Seborrheic (seb-o-REE-ik) dermatitis is a relatively common inflammatory skin condition characterized by chronic redness, scaling, and flaking of oily skin on the head and neck. It is estimated to affect 3.5% of the population.
In the vast number of cases, symptoms appear only on skin of the upper chest, back, face, neck and scalp, though it is usually restricted to the face and scalp. Mild forms of seborrheic dermatitis may only cause minor flaking and persistent dandruff; more serious presentations can include widespread red, scaly patches over the face, scalp and upper torso with co-occurring soreness and cosmetic concerns. Patients with seborrheic dermatitis often describe flare-ups followed by extended periods of remission. While the specific causes are not clearly defined, multiple treatments are available.
Causes
The exact cause of seborrheic dermatitis is not known. Studies have demonstrated several possibilities: an inflammatory response caused by the immune system; skin that is especially sensitive to changes in season, as symptomatic episodes are often more severe in the winter and early spring; and a special type of yeast that utilizes oil at the base of hair follicles as a food source.
Genetic, hormonal, and environmental factors have been shown to play an important role in the appearance of seborrheic dermatitis. The condition is often most severe during periods of stress, illness and lack of sleep. Too much or too little of certain vitamins is associated with flare-ups in children. Higher rates of seborrheic dermatitis are noted in adult patients with weakened immune systems.
Symptoms
The most common symptom of seborrheic dermatitis is the presence of noticeable dandruff on the scalp, hair, and eyebrows. This may be accompanied by patches of red skin on the scalp or face. Some patients report an itching or stinging sensation. A common condition that may arise from seborrheic dermatitis is blepharitis, the medical term for redness and inflammation of the eyelids.
In severe cases, patches of very oily skin covered in white or yellow flakes or scales are noted. These patients may also develop large areas of inflamed, red skin over the scalp and face. Acne-like marks can also appear along the hairline, on the nose and eyebrows, and even inside the ears.
Flare-ups may last for a few weeks or continue for years, and the time period over which acute symptoms persist is likely unique to each person.
Treatments
There are many treatment options for seborrheic dermatitis. As an initial remedy, your physician will likely recommend a combination of over-the-counter medicated shampoo, cream, and lotion. These can alleviate symptoms by removing excess oil, reducing dandruff levels, and combating inflammation.
If these options do not work, prescription-strength steroid creams may be used to reduce redness and inflammation. Medicated shampoos, including special antifungal shampoos, are also common and quite effective for more serious cases. If your symptoms do not improve with typical creams and lotions, antifungal medication in pill form might be prescribed.
Seborrheic Dermatitis vs. Eczema
Seborrheic dermatitis is often likened to atopic dermatitis, which is more commonly referred to as eczema. Both are skin conditions that affect approximately 10% of the population, flaring up in response to stress, changes in seasons, and illness. Medical professionals do, however, consider the two to be distinct conditions. This is reflected in how the conditions are treated; doctors often prescribe hydrocortisone cream for eczema and antifungal medications for seborrheic dermatitis.
