Seborrheic dermatitis, also known as seborrhea, is an inflammatory skin condition that causes areas of the skin to become red, inflamed, and scaly. Itching is especially common. The condition is not contagious or harmful. It can usually be found in the areas of the skin with the most sebum-producing glands. When the condition affects the scalp of infants, it is called cradle cap.
While seborrheic dermatitis commonly affects the scalp, it can also affect other parts of the body. On the face, it can create patches in and around the ear canal. These patches can also appear on the skin below the eyebrows, on the eyelids, and in the center of the face. Other body parts that can be affected are the upper chest and back, the armpits, and even the genitals.1
Common Causes Of Seborrheic Dermatitis
The exact cause of seborrheic dermatitis is still unknown. It could be triggered by an imbalance of hormone levels, nutritional deficiencies, a weak immune system, or problems in the nervous system. However, observations and statistical studies show that there are some common risk factors associated with the condition.
- Seborrheic dermatitis often flares up in people who are stressed out or fatigued.
- Exposure to extreme weather conditions can trigger seborrheic dermatitis.
- Oily skin or failing to wash the scalp enough can both cause seborrheic dermatitis.
- In people who are HIV positive, seborrheic dermatitis can be found all over the body.
- Weakened immunity due to other conditions can cause seborrheic dermatitis, too. Causes of a weakened immunity include chemotherapy, immunosuppressant drugs, and diabetes.
- The presence of a yeast called Malassezia can also trigger seborrheic dermatitis.
- Sometimes, seborrheic dermatitis can run in families.2
Symptoms Of Seborrheic Dermatitis
The symptoms of seborrheic dermatitis appear slowly. At first, the skin becomes inflamed and red. Gradually, skin lesions develop. The skin begins to form scales that may appear white or yellow in color. If the inflamed area gets infected, it can become extremely itchy.
In children, the most commonly observed variant of seborrheic dermatitis is called cradle cap. It develops exclusively on the scalp and forehead, but may spread to the eyebrows. In newborn infants, it develops as a yellowish, greasy, and patchy skin rash on the scalp. This condition is very common and usually resolves by itself. Severe cases of cradle cap are rare.
When seborrheic dermatitis develops during adulthood, it is usually harder to get rid of. If left untreated, it can last for years. The itching is also more pesky and pronounced.3
Dandruff is a mild form of seborrheic dermatitis and only affects the scalp. It is believed that dandruff is caused by a type of fungus of the Malasezzia family.4The fungus can irritate the scalp, causing it to itch and produce the unpleasant flaking that most shampoo commercials try to cash in on.5
While itchy and flaky skin is common in both dandruff and seborrheic dermatitis, dandruff does not cause inflammation. Instead, the common trait of these conditions is a flaking (oily or dry) that is white or yellowish in color.6
Many patients think the white scales of seborrheic dermatitis are due to very dry skin. As a result, they reduce the frequency of shampooing their hair. Unfortunately, this actually causes more scales to accumulate, worsening symptoms with further inflammation.7
In more severe cases, it is common to see red patches (erythematous plaques) on the scalp, behind the ears, or other areas commonly affected by seborrheic dermatitis. Another complaint is a burning sensation in the affected areas. If such cases are untreated, the scales can become thick, greasy, and yellow. Secondary bacterial infections can eventually develop.8
Treating Seborrheic Dermatitis
In many cases, seborrheic dermatitis is not severe enough to require medical treatment. It can be treated by using over-the-counter (OTC) creams and shampoos that contain salicylic acid or ketoconazole.9While salicylic acid can reduce the severity of the symptoms, ketoconazole does a better job at clearing up potential fungal causes and infections.
In children, these products must always be used as per your doctor’s advice. After using a prescription shampoo, the scales begin to soften. You’ll need to gently brush them off with a baby brush. If your infant has cradle cap that looks severe, see the doctor. In recurrent cases, the doctor may ask you to apply medication on the scalp. Cradle cap usually resolves completely before a child is a year old.10
In some adults, the condition may not resolve with over-the-counter (OTC) medicines. It might even come back and continue to cause itching. Remember, scratching the inflamed area can increase your susceptibility to infection. If your condition doesn’t resolve on its own, a dermatologist may prescribe a strong steroidal cream to alleviate the symptoms.
In addition to medication, the best results often come from lifestyle adjustments. Such changes may include using a different shampoo, regularly washing the affected skin, avoiding alcohol products, and refraining from scratching. Wearing clothes that allow proper ventilation is just as important.
Surprisingly, seborrheic dermatitis can sometimes resolve by adequate exposure to sunlight. Sunlight can actually halt the growth of yeast organisms that cause skin inflammations. In fact, in certain patients, outdoor summer activities are enough to improve the condition.11 Of course, check with your doctor before soaking in the sun.
Alternative Treatments For Seborrheic Dermatitis
- Homeopathic Medication: Homeopathy believes that seborrheic dermatitis occurs when there is an imbalance of biochemical components in the body. Research shows that treatment of a low dose, oral homeopathic medication can improve (if not cure) the condition. In a placebo-controlled, double-blind study, 41 patients with seborrheic dermatitis and chronic dandruff were administered a low-dose homeopathic preparation containing potassium bromide, sodium bromide, nickel sulfate, and sodium chloride. After 10 weeks, the condition of the patients improved significantly.12
- Phototherapy: In a test study, 18 patients with severe seborrhoeic dermatitis were treated with phototherapy using UVB radiation thrice a week for 8 weeks. The treatment proved to be very effective. While 6 patients showed complete clearance, the other 12 showed notable improvement.13
- Aloe Vera: For centuries, aloe vera has been known for its antifungal properties. It is commonly used for treating psoriasis, eczema, wounds, and burns. One study found that aloe vera extract can help resolve symptoms such as scaliness and itching, two symptoms of seborrheic dermatitis. Patients even reported that they had fewer affected areas after using a topical application of aloe extract.14
- Tea Tree Oil: Even at mild concentrations, a tea tree oil shampoo can resolve dandruff due to its anti-fungal properties. In one study, the effectiveness of this shampoo was tested over a period of 4 weeks on a study group of 126 people. Some received a placebo. While the placebo group showed an improvement of 11%, the shampoo group showed an improvement of 41%. To top it off, there were no side effects.15
- Ashwagandha: In Ayurveda, it is believed that most skin conditions reflect the general state of the body. Purification of the blood may help treat seborrheic dermatitis and other skin conditions at their root. Ashwagandha (Withania somnifera) is commonly used by Ayurvedic doctors for blood purification. It is also used to resolve disorders that have a mind–body connection.16Arnica, extracted from the dried flowers of Arnica montana, is an active ingredient in many preparations prescribed for seborrheic dermatitis.17
With so much ongoing research on seborrheic dermatitis, there is no reason to continue dealing with the frustrating symptoms. If you have been suffering from this condition, make an effort to check out traditional and natural cures. Remember, seborrheic dermatitis is often a life-long condition. Relief depends on the type of treatment, time, and a large helping of patience.
|↑1, ↑5, ↑9, ↑11||Seborrheic dermatitis, US National Library Of Medicine.|
|↑2, ↑7, ↑8||Johnson, Betty Anne, and Julia R. Nunley. “Treatment of seborrheic dermatitis.” American family physician 61, no. 9 (2000): 2703-10.|
|↑3, ↑10||SEBORRHEIC DERMATITIS: SIGNS AND SYMPTOMS, American Academy Of Dermatology|
|↑4||DeAngelis, Yvonne M., Christina M. Gemmer, Joseph R. Kaczvinsky, Dianna C. Kenneally, James R. Schwartz, and Thomas L. Dawson. “Three etiologic facets of dandruff and seborrheic dermatitis: Malassezia fungi, sebaceous lipids, and individual sensitivity.” In Journal of Investigative Dermatology Symposium Proceedings, vol. 10, no. 3, pp. 295-297. Elsevier, 2005.|
|↑6||Borda, Luis J., and Tongyu C. Wikramanayake. “Seborrheic Dermatitis and Dandruff: A Comprehensive Review.” Journal of clinical and investigative dermatology 3, no. 2 (2015).|
|↑12||Smith, Steven A., Ardith E. Baker, and John H. Williams Jr. “Effective treatment of seborrheic dermatitis using a low dose, oral homeopathic medication consisting of potassium bromide, sodium bromide, nickel sulfate, and sodium chloride in a double-blind, placebo-controlled study.(Original research: seborrhea).” Alternative Medicine Review 7, no. 1 (2002): 59-68.|
|↑13||Pirkhammer, D., A. Seeber, H. Hönigsmann, and A. Tanew. “Narrow‐band ultraviolet B (TL‐01) phototherapy is an effective and safe treatment option for patients with severe seborrhoeic dermatitis.” British Journal of Dermatology 143, no. 5 (2000): 964-968.|
|↑14||Vardy, D. A., A. D. Cohen, T. Tchetov, E. Medvedovsky, and A. Biton. “A double-blind, placebo-controlled trial of an Aloe vera (A. barbadensis) emulsion in the treatment of seborrheic dermatitis.” Journal of dermatological treatment 10, no. 1 (1999): 7-11.|
|↑15||Satchell, Andrew C., Anne Saurajen, Craig Bell, and Ross StC Barnetson. “Treatment of dandruff with 5% tea tree oil shampoo.” Journal of the American Academy of Dermatology 47, no. 6 (2002): 852-855.|
|↑16||Sehgal, Virendra N., and Govind Srivastava. “Traditional/ayurvedic pharmacotherapy of skin diseases.” Skinmed 8, no. 5 (2010): 282.|
|↑17||Shenefelt, Philip D. “Herbal Treatment for Dermatologic Disorders.” (2011).|