Seborrheic Dermatitis – Dandruff, Cradle Cap and Adult Seborrhea

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Photo credit: http://hardinmd.lib.uiowa.edu/dermnet/seborrheicdermatitis22.html

Photo credit:  http://siklusair.com/seborrheic-dermatitis-eyes

Photo credit:  http://medicalcontent.hubpages.com/hub/Seborrheic-Dermatitis-Pictures-on-Face-Scalp-Hair-loss-Causes-Treatment

 

Seborrheic dermatitis is a common skin condition that occurs in infants and adults and can cause redness, greasy scales, skin flaking along the eyebrows and itching.  It is one of the most common skin conditions that I see as an urgent care physician.

Seborrheic dermatitis (also called seborrhea) is an inflammation of the skin that usually occurs in areas that have an abundance of oil glands such as on the scalp, face, around the eyes, ears, neck, and even the diaper area.  In men, it’s more common in areas where there is hair on the face.  Infants often have seborrhea on their scalp that is known as cradle cap.  A mild form of seborrhea is known as dandruff and that is when it is confined to the scalp in children or adults.  Some symptoms may be:

1)   Skin scales – white or yellow and usually oily/greasy

2)   Itching

3)   Mild redness

4)   Skin lesions or plaques

The exact cause of seborrheic dermatitis is unknown but there is some evidence that it seems to flair up in times of stress, hormonal changes or during particular seasons (ie. During extreme cold or warm weather).  It is more common in those people with weakened immune systems, in people who have oily skin, or certain neurological conditions such as Parkinson’s Disease.

Diagnosis:  Your healthcare provider is usually able to diagnose seborrheic dermatitis by examining you and taking a history.  A biopsy (sample of skin that is surgically removed and sent to a doctor to examine under a microscope) is rarely needed.

Treatment:  Usually tailored toward the individual patient and what part of the body is affected.  Some possible treatments include:

1)   Medicated shampoos such as Neutrogena T-Gel or T-Sal, Head and Shoulders or Nizoral are commonly prescribed.   These shampoos usually contain Salicylic acid, Coal Tar, Zinc, Selenium Sulfide, Ketoconazole, or Resorcin.  Even if you do not have dandruff, these shampoos may be used on the face and/or other body areas and usually work best if they are left in place for 5-10 minutes before rinsing.

2)   Topical Steroid creams, lotions, foams or shampoos:  Low, medium or even high potency steroid creams are sometimes prescribed to help decrease the inflammation depending on the severity and where the rash is. Usually the lower potency creams are used on the face (such as Desonide 0.05% lotion).

3)   Antibacterial creams:  Sometimes topical antibacterials such as Sodium Sulfacetamide with sulfur are prescribed.

4)   Antifungal creams:  Ketoconazle 2% cream, and Ciclopirox 1% creams are commonly used.

5)   Other anti-inflammatory medications such as pimecrolimus cream or tacrolimus ointment are sometimes prescribed for use on facial seborrhea.

6)   Dermatologists sometimes recommend a compound or mixture of a combination of a steroid cream along with an anti-fungal or antibacterial agent.

Cure:  Unfortunately there is no cure for seborrheic dermatitis. It is a chronic life-long condition. It may go away for months or years and then return (relapse).  We usually focus on controlling seborrhea often by using a combination of the strategies for treatment listed above along with decreasing known triggers such as emotional stress, extreme cold temperatures and decreasing body weight.

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.

 

I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO

Blog: https://doctorrennie.wordpress.com

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2 thoughts on “Seborrheic Dermatitis – Dandruff, Cradle Cap and Adult Seborrhea

  1. Lin

    I’ve read that tee trea oil is good for this as well. do you recommend that mixed with mineral oil or any other herbal alternatives where the steroid creams and antifungals arent working?. We had a run with amoxicillin rash and can’t seem to rid my teenager of rash.

    1. Dr. Scott Rennie

      I’ve heard that mineral oil has been helpful for seborrheic dermatitis especially on the scalp in babies – ie. cradle cap. You could try it and see if it helps. If it’s not working I would recommend checking with your healthcare provider though.

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