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Seborrhoeic dermatitis

Woman washing hair in shower
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Have you developed dandruff, or noticed scaly red patches of skin on your scalp, face or chest? You might be experiencing the skin condition called seborrhoeic dermatitis.

What is seborrhoeic dermatitis?

Seborrhoeic dermatitis is a type of eczema that usually affects the scalp, face and chest. It is most common in adults, and is thought to affect around 1-3% of the population*.

This type of eczema occurs in areas of the skin that have numerous sebaceous glands. These glands create sebum, an oily lubricant that prevents the skin from drying out. Areas with lots of sebaceous glands include the scalp, the sides of the nose, the ears, the neck, the chest, and the back.

What causes seborrhoeic dermatitis?

The exact causes of seborrhoeic dermatitis are not fully understood. It’s thought that in people with this condition, the body reacts badly to a certain type of yeast living on the skin. In most people malassezia yeast is completely harmless, and a normal part of healthy skin flora – but in people with seborrhoeic dermatitis, its presence can trigger symptoms.

As with any type of eczema, seborrhoeic dermatitis is not caused by being unclean. It is not a contagious condition, so you don’t need to worry about passing it on to anyone else.

What does seborrhoeic dermatitis look like?

The precise symptoms of seborrhoeic dermatitis will vary depending on where it develops. Typically, the skin looks inflamed and red – it may also be covered in white or yellow scales that look greasy. On darker skin tones, seborrhoeic dermatitis may make the affected skin look lighter or darker.

If you develop symptoms on the scalp, you might notice dandruff (skin flakes in the hair), or red and scaly patches underneath the hair. Seborrhoeic dermatitis on the scalp can sometimes weep.

On the face, seborrhoeic dermatitis can affect the eyebrows, nose and cheeks. You might notice red and scaly skin developing in these areas, and some skin flaking around the eyebrows.

If the ears are affected, symptoms can include inflammation and infection of the ear canal.

On the chest and back symptoms appear closer to other varieties of eczema. You might notice dry, round patches of red and scaly skin in the middle of the chest or the shoulder blades.

When dermatitis affects skin creases, such as the armpits and groin, the skin may look moist and shiny, as opposed to dry and scaly.

What is the treatment for seborrhoeic dermatitis?

If you’re experiencing seborrhoeic dermatitis, it’s normally a good idea to visit a doctor for a diagnosis. This is because this condition can cause symptoms similar to other conditions such as scalp psoriasis – by visiting a doctor you can make sure you get the correct diagnosis and treatment.

If your symptoms are only mild, however, you can start by speaking to a pharmacist and trying out some non-prescription treatments.

Scalp treatments

For seborrhoeic dermatitis on the scalp, the main treatment is a medicated shampoo. The two main varieties of medicated shampoo are:

  • Anti-yeast shampoos containing ketoconazole
  • Tar-based shampoos

Typically, both types are available without a prescription. Polytar scalp shampoo can be used to treat seborrheic dermatitis as well as psoriasis and eczema. The shampoo features a 4% coal tar solution which reduces scales, itchiness and inflammation.

If your symptoms are more severe, and you have thick scales on your scalp, you may require a prescription treatment. Diprosalic scalp application contains salicylic acid and is designed to be applied to the scalp to “descale” thickened skin. It is only available with a prescription.

Your doctor may also prescribe a steroid lotion or gel to apply to the scalp.

Treatments for elsewhere on the body

For other areas of the body, treatment typically involves the use of anti-yeast creams, applied directly to affected skin. You might also be advised to use an anti-yeast shampoo, washing your body with it and then leaving the treatment on for around five minutes before rinsing.

Three ingredients commonly found in anti-yeast creams are: ketoconazole, clotrimazole, and miconazole. These are available in prescription-strength products and milder over-the-counter treatments.

Mild topical corticosteroids such as hydrocortisone including, LloydsPharmacy hydrocortisone, are also a treatment for seborrhoeic dermatitis.

In severe cases, a short course of an oral anti-yeast medication might be necessary.

What is the best seborrhoeic dermatitis shampoo?

Popular anti-yeast shampoos include nizoral and selsun, both of which are available over the counter without a prescription, in-store and online. These shampoos treat dandruff a symptom of dermatitis for a healthier scalp.

Tar-based shampoos such as Polytar and Neutrogena t/gel are even more readily available, as you typically don’t have to obtain them over the counter.

  • Polytar – helps alleviate itching with mild antiseptic and anti-inflammatory formulation
  • Neutrogena – helps to treat your scalp while leaving your hair shiny

Anti-yeast shampoos work by reducing the amount of malassezia yeast on the scalp. Tar-based shampoos work by soothing mild symptoms such as flaking and scaling. Both types should be used as a treatment, rather than to clean your hair – you should apply them for five to 10 minutes before washing them out.

For more severe scalp symptoms, a shampoo called capasal may be recommended. This is a tar-based shampoo that also contains coconut oil and salicylic acid. The product can “descale” thick patches on the scalp while simultaneously moisturising dry skin.

How is seborrhoeic dermatitis treated in babies?

Seborrhoeic dermatitis that affects the scalp in babies and young children is often referred to as “cradle cap”. It can also occur elsewhere on the body, but is most commonly found on the face and head.

Typically, seborrhoeic dermatitis in babies is treated with gentle shampooing and the application of emollients. These are cleansers and moisturisers tailored towards very dry, sensitive skin.

If your baby has cradle cap you should use a mild baby shampoo to gently wash their scalp every day. This should help to loosen dry skin and scales. In addition you can apply emollients to the scalp.

For seborrhoeic dermatitis elsewhere on your baby’s skin, try using emollient bath oils, and emollient moisturisers on a daily basis to keep the skin soft and moist.

In some cases, your doctor may recommend the use of mild topical corticosteroids or anti-yeast creams. You should never use these on your baby without checking with your doctor first.