Am Fam Physician. 2000;61(9):2713-2714
See related article on seborrheic dermatitis.
What is seborrhea?
Seborrhea (say: seb-uh-ree-uh) is a common skin problem. It causes a red, itchy rash and white scales. When it affects the scalp, it is called “dandruff.” It can be on parts of the face as well, including the folds around the nose and behind the ears, the forehead, and the eyebrows and eyelids. On the body, seborrhea often occurs in the middle part of the chest, around the navel and in the skin folds under the arm, below the breasts and in the groin and buttocks area.
Who gets seborrhea?
Infants may get seborrhea. It's known as “cradle cap.” Cradle cap goes away after about 6 months. It may also affect the diaper area and look like a diaper rash.
Seborrhea also affects adults and elderly persons, and is more common in men than in women. Seborrhea occurs more frequently in persons with oily skin. It is also common in patients with Parkinson's disease or AIDS.
What causes seborrheic dermatitis?
The cause of seborrheic dermatitis is not fully understood. It is likely that a number of factors, such as hormones and stress, can cause it. A yeast-like organism plays an important role.
How is seborrheic dermatitis treated?
Treatment will help keep seborrhea under control. It's important to keep your body clean.
If you have dandruff, use medicated shampoos (see box below).
When using dandruff shampoo, first wet your hair. Rub some shampoo into your scalp and hair. Leave the shampoo on your scalp and hair for at least 5 minutes. Then rinse it out. Use the dandruff shampoo every day until your dandruff goes away. Then use the medicated shampoo 2 or 3 times a week to keep dandruff away. Having dandruff does not mean that your scalp is too dry! Dandruff comes because you need to wash your hair more often.
For black persons, daily shampooing may not be needed. Ask your doctor about a special steroid preparation in oil that can be used on the scalp like a pomade. Or you can use a steroid-containing shampoo.
Head & Shoulders
Cradle cap in infants also gets better with daily shampooing. First try a mild, nonmedicated baby shampoo. If that doesn't work, try an a dandruff shampoo. If the patch of cradle cap is large and thick, first try softening it by rubbing on warm mineral oil. Next, gently brush with a baby hairbrush. Then use shampoo.
Seborrhea on the Face and Body
Seborrhea on the face and body gets better if it is washed every day with soap and water. Rest and exercise, especially outdoors, also help. Sunlight seems to stop growth of the yeast organism that causes affected areas to become inflamed. Don't forget to use a sunscreen! If you have seborrhea around your beard and mustache, the problem will often go away if you shave the hair.
Medicated shampoos (applied as a lotion to the face and body), sulfur products, topical corticosteroid preparations, as well as topical antifungals, are also used to control this problem. See your doctor for advice, as some of these preparations have side effects and require a prescription.
Is there a cure for seborrhea?
If you have seborrhea because of an underlying medical problem, the seborrhea may go away when the medical problem is treated. For most people, however, seborrhea is a lifetime problem that can be controlled with good hygiene and by using the right preparation.