Seborrheic Dermatitis

In seborrheic dermatitis, the skin is usually itchy, red, and flaky. It often affects the scalp (causing dandruff) and the central part of the face or chest. Seborrheic dermatitis can also affect skin on other parts of the body.

Dandruff is common among adults of all ages. Seborrheic dermatitis of the face and chest becomes more common as people age.

Causes and Symptoms

The cause is unknown, but seborrheic dermatitis may be a reaction to an otherwise harmless fungus. Seborrheic dermatitis is more common among people who have certain brain or nerve disorders (such as Parkinson's disease), those whose immune system is weakened (for example, by some cancers or by use of corticosteroids for a long time), and those who take certain drugs (such as chlorpromazine or haloperidol).

In older people, seborrheic dermatitis most commonly affects the scalp, eyebrows, eyelids, the skin between the nose and upper lip, the part of the face where the beard grows, and the area just behind the ears. The disorder can also affect the middle of the chest and the area between the shoulder blades.

Sometimes the eyes burn or become red. These symptoms may indicate conjunctivitis. Scales sometimes accumulate at the base of the eyelashes, plugging the follicles and causing them to become red, painful, or swollen (a disorder called seborrheic blepharitis).

Treatment and Outlook

Dandruff can be treated with shampoos that contain sulfur, zinc pyrithione, salicylic acid, tar, ketoconazole (an antifungal drug), or a combination of these substances. If shampooing is difficult, particularly if scalp symptoms are severe, hydrocortisone (a corticosteroid) can be applied as a lotion.

If the face or body is affected, hydrocortisone cream or creams or lotions containing ketoconazole, sulfacetamide, sulfur, or salicylic acid are effective.

For conjunctivitis, treatment with eye drops or an eye ointment containing a corticosteroid is occasionally needed.

For seborrheic blepharitis, an ointment containing hydrocortisone can be applied to the eyelids. Scales should be removed from the eyelashes. Applying warm compresses or gently cleaning with a cotton-tipped swab dipped in diluted baby shampoo is effective.

Seborrheic dermatitis is usually permanent. However, serious complications are rare, and symptoms can usually be controlled with treatment.