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Seborrhoeic dermatitis

Expert reviewer Dr Anton Alexandroff, Consultant Dermatologist
Next review due May 2023

Seborrhoeic dermatitis is a condition that makes your skin red, flaky and itchy. It affects areas of your skin that tend to be greasier – for example, your face, scalp and centre of your chest. It’s also known as seborrhoeic eczema.

Photo showing seborrhoeic dermatitis on the face of a baby

About seborrhoeic dermatitis

Seborrhoeic dermatitis is an inflammation in the areas of your skin that have a lot of sebaceous glands. These glands make an oily fluid which keeps your skin supple. The skin areas most affected are where you have hair or where there are skin folds.

The inflammation in seborrhoeic dermatitis may be due to an overreaction to a yeast called Malassezia, which is present on your skin. See our section on causes for more information about this.

The symptoms of seborrhoeic dermatitis vary in severity from person to person, from mild dandruff to widespread patches of red, itchy, inflamed skin. You may notice your symptoms flare up at times and then get better again. You can find out more about this in our section on symptoms.

Seborrhoeic dermatitis is quite common, affecting up to five in every 100 people. Many people have a mild form of this condition, without even being aware they have it. For instance, around half of adults have dandruff, which is a mild form of seborrhoeic dermatitis.

You can develop seborrhoeic dermatitis at any age, from puberty onwards. It's most common to develop it as a teenager, and between the ages of 30 and 70. Men are more likely to get it than women.

It’s also very common for babies to get seborrhoeic dermatitis. This mainly affects a baby's scalp, where it’s known as cradle cap.

Symptoms of seborrhoeic dermatitis

Symptoms in teenagers and adults

Seborrhoeic dermatitis causes red, flaky or scaly patches on your skin. The affected area may be itchy and sore. The most commonly affected areas include the following.

  • Your scalp – symptoms range from mild, flaky skin (dandruff) to a more severe, scalier, itchy rash which may weep.
  • Your face – especially between your eyebrows, on your cheeks and in the folds at the sides of your nose. It can also affect your eyelids, making them red, swollen and flaky. This is known as blepharitis.
  • Your ears – the skin inside your ear may become inflamed, as well as your outer ear and the skin behind your ear.
  • Your upper chest and your back, between your shoulder blades, may have round, pink or red patches with mild scaling.
  • Skin folds – these are areas that tend to stay moist and include your armpits, under your breasts and your groin. Your skin here might appear pink, shiny and cracked.

You’ll usually be able to deal with mild symptoms such as dandruff by yourself. You can also get advice from a pharmacist. If your symptoms are more severe or cover a lot of your skin, contact your GP for advice.

Symptoms in babies

Babies often get a short-lived form of seborrhoeic dermatitis on their scalp, known as cradle cap. This causes greasy, yellow-brown, scaly patches on their scalp. Seborrhoeic dermatitis can sometimes also affect other parts of your baby’s body, including their face, behind their ears and in skin folds. In these areas, the affected skin usually has drier, whiter scales than those on their scalp. It can also develop in your baby's nappy area. Any itching in babies is usually mild, and is unlikely to bother your baby.

Cradle cap usually gets better by about four months of age, but your baby may have it for up to a year.

If your baby just has cradle cap, you won't normally need to see a doctor for a formal diagnosis. Your health visitor may be able to give you some advice on dealing with it. But if it's affecting other areas of your baby's body or they have cradle cap that doesn't seem to be responding to normal treatments, contact your GP.

Diagnosis of seborrhoeic dermatitis

Your GP will usually be able to diagnose seborrhoeic dermatitis by looking at your skin and asking you some questions about your symptoms. Seborrhoeic dermatitis can look similar to a number of other skin conditions, especially psoriasis. Sometimes the two conditions can overlap.

If they’re not sure if your symptoms are due to seborrhoeic dermatitis or your symptoms are severe, your GP may refer you to a dermatologist. A dermatologist is a doctor who specialises in identifying and treating skin conditions.

You’re more likely to have seborrhoeic dermatitis, especially in a severe form, if you are immunocompromised (have a low immune system). An example of this is if you are living with HIV. This is why, if you have severe symptoms of seborrhoeic dermatitis, your doctor may recommend you have an HIV test.

Self-help

If you have areas of skin affected by seborrhoeic dermatitis, try to keep them clean and as dry as possible. Don’t use soap or shaving cream if these irritate your skin. Use an emollient (moisturising) soap substitute instead. You can ask your pharmacist for advice.

Your symptoms may get worse when you’re tired or stressed. Try doing things to help you relax, and avoid stress when you can. And try to avoid scratching your skin too much as this may break the skin and cause an infection.

Cradle cap

If your baby has seborrhoeic dermatitis on their scalp (cradle cap), try using olive oil or vegetable oil to soften the scales. Then gently brush them off and wash your baby’s scalp with a baby shampoo. If the scales are very thick, you may need to leave the oil on overnight and wash with shampoo in the morning.

If your baby is affected in other areas, your GP may advise you to bathe them at least once a day and use an emollient soap substitute. Frequent nappy changes, and using barrier creams such as zinc and castor oil cream or white soft paraffin, can help your baby’s nappy area.

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Treatment of seborrhoeic dermatitis

There's no permanent cure for seborrhoeic dermatitis, but treatment can improve and temporarily clear your symptoms. Be aware that your symptoms may well come back when you stop using the treatment.

The treatments aim to reduce inflammation and to reduce the amount of Malassezia yeast on your skin.

Scalp seborrhoeic dermatitis

If you have scalp seborrhoeic dermatitis, your pharmacist or GP will probably recommend that you try one of the following treatments.

  • Medicated anti-dandruff shampoos that contain ingredients such as ketoconazole, selenium, coal tar, zinc pyrithione or salicylic acid. You can buy these shampoos from a pharmacy. In some cases, your GP may be able to prescribe them for you. See our FAQs for more information on how to use these shampoos.
  • Corticosteroid gels or lotions. These are recommended if you have severe inflammation, itching and flaking. You should only use them for short periods unless you have specific advice from your GP.

If your seborrhoeic dermatitis keeps coming back, your GP may recommend that you carry on using an antifungal cream or shampoo once a week or once every two weeks.

If your baby has cradle cap, see our section on self-help for tips on how to treat it yourself. Your GP may also prescribe a medicated shampoo if your baby has cradle cap that doesn't clear up by itself.

Seborrhoeic dermatitis on your face and body

Your GP may prescribe the following treatments for seborrhoeic dermatitis on your face or body.

  • An antifungal cream containing ketoconazole or another antifungal agent. It can take up to four weeks of using these treatments daily for your symptoms to get better. Or your doctor may suggest you use an antifungal shampoo as a body wash.
  • If your ears are affected, your GP may prescribe medicated eardrops.
  • A corticosteroid cream to reduce inflammation. You may be prescribed this together with an antifungal agent for one or two weeks.
  • Topical calcineurin inhibitors. These include tacrolimus ointment and pimecrolimus cream. Your doctor may prescribe these if you need long-term treatment for inflammation, to avoid the side-effect of skin thinning you might get from corticosteroids.

Severe seborrhoeic dermatitis

Your GP may refer you to a dermatologist if your seborrhoeic dermatitis:

  • is severe
  • covers many areas of your body
  • doesn’t respond to normal treatments

Your dermatologist may prescribe antifungal tablets if your rash is very widespread.

Causes of seborrhoeic dermatitis

Doctors aren’t sure why some people get seborrhoeic dermatitis. However, it's thought to be associated with a yeast called Malassezia, which is present on our skin. People with seborrhoeic dermatitis seem to have more of this yeast or are more sensitive to it, which leads to an inflammatory reaction.

In most people, seborrhoeic dermatitis isn’t associated with any underlying conditions. However, you may be more likely to get it if you have a condition that affects your nervous system (for example, Parkinson's disease) or you’ve had a stroke. You’re also at greater risk of getting it if your immune system is suppressed (for example, if you have HIV). HIV can also make your symptoms more severe.

Your symptoms may get worse when you’re tired, stressed or generally unwell. You may also notice that your symptoms are worse when it's cold, and better in warmer weather.

The condition isn't related to your diet. It also isn’t contagious, meaning that you can’t catch it or pass it on to another person.

Frequently asked questions

  • You use an antifungal shampoo in the same way that you use your usual, unmedicated shampoo but you need to leave it on your hair for longer.

    Antifungal shampoos contain antifungal agents such as ketoconazole, selenium sulfide or zinc pyrithione. You need to leave an antifungal shampoo on your hair for about five to 10 minutes before rinsing it off. You can use your regular shampoo afterwards if you want to. You’ll usually need to use the antifungal shampoo twice a week for up to four weeks. Don’t use it more often than this without getting advice from your pharmacist first. If you need to wash your hair more than twice a week, use your usual shampoo in between washes with the antifungal shampoo.

    Sometimes you may need to remove thick crusts or scales from your scalp before using an antifungal shampoo. You can do this by applying a descaling preparation to your scalp for several hours before you shampoo. A descaling preparation usually contains coconut or olive oil and salicylic acid.

    Once your symptoms have cleared up, you can use the antifungal shampoo once a week or once every two weeks to prevent further flare-ups.

    Different products may work slightly differently. Always read the patient information leaflet that comes with your shampoo, and if you have any questions, ask your pharmacist for advice.

  • Yes, there’s no reason why you can't use make-up on areas of your skin where you have seborrhoeic dermatitis if you want to. But bear in mind that make-up can cause further irritation to your skin.

    You may find that non-greasy moisturisers and moisturising (emollient) soap substitutes help to ease your symptoms.

    Many cosmetic products contain allergens (substances which our bodies may have an allergic response to). Soap and cosmetics containing alcohol may also irritate your skin. If you can, buy products designed for sensitive skin, that are free from alcohol and certain other allergens.

  • Seborrhoeic dermatitis doesn’t cause hair loss. It may cause your scalp to become greasy, scaly and irritated. In mild cases, your head may feel itchy and you may notice fine flakes of dandruff. In more severe cases, the skin on your scalp may become red and weep, or even bleed if you scratch it. But it shouldn't mean you lose hair.

    Medicated shampoos and steroid creams should help clear symptoms of seborrhoeic dermatitis on your scalp. See our section on treatment for more information.



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Related information

    • Seborrhoeic dermatitis. BMJ Best practice. bestpractice.bmj.com, last reviewed March 2020
    • Dermatitis (seborrhoeic) of the body. BMJ Best practice. bestpractice.bmj.com, published January 2020
    • Seborrhoeic dermatitis. Patient. patient.info, last edited August 2016
    • Seborrheic dermatitis. The MSD Manuals. www.msdmanuals.com, last full review/revision August 2019
    • Seborrhoeic dermatitis. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised February 2019
    • Seborrhoeic dermatitis. British Association of Dermatologists. skinhealthinfo.org.uk, updated April 2018
    • Scalp and hair conditions. NICE British National Formulary. bnf.nice.org.uk, accessed May 2020
    • Irritant contact dermatitis. Medscape. emedicine.medscape.com, updated August 2019
    • Allergic contact dermatitis. Medscape. emedicine.medscape.com, updated February 2019
    • Personal communication, Dr Anton Alexandroff, Consultant Dermatologist, May 2020
  • Reviewed by Dr Kristina Routh, Freelance Health Editor, Bupa Health Content Team, May 2020
    Expert reviewer, Dr Anton Alexandroff, Consultant Dermatologist
    Next review due May 2023

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