Seborrheic Dermatitis

Seborrheic Dermatitis/Dandruff/Scalp Conditions

What is seborrheic dermatitis?

Seborrheic dermatitis is a common red, scaly, itchy rash that develops in areas of the skin rich in oil glands, such as the scalp, sides of the nose, eyebrows, ears, eyelids, and middle of the chest. Other areas, such as the navel (belly button), buttocks, underarms, breasts, and groin, may be involved.
Seborrheic dermatitis is chronic and relapsing, worsening during seasonal changes and at times of stress. It may be socially embarrassing, especially because of the scaling scalp, which may be perceived as uncleanliness.

Who gets seborrheic dermatitis?

Seborrheic dermatitis is considered one of the most frequent skin disorders. It is most common in three age groups — infancy, middle age, and in seniors.

In infants, this condition most often involves the scalp (cradle cap), the face and the diaper area. It affects up to 70% of newborns during the first three months of age and disappears by 1 year of age. In some infants, seborrheic dermatitis develops only in the diaper area and can be confused with other forms of diaper rash.

Seborrheic dermatitis appears less often between 1 year of age and the onset of adolescence, when the typical scalp and facial scaling tends to flare again.

When seborrheic dermatitis develops after infancy, it tends to come and go. For people living in northern climates, winter can worsen seborrheic dermatitis.

What causes seborrheic dermatitis?

Seborrheic dermatitis is thought to be due to an irritation from a yeast called Malassezia.  Malassezia is a normal inhabitant of hair follicles in oily areas of the skin.  People with seborrheic dermatitis seem to have a decreased resistance to this organism.

Seborrheic dermatitis appears to run in families.

Seborrheic dermatitis is not contagious or related to diet, but it may be aggravated by illness, psychological stress, fatigue, change of season and reduced general health.

Oily skin, infrequent shampooing or skin cleansing, use of lotions that contain alcohol and skin conditions, such as acne, may increase the risk. 

Those with immunodeficiency (especially infection with HIV) and with neurological disorders such as Parkinson's disease, head injury and stroke are particularly prone to it.

What does seborrheic dermatitis look like?

Seborrheic dermatitis appears as thick, crusty, pink or red plaques with a yellowish, greasy scale or flaking in areas of increased oil production, such as the scalp, ears, central face, beard area, chest, and occasionally in the axillae and groin.

In patients with skin types IV-VI, seborrheic dermatitis is often seen as sharply defined scaling or flaking patches, lighter than normal skin color.

Seborrheic dermatitis can affect the eyelids, causing redness, swelling, scaling and irritation (blepharitis).

Seborrheic Dermatitis  Seborrheic Dermatitis  Seborrheic Dermatitis
Seborrheic Dermatitis  Seborrheic Dermatitis

How is seborrheic dermatitis diagnosed?

The diagnosis of seborrheic dermatitis is usually based on the characteristic clinical appearance.  In rare cases of chronic seborrheic dermatitis that does not respond to treatment, a skin biopsy or other laboratory tests may be necessary to eliminate the possibility of another disease.

Seborrheic dermatitis is occasionally difficult to differentiate from:

  • Psoriasis
  • Eczema (atopic dermatitis)
  • Fungal infection of the scalp (tinea capitis)
  • Contact dermatitis
  • Rosacea
  • Lupus erythematosus
  • Erythrasma
  • Rare conditions, such as Langerhans cell histiocytosis, Wiskott-Aldrich syndrome, and dermatomyositis

Association with other diseases

Although seborrheic dermatitis is very common, people with certain medical conditions are more likely to get severe seborrheic dermatitis

  • Diseases of the nervous system, such as Parkinson’s disease, head injury or stroke
  • Recovery from stressful medical conditions, such as a heart attack
  • Immune system disorders, such as HIV
  • Trisomy 21 (Down’s syndrome)
  • Patients taking certain medications

Treatments for seborrheic dermatitis

  • Topical antifungal medications are the mainstay of treatment of seborrheic dermatitis
  • Topical steroid preparations, usually in combination with antifungal agents
  • Shampoos with selenium sulfide or zinc pyrithione
  • Topical calcineurin inhibitors, such as pimecrolimus or tacrolimus
  • For severe seborrheic dermatitis, oral antifungal medications, such as ketoconazole, may be necessary

Summit Medical Group is proud to provide medical, surgical and cosmetic dermatology services to women and men in the Tri-State Area, New York and New Jersey, including the following counties and cities: Essex County, Morris County, Bergen County, Union County, Passaic County, Somerset County and Sussex County, NJ - Livingston, Millburn, Short Hills, West Orange, Berkley Heights, Caldwell, Cedar Grove, Cedar Knolls, Chatham, East Hanover, Englewood Cliffs, Essex Fells, Fair Lawn, Florham Park, Fort Lee, Glen Ridge, Jersey City, Kinnelon, Madison, Maplewood, Mendham, Montclair, Montvale, Morristown, New Providence, North Caldwell, Parsippany, Randolph, Roseland, South Orange, Springfield, Summit, Union, Verona, West Caldwell, Whippany and Westfield, NJ.

Seborrheic Dermatitis
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