Seborrheic dermatitis explained
Seborrheic dermatitis (SD) is a type of dermatitis that appears as a greasy scaling red rash. It affects areas of the body with more oil-producing glands, like the scalp, but can also occur in other areas such, as around the nose, the eyebrows and behind the ears. Seborrheic means sebaceous (oil-producing) glands, and dermatitis means an inflamed skin condition. In its mildest form, it’s known as dandruff. In babies, it’s called cradle cap.
It’s unclear why it occurs, but it may be an inflammatory reaction to a yeast commonly found on the skin. Some people may feel anxious or embarrassed about their symptoms – but it is not caused by poor hygiene and is not contagious.
We spoke with Dr. Maxwell Sauder, a Toronto-based dermatologist, to discuss SD and helpful treatment options.
What are the symptoms of SD?
“Symptoms of SD include:
- Flaking, greasy, or scaly patches of skin
- White, pink, or yellow colouration
- Itching or burning sensations
Symptoms can come and go and may be worse during cold weather, dry climates, stressful times, hormonal changes, or illness,” says Dr. Sauder. “A dermatologist can diagnose SD by looking closely at your skin.”
What is the difference between dandruff, cradle cap, and SD?
Dr. Sauder tells ESC, “Dandruff is mild, common, and usually appears as flaking skin on the scalp. It can be dry or oily and is sometimes itchy. It can be white or yellow coloured.
Cradle cap is also on the scalp, but can rarely occur all over the baby’s body, including the diaper area. It often begins as yellow-brown scaly patches on the baby’s head, which can become a thick, crusty area, but it’s usually not itchy and goes away on its own.
Seborrheic dermatitis affects skin with more oil glands, not only the scalp but especially the face and occasionally the body. It’s often red-pink with soft greasy scale and can be itchy.”
Who gets SD?
“SD is a common skin condition and can develop in all ages, sexes and races,” said Dr. Sauder. “However, it is more common during:
- Infancy (2 to 12 months)
- Adolescence
- Adulthood (30 to 60 years).”
Dr. Sauder further explains that “some people are more likely to develop SD, including:
- Men
- Black people
- People with HIV or AIDS
- People with neurologic disorders, like Parkinson’s disease
- People with psoriasis or rosacea
- People with a family member with SD.”
Can I prevent SD?
“While we can’t prevent SD,” says Dr. Sauder. “The good news is that we can manage the condition well with topical treatments. Equally important, we may be able to reduce SD flares with healthy lifestyle habits, like getting enough sleep and managing stress.”
How is SD treated?
Dr. Sauder tells us that, “Fortunately, treatment is usually effective. SD historically has been treated with anti-dandruff shampoos, topical corticosteroids, calcineurin inhibitors, or antifungal medications. However, in October 2024, a new topical phosphodiesterase-4 (PDE4) inhibitor was approved for the treatment of SD in patients 9 years of age and older. ZORYVE® (roflumilast foam 0.3%), is the first novel treatment for SD in 20 years.”
“Dandruff can usually be managed using over-the-counter shampoos that contain selenium sulfide, tar, zinc pyrithione, or ketoconazole. Cradle cap is treated by rubbing an emollient (i.e. moisturizing substance that softens the skin), like baby oil, on the affected area, a gentle massage with a soft brush to loosen the patches, and then washing with a gentle shampoo.”
What do the experts say?
“While seborrheic dermatitis can be frustrating, it’s important to remember that it’s a manageable condition,” said Dr. Sauder. “With the right treatment plan and consistent care, many people can achieve clear or almost clear skin with minimal flares. You’re not alone in this journey; effective options are available to help you maintain healthy skin and regain confidence.”
Eczema Society of Canada (ESC) thanks Maxwell Sauder, MD, FRCPC, DABD, for his volunteer contribution to this educational content.
This blog was developed as part of our Educational Content program, and funding support for this initiative has been provided by AbbVie, Arcutis Canada, Inc., Eli Lilly Canada Inc., Incyte Biosciences Canada, and LEO Pharma Inc.
References:
- Bholah NG. Seborrheic dermatitis: Causes and treatment — DermNet. DermNet®. July 2024. Accessed September 16, 2024. https://dermnetnz.org/topics/seborrhoeic-dermatitis
- Clark GW, Pope SM, Jaboori KA. Diagnosis and Treatment of Seborrheic Dermatitis. AFP. 2015;91(3):185-190. Accessed September 16, 2024. https://www.aafp.org/pubs/afp/issues/2015/0201/p185.html
- Dall’Oglio F, Nasca MR, Gerbino C, Micali G. An Overview of the Diagnosis and Management of Seborrheic Dermatitis. Clin Cosmet Investig Dermatol. 2022;15:1537-1548. doi:10.2147/CCID.S284671
- Ludmann P. Seborrheic dermatitis: Overview. American Academy of Dermatology Association. June 12, 2022. Accessed September 16, 2024. https://www.aad.org/public/diseases/a-z/seborrheic-dermatitis-overview
- Ruenger TM. Seborrheic Dermatitis – Dermatologic Disorders. Merck Manual Professional Edition. January 2023. Accessed September 16, 2024. https://www.merckmanuals.com/en-ca/professional/dermatologic-disorders/dermatitis/seborrheic-dermatitis
- Tucker D, Masood S. Seborrheic Dermatitis. In: StatPearls. StatPearls Publishing; 2024. Accessed September 16, 2024. http://www.ncbi.nlm.nih.gov/books/NBK551707/
Disclaimer: Information provided in this resource does not constitute medical advice and is not intended to be used as a diagnostic tool. The information is up-to-date at time of publication. All medications, interventions, and treatment plans have risks and benefits, and it is important that individuals discuss their or their child’s specific health care needs with a qualified health care professional.
December 2024
