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Seborrheic Dermatitis: Spreads To The Face & Beyond

Written by Megan Kinder [email protected]

Usually beginning on the scalp as oily, waxy patches, this common type of eczema sometimes spreads to the face and beyond. A severe case, while rare, produces widespread lesions. Like most types of eczema, seborrheic dermatitis tends to flare in cold, dry weather.

Signs and symptoms can vary from day to day and include:

• Oily, waxy appearance to the skin
• Flaking skin with scale that ranges in color from white to yellowish-brown
• Reddish, somewhat swollen patches of skin — often resembling atopic dermatitis (another type of eczema) or psoriasis
• Patches may appear on the scalp, hairline, upper lip, beneath the eyebrows, inside and behind the ears, eyelids, creases near the mouth, around the nose, armpits, groin, navel, buttocks, underneath the breasts, and upper back. These areas contain oil-producing glands called sebaceous glands.
• If you have an itch that won't go away, it could be a sign of a skin infection. Skin infections often cause burning and inflammation, in addition to itchiness.
• If severe, widespread patches

Who Can be Affected by Seborrheic Dermatitis?

• Develops in all races
• Tends to begin during infancy (newborn to 6 months), puberty, or between 40 and 70 years of age. After 6 months of age, the condition rarely appears before puberty. When seborrheic dermatitis begins during infancy, it usually clears by 9 to 12 months of age.

Possible Causes 

While the exact cause is not known, researchers believe that a number of factors interact to cause seborrheic dermatitis. These factors include the genes we inherit, yeast that normally lives on human skin, stress, climate, and overall general health. 

Risk Factors 

The following tend to increase the likelihood of developing seborrheic dermatitis:

• A family history of eczema
• Having oily skin or hair
• Stress
• Fatigue
• A cold, dry climate
• Gender: Males tend to develop more often and have more severe cases
• Obesity
• Injury to the skin, such as an abrasion or scratch
• Using lotions or other topicals that contain alcohol
• Having acne, rosacea, psoriasis, or blepharitis (inflammation of the eyelid)
• Some medical conditions (Parkinson’s disease, human immunodeficiency virus (HIV), and recovering from a stroke or heart attack) increase the risk significantly. Estimates indicate that as many as 90% of HIV-infected individuals develop seborrheic dermatitis.
• Taking certain medications, including interferon-α, lithium, and psoralen, significantly increases one’s risk.

 Duration

• Infants. The condition usually clears on its own over a period of weeks or months but may return at puberty.
• Adults. Seborrheic dermatitis is often chronic, flaring periodically and without warning.

How Seborrheic Dermatitis is Diagnosed

• Visual examination of the skin and complete medical history. These are usually all that are needed to diagnose seborrheic dermatitis. It is best to see a dermatologist because seborrheic dermatitis can resemble many other skin conditions, including atopic dermatitis, psoriasis, and rosacea. In infants, seborrheic dermatitis may develop only in the diaper area and be mistaken for diaper rash. Effective treatment requires an accurate diagnosis.
• A skin biopsy or another laboratory testing. This may be necessary to eliminate the possibility of another medical condition.

Specific Treatment Towards Individuals

While seborrheic dermatitis cannot be cured, most cases respond quickly to proper treatment. The goals of treatment are to loosen and remove scales and crusts, prevent skin infections, as well as reduce inflammation and itching. 

Treatment varies by age and area of the body to be treated:

• Cradle cap, which only develops in infants, can usually be controlled by shampooing more frequently with baby shampoo and by softly brushing away the scales. A dermatologist also may prescribe a mild corticosteroid or anti-fungal medication.
• When the condition spreads beyond the scalp in infants, dermatologists usually prescribe a topical medication, such as a mild corticosteroid or anti-fungal cream.
• African-American patients often get relief by shampooing once a week with a product recommended by a dermatologist. 
• Caucasian patients with seborrheic dermatitis may find that their condition clears by shampooing more frequently than usual and leaving the lather on the scalp for a longer time. Shampoos that are specifically designed to relieve dandruff are often effective. However, sometimes it is necessary to alternate between different dandruff shampoos, using a different one every few days, in order to see results. A dermatologist can explain this process and recommend which shampoos a patient should use and when. A dermatologist may prescribe a topical corticosteroid or antifungal medication to effectively treat the scalp.
• While tar shampoos can effectively reduce skin cell buildup, they also tend to discolor blond and gray hair.
• An adolescent or adult with a severe case of dandruff may require oral antifungal medication or phototherapy in addition to the medicated shampoo. A dermatologist can explain how to use shampoo to treat other affected areas.

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