellowish scale between their eyelashes. While blepharitis can feel uncomfortable, it rarely damages the eyes.

Rash around or inside the ears

Seborrheic dermatitis can cause inflammation around or inside the ear. You may see flakes, crusting, cracks in the skin, or oozing from the ear.

Rash in the skin folds

If skin stays wet for a long time, it starts to break down. The medical name for this is maceration, which is more common in areas like the armpits, belly button, or beneath the breasts. Maceration causes pain, tenderness, and sometimes itchiness or a burning sensation. Left untreated, the skin may start to split or become infected.

Good health

While the rash can be irritating, most people who develop seborrheic dermatitis feel well unless they have another condition like HIV/AIDS or Parkinson’s disease.

Pictures of cradle cap (seborrheic dermatitis in babies)

Like adults, what you see on a child’s body differs with skin tone and severity.

Cradle cap in lighter skin tones

If your baby has a light skin tone, cradle cap often begins with scaly, greasy patches on the top of the head, which later become a thick, crusty mass that covers the entire scalp and sometimes the parts of the face.

Cradle cap in darker skin tones

Babies with darker skin tones have discoloration, flakes, and areas of lighter or white skin on their scalp.

Cradle cap on the entire body

Occasionally, cradle cap develops on a baby’s entire body or the diaper area where it is often mistaken for diaper rash. In babies who have a lighter skin tone, the scales can be dry or greasy and the rash red. Babies who have darker skin tones may have white spots, flaky skin, and a rash that is either darker than their natural skin tone or purplish.

Many parents of a child with cradle cap and patients with seborrheic dermatitis want to know why they have this condition. To see what researchers have discovered, go to Seborrheic dermatitis: Causes.

Images
Images 1, 4, 7, 9, 10, 14: Used with permission of DermNet NZ.

Images 2, 3, 8: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Image 5: Used with permission of the Journal of the American Academy of Dermatology. (J Am Acad Dermatol. 2003;48:S127-33).

Images 6, 11, 12, 13: Getty Images

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

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

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