Seborrheic dermatitis: causes, symptoms & natural treatments

Seborrheic dermatitis

Seborrheic dermatitis is a common skin condition that mainly affects areas of the body where there are a lot of oil-producing (sebaceous) glands. It is characterized by red, itchy, and flaky skin, and it often occurs on the scalp (resulting in dandruff), face, and chest. Seborrheic dermatitis is a chronic condition that tends to flare up periodically.

Causes

Microscopic view of Malassezia pachydermatis cells

The exact cause of seborrheic dermatitis is not fully understood, but it is likely to be influenced by a combination of factors. Here are some of the key factors believed to contribute to the development of seborrheic dermatitis:

  1. Malassezia yeast: The presence of a yeast called Malassezia on the skin is associated with seborrheic dermatitis. This yeast is naturally found on the skin, but an overgrowth or an abnormal response to it may trigger inflammation and skin changes.
  2. Genetics: There appears to be a genetic predisposition to seborrheic dermatitis. If you have a family history of the condition, you may be more likely to develop it.
  3. Hormones: Changes in hormone levels can play a role in the development of seborrheic dermatitis. This is why the condition is common in infants (where it’s called “cradle cap”) and in adults during puberty.
  4. Immune system response: An abnormal response of the immune system to the presence of Malassezia or other factors on the skin may contribute to inflammation and the characteristic symptoms of seborrheic dermatitis.
  5. Neurological conditions: There is an association between certain neurological conditions, such as Parkinson’s disease, and an increased risk of seborrheic dermatitis.
  6. Environmental factors: Cold and dry weather can exacerbate symptoms, and stress may also play a role in triggering or worsening seborrheic dermatitis.

It’s important to note that seborrheic dermatitis is not caused by poor hygiene, and it is not a result of an allergy. While these factors may contribute to flare-ups, they are not the primary causes of the condition.

The interplay of genetic predisposition, the presence of Malassezia yeast, and immune system responses seems to be central to the development of seborrheic dermatitis. Treatment often involves managing symptoms and triggers rather than curing the underlying cause, as it is a chronic condition with periods of remission and exacerbation. If you are experiencing persistent or severe symptoms, it’s advisable to seek the guidance of a healthcare professional, preferably a dermatologist, for an accurate diagnosis and appropriate treatment plan.

Symptoms

Dandruff is caused by yeast-like fungi (Malassezia) living on your scalp.

Seborrheic dermatitis can present with a variety of symptoms, and the severity of these symptoms can vary from person to person. The condition commonly affects areas of the body where there are a lot of oil-producing (sebaceous) glands, such as the scalp, face, and chest. Here are the common symptoms associated with seborrheic dermatitis:

On the scalp (dandruff):

  • Flaky, greasy, and yellowish scales on the scalp.
  • Itchy scalp.
  • Redness on the scalp.

On the face:

  • Red patches on the skin, especially in areas rich in sebaceous glands (eyebrows, nose, and ears)
  • Persistent dandruff.
  • Scaly or crusty skin on the face.
  • Itching and discomfort.

On the chest and back:

  • Reddish-brown patches with scales.
  • Itching and discomfort.

In and around the ears:

  • Scales or crusts on the ears.
  • Redness and itching.

Eyebrows and eyelids:

  • Flaky and scaly skin on the eyebrows.
  • Redness and itching on the eyelids.

Other areas:

Seborrheic dermatitis can occur in other areas with sebaceous glands, such as the armpits and groin.

It’s important to note that seborrheic dermatitis is a chronic condition, and symptoms often come and go. The severity of symptoms can also vary, with some individuals experiencing mild, occasional flares, while others may have more persistent and severe symptoms.

In infants, seborrheic dermatitis may present as “cradle cap,” characterized by thick, yellowish, and greasy scales on the scalp.

While seborrheic dermatitis is not a serious medical condition, the symptoms can be bothersome and may affect a person’s quality of life. If you are experiencing persistent or severe symptoms, it is advisable to consult with a dermatologist or healthcare professional for a proper diagnosis and appropriate treatment.

Risk factors

Seborrheic dermatitis-risk factors

Several factors may increase the risk of developing seborrheic dermatitis. While the exact cause is not fully understood, the interplay of genetic, environmental, and immunological factors is believed to contribute to its development. Here are some common risk factors associated with seborrheic dermatitis:

  1. Age: Seborrheic dermatitis is more common in infants, where it’s known as “cradle cap.” It can also occur in adults, typically between the ages of 30 and 60.
  2. Genetics: A family history of seborrheic dermatitis may increase the likelihood of developing the condition. There appears to be a genetic predisposition.
  3. Neurological conditions: Certain neurological conditions, such as Parkinson’s disease, may be associated with an increased risk of seborrheic dermatitis.
  4. Immune system disorders: Conditions that affect the immune system, such as HIV/AIDS or other immunodeficiency disorders, may increase the risk of developing seborrheic dermatitis.
  5. Hormonal changes: Hormonal changes, especially during puberty, can contribute to the development of seborrheic dermatitis. The condition is more common in individuals with increased oil production on the skin.
  6. Environmental factors: Cold and dry weather conditions can exacerbate symptoms. Exposure to harsh weather or a lack of humidity may contribute to skin dryness.
  7. Stress: Psychological stress may trigger or worsen seborrheic dermatitis in some individuals.
  8. Malassezia yeast: An overgrowth of the yeast Malassezia on the skin is associated with seborrheic dermatitis. This yeast is naturally present on the skin but can contribute to inflammation when present in excessive amounts.
  9. Medications: Certain medications, such as lithium, may increase the risk of seborrheic dermatitis as a side effect
  10. Obesity: There is some evidence to suggest a potential association between obesity and seborrheic dermatitis.

Understanding these risk factors can help individuals and healthcare professionals identify potential triggers and manage the condition effectively. If someone has a combination of these risk factors or is experiencing symptoms of seborrheic dermatitis, it’s advisable to consult with a dermatologist for a proper diagnosis and appropriate treatment plan.

Treatments

Seborrheic dermatitis at the scalp of adult male patient. lateral view.

The treatment of seborrheic dermatitis typically focuses on managing symptoms and preventing flare-ups. While there is no cure for the condition, various treatments can help alleviate symptoms and improve the overall health of the skin. Here are common treatment approaches for seborrheic dermatitis:

  1. Ketoconazole: Available in shampoos, creams, and foams, ketoconazole is an antifungal agent that helps reduce the growth of the yeast Malassezia. It is often used for scalp conditions and facial seborrheic dermatitis.
  2. Topical steroids: These can help reduce inflammation, itching, and redness. They are available in various strengths and formulations. However, prolonged use of potent steroids on the face should be avoided due to the risk of skin thinning.
  3. Coal tar: Shampoos or creams containing coal tar can help reduce scaling, itching, and inflammation.
  4. Tacrolimus and pimecrolimus: These immunomodulators can be applied topically and are particularly useful for seborrheic dermatitis on the face. They help modulate the immune response and reduce inflammation.
  5. Selenium sulfide: Shampoos containing selenium sulfide can help control flaking and reduce the growth of Malassezia. They are commonly used for treating dandruff.
  6. Shampoos or creams with salicylic acid: These can help soften and remove scales.
  7. Metronidazole or clindamycin: In some cases, particularly when there is evidence of bacterial infection, topical antibiotics may be prescribed.
  8. Narrowband UVB (ultraviolet B) light: Phototherapy may be used in some cases to reduce inflammation and improve symptoms.
  9. Proper skin care:
    • Gentle cleansing: Use mild, fragrance-free cleansers to wash the affected areas.
    • Avoid harsh products: Avoid harsh soaps and skin care products that may exacerbate irritation.
  10. Lifestyle and home care:
    • Dietary modifications: Some individuals may find that certain dietary changes, such as reducing sugar intake, can help manage symptoms.
    • Stress management: Practices like meditation and stress reduction techniques may be beneficial.

It’s important to note that treatment plans should be individualized based on the severity of symptoms, the areas affected, and individual response to different therapies. Consultation with a dermatologist is recommended for an accurate diagnosis and appropriate treatment plan. In some cases, long-term management may be necessary to control flare-ups and maintain skin health.

Natural treatments

Bottle of essential oil with herbs

While medical treatments prescribed by healthcare professionals are often effective for managing seborrheic dermatitis, some people may also consider natural or home remedies as complementary options. It’s crucial to note that individual responses to natural remedies can vary, and not all methods may work for everyone. Here are some natural approaches that some individuals find helpful:

  1. Tea tree oil: Tea tree oil has natural antifungal and anti-inflammatory properties. Dilute a few drops of tea tree oil with a carrier oil (such as coconut oil) and apply it to affected areas. Be cautious, as tea tree oil can be irritating to some individuals. Perform a patch test first.
  2. Coconut oil: Coconut oil has moisturizing and anti-inflammatory properties. Applying virgin coconut oil to affected areas may help soothe dryness and reduce inflammation.
  3. Aloe vera: Aloe vera gel, obtained directly from the plant or in a pure form, has cooling and anti-inflammatory effects. Apply a thin layer of aloe vera to affected areas.
  4. Apple cider vinegar: Dilute apple cider vinegar with water and apply it to the scalp or affected skin. It may help balance the pH of the skin and has mild antifungal properties.
  5. Honey: Honey has natural antibacterial and wound-healing properties. Applying raw honey to affected areas may help soothe and moisturize the skin.
  6. Probiotics: Probiotics, whether taken as supplements or through fermented foods, may help balance the gut microbiome, potentially impacting skin health. Some studies suggest a link between gut health and skin conditions.
  7. Oatmeal baths: Colloidal oatmeal baths can help soothe irritated skin. Add finely ground oatmeal to a warm bath and soak for 15-20 minutes.
  8. Sunlight exposure: Limited exposure to sunlight may help improve symptoms, as sunlight has anti-inflammatory effects. However, practice sun safety and avoid prolonged exposure.
  9. Dietary changes: Some people find that reducing the intake of certain foods, such as dairy or foods high in sugar, may help improve their skin condition. However, individual responses vary, and it’s advisable to consult with a healthcare professional before making significant dietary changes.
  10. Proper hygiene: Regular but gentle cleansing of the affected areas with mild, fragrance-free products can help manage symptoms.

It’s essential to approach natural remedies with caution, especially if you have allergies or sensitivities. Before trying any new remedy, it’s advisable to consult with a healthcare professional, particularly a dermatologist, to ensure that the chosen approach is safe and appropriate for your specific case. Natural remedies should not replace medical treatments but can be considered as complementary options.

FAQ

FAQ about seborrheic dermatitis

Is seborrheic dermatitis contagious?

No, seborrheic dermatitis is not contagious. It is a skin condition that involves inflammation and flaking of the skin but is not caused by a contagious microorganism.

Can seborrheic dermatitis be cured?

Seborrheic dermatitis is a chronic condition, and while it can be managed effectively, there is no permanent cure. Treatment focuses on controlling symptoms and preventing flare-ups.

Does seborrheic dermatitis only affect the scalp?

No, seborrheic dermatitis commonly affects areas rich in oil glands, including the scalp, face, and chest. It can also occur in other areas of the body, such as the back, ears, and groin.

What causes seborrheic dermatitis on the face?

The exact cause is not fully understood, but factors such as the presence of the yeast Malassezia, genetics, hormonal changes, and immune system responses are believed to contribute to seborrheic dermatitis on the face.

Can stress trigger seborrheic dermatitis?

Stress may contribute to flare-ups in some individuals. While stress is not a direct cause, managing stress through relaxation techniques and stress reduction may help improve symptoms.

Can diet affect seborrheic dermatitis?

There is limited evidence linking diet to seborrheic dermatitis. Some individuals find that certain dietary changes, such as reducing sugar intake, may help manage symptoms, but this can vary.

What is the difference between seborrheic dermatitis and psoriasis?

Seborrheic dermatitis and psoriasis are both skin conditions with similar symptoms, but they have different causes. Psoriasis is an autoimmune condition, while seborrheic dermatitis is linked to factors like yeast overgrowth and genetics.

Can infants get seborrheic dermatitis?

Yes, seborrheic dermatitis can affect infants, and it is commonly known as “cradle cap.” It usually resolves on its own, but gentle cleansing and applying baby oil can help manage symptoms.

Are there any complications associated with seborrheic dermatitis?

While seborrheic dermatitis is not a serious medical condition, complications may include secondary bacterial infections or temporary changes in skin color. These are rare and can be addressed with proper care.

Can I use over-the-counter shampoos for seborrheic dermatitis?

Yes, over-the-counter shampoos containing ingredients like ketoconazole, selenium sulfide, or tar can be effective for managing seborrheic dermatitis on the scalp. However, for more severe cases, a dermatologist may prescribe stronger medications.

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