People of any age can develop seborrheic dermatitis including infants (known as “cradle cap”). However, it most commonly affects adults between the ages of 30-60 and infants under 3 months.

Symptoms of Seborrhea

Seborrhea occurs around hair follicles, which are the same place as the ducts for sebaceous glands. Since most hair is present on the head, the most common form of seborrhea is seborrheic dermatitis better known as “Dandruff.”

Also, people experiencing seborrhea may notice red, itchy scaliness at the base of the neck, behind and inside the ears, in the eyebrows, and/or around the nostrils. Since it’s a hair-rooted irritant, some men can also get it on their chest (chest hairs).

Seborrhea Causes

We know yeast causes the irritation, and it spreads because of oil production, but we know little about where the yeast comes from. However, once it’s there, it is hard to remove completely.

Seborrheic Dermatitis Triggers:

• Stress
• Hormonal changes or illness
• Harsh detergents, solvents, chemicals and soaps
• Cold, dry weather
• Medications such as psoralen, interferon and lithium

Seborrheic Dermatitis Appearance

Seborrheic dermatitis often appears on the scalp, where symptoms may range from dry flakes (dandruff) to yellow, greasy scales with reddened skin. Patients can also develop seborrheic dermatitis on other oily areas of their body, such as the face, upper chest and back. Seborrheic dermatitis appears in oily skin areas like the side of the nose and causes redness and yellow scale patches and flakes. Common symptoms of seborrheic dermatitis include:

• Redness
• Greasy, swollen skin
• White or yellowish crusty flakes
• Itch and burning
• Pink-colored patches, most prominent in people with dark skin

Diagnosis

Seborrheic dermatitis can often look like (and even appear with) other skin conditions such as atopic dermatitis and psoriasis.  There is no formal test for diagnosing seborrheic dermatitis, However, your doctor will ask about your medical history and also perform a physical examination of your skin. Sometimes, the doctor with scrape a bit of skin, mix it with a chemical and look at it under a microscope to determine if there is a fungal infection.

Similarly, your doctor may also obtain perform a skin biopsy. This is a procedure where a small sample of skin is taken for study. It may be required to rule out the other conditions that look similar to seborrheic dermatitis.

If you or a loved one are experiencing symptoms, don’t hesitate to make an appointment with your doctor to get the proper diagnosis and treatment for the condition.

Treatment

The first goal is to to successfully remove the yeast completely from the body. However, this is easier said than done. It can quickly and easily return to an affected area, even after it’s initially removed. Dandruff products like Head and Shoulders, Selsun Blue, and Neutrogena T/Gel work to reduce yeast build-up. Unfortunately, they’re not extremely effective long term. When the yeast returns (within a few days, give or take) so does the itchy, scaly skin! The dandruff shampoos are better than nothing, but in order to stop the ailment in its tracks, it requires medical attention. Treatment for seborrheic dermatitis focuses on reducing breakouts, inflammation, swelling, and itching. In mild cases, a topical antifungal cream or medicated shampoo (such as ketoconazole, selenium sulfide, coal tar, and zinc pyrithione) may be enough to control symptoms.

Guidelines for treating seborrheic dermatitis include:

For the scalp: Alternate between using your regular shampoo and a medicated dandruff shampoo. For people of color or those with a dark complexion, wash with the medicated shampoo once weekly. Taper off as your symptoms improve. Your doctor will be able to offer guidance.

For the body: Wash daily with a gently cleanser that has 2% zinc pyrithione, followed by a moisturizer. To further soften scale, use a cream containing salicylic acid and sulfur or coal tar. In more severe cases, a mild corticosteroid medication may be prescribed to calm the inflammation down. Use topical corticosteroids only as directed by your doctor, when the seborrheic dermatitis is actively flaring up.

In cases where corticosteroids are NOT appropriate, or when they have been used for a prolonged period, a non-corticosteroid topical medication such as tacrolimus (Protopic) or pimecrolimus (Elidel) may be prescribed. These medications are called Topical Calcineurin Inhibitors (TCIs) and are approved for use by adults and children two years of age or older. Oral antifungal agents may be used in very severe cases. Seborrhea is much more effectively managed by treating the inflammation instead of the yeast. Mild topical steroids reduce the inflammation, which combats the redness and itchiness.

If you’re dealing with a red, itchy, scaly scalp and dandruff shampoos aren’t helping, it’s time to visit your doctor, dermatologist or health care professional. Seborrhea will not go away on its own without help. It will return seasonally, but you don’t have to live with the symptoms. With the right medication and proactive treatments, that red, itchy skin will soon disappear. Be sure to seek out the help you need to get on the road to wellness.