Seborrhoeic dermatitis
Created: 09.01.2025
Updated 30.03.2026
Approved by: Consultant Dermatologist, Dr James Denny
What is Seborrheic Dermatitis?
Seborrhoeic dermatitis, sometimes referred to as seborrhoeic eczema, is a common, chronic inflammatory skin condition that affects areas rich in sebaceous, or oil-producing, glands. These areas include the scalp, face, eyebrows, sides of the nose, ears, chest, upper back, and skin folds.
The condition is associated with an inflammatory response to a naturally occurring yeast called Malassezia, which lives on the skin surface. People with seborrhoeic dermatitis appear to have an increased sensitivity to this yeast, leading to redness, irritation, and flaking skin.
Several factors can contribute to flare-ups, including:
- Stress
- Cold or dry weather
- Hormonal changes
- Fatigue
- Underlying neurological conditions
- Immune system changes
Seborrhoeic dermatitis is not contagious and is not caused by poor hygiene.
What are the Symptoms?
Seborrhoeic dermatitis typically presents with:
- Red or pink affected areas
- Greasy or yellowish scaly patches
- Persistent flaking skin, particularly on the scalp
- Mild to moderate itching
- Irritation of the surrounding skin
On the scalp, it commonly causes dandruff. In more pronounced cases, thick, crusted plaques may form.
On the face, redness and scaling often affect the eyebrows, sides of the nose, beard area, and behind the ears. In body skin folds, such as under the breasts or in the groin, the skin may appear red, shiny, and inflamed rather than scaly.
Seborrhoeic dermatitis in infants
In infants, the condition is known as infantile seborrhoeic dermatitis, commonly referred to as cradle cap.
Cradle cap appears as thick, greasy, yellowish scales on the scalp. It may also involve the eyebrows, behind the ears, or the nappy area.
Infantile seborrhoeic dermatitis is very common, usually develops within the first few months of life, and typically resolves on its own without causing discomfort. Unlike eczema, it does not usually itch.
How is seborrhoeic dermatitis diagnosed?
Diagnosis is usually made clinically by a dermatologist based on the distribution and appearance of the rash.
In atypical or persistent cases, specialist review helps exclude other conditions such as psoriasis, contact dermatitis, fungal infections, or rosacea. Investigations are rarely required, but accurate diagnosis ensures appropriate treatment.
What are the treatments?
Although seborrhoeic dermatitis is a chronic condition, symptoms can usually be well controlled with appropriate treatment and maintenance therapy.
Scalp treatment
For scalp involvement, medicated shampoos are first-line treatment. An antifungal shampoo containing ketoconazole, selenium sulfide, or zinc pyrithione helps reduce yeast levels and inflammation.
In cases with thick scale build-up, preparations containing salicylic acid may be recommended to help soften and remove excess scale before antifungal treatment.
Shampoos are typically used several times weekly during flares and then reduced to maintenance use once symptoms improve.
Facial and body treatment
For facial or body involvement, topical antifungal creams are commonly prescribed.
Short courses of mild topical corticosteroids may be used to reduce significant inflammation, particularly during flare-ups. These should be used under medical supervision to avoid thinning of the skin or rebound symptoms.
Calcineurin inhibitors may be considered in sensitive areas such as the face or in cases requiring longer-term management.
Gentle skincare is essential. Harsh cleansers, fragranced products, and excessive washing can aggravate the condition.
Long-term management
Seborrhoeic dermatitis tends to follow a relapsing and remitting course. Even after successful treatment, maintenance therapy is often needed to prevent recurrence.
Patients benefit from:
- Regular use of antifungal shampoos or creams as advised
- Early treatment of flare-ups
- Stress management
- Avoidance of irritating skincare products
Specialist dermatology input is valuable in persistent, widespread, or treatment-resistant cases, ensuring accurate diagnosis and tailored treatment plans.
What is the prognosis?
Seborrhoeic dermatitis is a long-term condition, but it is manageable. Most patients achieve good control with appropriate treatment. Infantile seborrhoeic dermatitis usually resolves spontaneously within the first year of life.
Although the condition is not medically dangerous, it can cause discomfort and affect confidence, particularly when visible on the face or scalp. Early specialist care can significantly improve symptom control and quality of life.
Frequently Asked Questions
Is seborrhoeic dermatitis the same as dandruff?
Dandruff is a mild form of seborrhoeic dermatitis affecting the scalp. When inflammation, redness, and thicker scaly patches develop, it is considered seborrhoeic dermatitis rather than simple dandruff.
Is seborrhoeic dermatitis contagious?
No. Seborrhoeic dermatitis is not contagious and cannot be passed from person to person. It is linked to an inflammatory response to naturally occurring yeast on the skin.
What is the best treatment for seborrhoeic dermatitis?
Treatment depends on the affected areas. An antifungal shampoo is usually recommended for scalp involvement. For the face or body, antifungal creams and short courses of mild topical corticosteroids may be prescribed. Ongoing maintenance treatment is often needed to prevent flare-ups.
Can seborrhoeic dermatitis affect areas other than the scalp?
Yes. In addition to the scalp, it commonly affects the eyebrows, sides of the nose, ears, chest, upper back, and skin folds. These areas may show redness, irritation, and greasy scaling.
Will seborrhoeic dermatitis go away permanently?
Seborrhoeic dermatitis is a chronic condition that tends to flare and improve over time. While it cannot usually be cured permanently, symptoms can be effectively controlled with appropriate treatment and regular maintenance.
