Seborrheic dermatitis symptoms appear slowly and mostly the first symptom is flaky skin and scalp. Symptoms develop anyplace on the skin of the face, back of the ears and in places where the skin folds are seen. Flakes may be yellow, white or grayish. The skin near the eyelashes, forehead, nose, chest and upper back can have redness and flaking.

In serious conditions, yellowish to reddish scaly pimples are seen behind both pinnae, inside the ear canal, topping the eyebrows, on the nasal bridge, along the hairline, around the nose, chest, and upper back.

Generally, patients experience little redness, scaly skin lesions and in few cases hair loss. Various other symptoms are patchy scaling or hard coating on the scalp, red, greasy skin enclosed with flaky white or yellow scales, intense itching, pain and yellow or white scales that can be attached to the shaft of hair.

Seborrheic dermatitis in infants younger than three months can present as thick, oily, yellowish crust surrounding the hairline and on the scalp. This condition is also known as cradle cap. Itching is not common in infants. Commonly, a persistent diaper rash develops along with the scalp rash. Generally, when the rash develops in infants it resolves on its own in a few days, without any treatment, whereas in adults the symptoms can last from couple of weeks to years.

• Inflammation

  None of the eight patients without seborrheic dermatitis demonstrated inflammation in the seborrheic distribution (0%). [dx.doi.org]

  Dandruff is restricted to the scalp, and involves itchy, flaking skin without visible inflammation. SD can affect the scalp as well as other seborrheic areas, and involves itchy and flaking or scaling skin, inflammation and pruritus. [ncbi.nlm.nih.gov]

  RESULT: Inflammation > pruritis. Hyperprolifration> flakes = SD 10. [slideshare.net]

  Clinically, there is no inflammation (pain or redness) but at a microscopic level there is inflammation associated with dandruff, which is why people with this condition sometimes complain of an itchy scalp. [internationaleczema-psoriasisfoundation.org]

  'Additionally, curcumin displays powerful blood purifying properties and this coupled with calming inflammation helps to control this form of dermatitis very effectively and quickly.’ [dailymail.co.uk]

• Epilepsy

  However, it has been linked to neurologic disorders such as Parkinson’s disease and epilepsy. Can Seborrheic Dermatitis be treated? Yes. Treatment options will depend on the patient’s age and the location of the body it affects. [mamashealth.com]

  SD prevalence was also higher in patients treated for depression and epilepsy. Furthermore, as education levels increased, SD prevalence increased proportionally. [ncbi.nlm.nih.gov]

  […] to large vesicles on palms and soles (dyshidrosis) Not due to any known agents, although associated with irritant contact dermatitis One of the most common cutaneous manifestations of AIDS, affecting 20 – 80% Also associated with Parkinson's disease, epilepsy [pathologyoutlines.com]

  It is also more common in men, and people with epilepsy, Parkinson’s disease, HIV, and vitamin B deficiencies. [web.archive.org]

• Fever

  No reasons were detected for his fever following a routine search. [ncbi.nlm.nih.gov]

  They can include sudden onset of fever, chills, headache, sore throat and muscle pain. Additional symptoms are specific to the way that SEB enters the body. [www1.nyc.gov]

  Doctors do not know what causes atopic dermatitis, but people who have it usually have many allergic disorders, particularly asthma, hay fever, and food allergies. [web.archive.org]

  […] if you have these conditions: Nervous system disorders, including Parkinson's disease, traumatic brain injury, stroke, and epilepsy HIV/AIDS Other skin conditions, like psoriasis, rosacea, or acne Allergies or a family history of allergies, like hay fever [everydayhealth.com]

• Chills

  They can include sudden onset of fever, chills, headache, sore throat and muscle pain. Additional symptoms are specific to the way that SEB enters the body. [www1.nyc.gov]

  This would clear them up and instantly take away the itch (didn't hurt surprisingly) and chilled them out. At the end of September it was my son's 4th birthday. [earthclinic.com]

  Although many people have a fever, they may feel cold and have chills because so much heat is lost through the damaged skin. Large amounts of fluid and protein may seep out, and the damaged skin is a poor barrier against infection. [web.archive.org]

  Severe, or second-degree, sunburn leads to intense pain and blistering, accompanied by fevers, chills and nausea; the range of these symptoms is usually referred to as sun poisoning. [dermatologistoncall.com]

• Rigor

  A dermatologist can provide more rigorous or specialized treatment options with prescription strength skin and hair care products. [psico.com]

  History Part 2: Prevalence: Without rigorous diagnostic criteria, it is difficult to obtain accurate prevalence rates. Affects approximately 5-10% of the general population. The typical patient is 30 to 60 years old. [clinicaladvisor.com]

• Dermatitis

  Lynchburg, VA, USA Seborrheic dermatitis is a common cutaneous disorder occurring in at least 3%–5% of the population. 1 Dandruff, the less inflammatory form of seborrheic dermatitis, occurs in 50%–80% of teenagers and adults. 2 Diagnosis Seborrheic dermatitis [skintherapyletter.com]

  Seborrheic dermatitis is scaly skin normally found on the face and scalp where there is an abundance of sebaceous glands. However, any part of the body could have the seborrheic dermatitis symptoms. Seborrheic dermatitis appears to run in families. [internationaleczema-psoriasisfoundation.org]

  Seborrheic dermatitis may worsen in Parkinson disease and in AIDS. [21, 22] Increased perspiration in Parkinson disease may be the link to seborrheic dermatitis. [emedicine.medscape.com]

  The prevalence of seborrheic dermatitis is 3%–5% of young adults, and 1%–5% of the general population, although its lifetime incidence is significantly higher. 10 In 1887, Unna first described seborrheic dermatitis. [accessmedicine.mhmedical.com]

• Cradle Cap

  What causes cradle cap? The cause is unknown. But we do know that cradle cap is not caused by poor hygiene or allergies. [babycenter.com]

  Cradle cap harmless to the child and is only a temporary cosmetic condition that normally goes away shortly. Cradle cap is not caused an allergy or poor hygiene. Itching can occur but does not always exist. [internationaleczema-psoriasisfoundation.org]

• Eczema

  seborrhea, eczema; seborrheic, seborrhea; dermatitis, seborrhea; eczema, seborrheic; eczema, Seborrhea, NOS, Seborrhoea, NOS, dermatitis seborrheica, Seborrheic dermatitis NOS, Dermatitis;seborrheic, Eczema;seborrheic, seborrhoea, seborrhoeic dermatitis [fpnotebook.com]

  Note In this block the terms dermatitis and eczema are used synonymously and interchangeably. [icd10data.com]

  Areas affected Seborrheic eczema tends to develop in oily areas of the body. [healthline.com]

• Erythema

  Abstract Seborrheic dermatitis is a chronic from of inflammatory dermatitis characterized by erythema and desquamation with predominant localization on the face (nasolabial folds, eyebrows, hair-line and ears). [ncbi.nlm.nih.gov]

  It is characterized by moderate erythema, dry, moist, or greasy (sebaceous gland) scaling and yellow crusted patches on various areas, especially the scalp, that exfoliate as dandruff. [icd9data.com]

• Pruritus

  SD treatment focuses on clearing signs of the disease; ameliorating associated symptoms, such as pruritus; and maintaining remission with long-term therapy. [doi.org]

• Irritability

  For me, excessive facial sweat sometimes irritates my seborrhea and causes a flare-up. Use only general skin care products that don’t irritate your seborrhea-prone skin. [drbaileyskincare.com]

  Furthermore, irritants such as topical tretinoin do not preferentially affect the seborrheic distribution. [dx.doi.org]

  Wear pure cotton clothing as it reduces irritation. Avoid scratching as it tends to increase skin irritation and the chances of infection. [symptoma.com]

  The diagnosis is typically based on symptoms and confirmed by results of skin tests or skin samples or the presence of suspected drugs, irritants, or infection. Avoiding known irritants and allergens reduces the risk of dermatitis. [merckmanuals.com]

  If irritation is troublesome, your doctor may prescribe a steroid scalp lotion, gel or shampoo for occasional use. Elsewhere: anti-yeast creams or ointments are usually effective and can be used safely as long-term treatment. [bad.org.uk]

• Seizure

  Additional settings in which seborrheic dermatitis may be seen include: Underlying neurological disease: Parkinson's disease, stroke, facial nerve injury, seizure disorder Obesity and diabetes Celiac sprue Intestinal malabsorption Beware: there are other [infectiousdiseaseadvisor.com]

Doctors can generally determine seborrheic dermatitis by a simple physical examination or they might scrape off skin cells for examination (biopsy) to rule out conditions with some symptoms similar to seborrheic dermatitis like psoriasis, atopic dermatitis and rosacea.

The main line of treatment for seborrheic dermatitis includes medicated shampoos, creams and lotions that control inflammation, fungal growth and keratolysis.

Creams, shampoos or ointments that control inflammation like hydrocortisone, fluocinolone or desonide which are corticosteroids are applied to the scalp or other troubled area. They are efficient and simple to use. In case they are used for a long period of time continuously, than they can lead to side effects like thinning skin or striae on skin and must be stopped soon.

Antifungal shampoos when used along with a stronger medication are very effective. Ketoconazole shampoo can be effective when used with clobetasol scalp product in turns twice weekly.

The antifungal medication terbinafine may be a treatment option. 
Medications that affect your immune system are also beneficial in the treatment. Therefore creams or lotions having calcineurin inhibitors tacrolimus and pimecrolimus may be adequate and have lesser side effects as compared to corticosteroids.

A cream or gel that fights bacteria is also helpful in the treatment. One can use metronidazole as a cream or gel once or twice daily till recovery is seen.

Light therapy along with medicines is a method of treatment that combines psoralen with light therapy (photochemotherapy). Once psoralen is taken by mouth or is applied on affected skin, the person is exposed to ultraviolet light. People with thick hair may not be benefited much with this therapy.

Antihistamines are used primarily to reduce itching. The research studies propose that some antihistamines have anti-inflammatory properties [9].

Cradle cap typically disappears on its own as a child develops. Other types of seborrheic dermatitis generally respond to treatment with shampoos and medication.

The exact cause is yet unknown, but the disease is thought to be the result of a combination of factors like microbes, sebum, and some trigger factors. At present various studies suggest, that a weakened immune system, the inadequacy of particular nutrients, or problems with the nervous system are causes of this condition.

Seborrheic dermatitis has a prevalence of about 1 to 5%. The incidence among patients with human immunodeficiency disease (HIV)/acquired immunodeficiency syndrome (AIDS) is about 34 to 83%.

In infants, seborrheic dermatitis is also known as cradle cap. It is due to the maternal androgens and affects up to 70% infants in the first three months of infancy. Recurrence is common around puberty and post 50 years age. Males are affected more than females by a narrow margin.

Seborrheic dermatitis can be due to an inflammatory reaction to multiplication of Malassezia, a type of yeast [2] [3]. Malassezia globosa is the form of yeast found on the scalp, whereas Malassezia furfur (called previously as Pityrosporum ovale) and Malassezia restricta are the other two types that are seen. The yeast yields poisonous substances that irritate and burn the skin. Individuals suffering from seborrheic dermatitis seem to have low resistance to the yeast. Anyhow, the degree of colonization might be lesser in affected skin as compared to the unaffected skin.

Malassezia dissolves human sebum, dispensing a blend of saturated and unsaturated fatty acids. It picks up the needed saturated fatty acids, leaving behind unsaturated fatty acids. The unsaturated fatty acids penetrate the stratum corneum. Due to their non-consistent structure, they break the skin's barrier function which results in irritation, causing dandruff and seborrheic dermatitis.

Factors like genetic, hormonal, environmental and immune-system are seen to be responsible in causing seborrheic dermatitis [4] [5].

Seborrheic dermatitis can be provoked by ill health, psychological stress, tiredness, reduced sleep, change of season and diminished general health [6].

In children, increased intake of vitamin A can lead to seborrheic dermatitis. Deficiency of vitamins pyridoxine (vitamin B6) [7], biotin, and riboflavin (vitamin B2) can also cause it.

People having immunity compromising conditions (infection with HIV) and those with neurological conditions like Parkinson's disease or stroke are especially prone to it [8].

Good personal hygiene is extremely essential for patients at a higher risk of developing the condition. Daily bathing and hair washes are recommended, especially for those having an oily skin. A clean scalp is a must to avoid outburst of seborrheic dermatitis. Natural and artificial UV radiations help in restricting the production of Malassezia yeast [10].

Pre-existing medical conditions that might predispose to seborrheic dermatitis should be attended to on a priority basis. As doctors do not know what causes seborrheic dermatitis, it cannot be prevented with precision, but the symptoms can be controlled with effective treatment.

Seborrheic dermatitis is a common chronic, relapsing inflammatory [1] skin condition defined by the fine scaling and erythematous patches. Most times, it affects the sebaceous gland-rich areas in our body like scalp, face and torso.

Seborrheic dermatitis does not have any harmful effect on your general health, but it can be distressing. It can cause embarrassment as it presents in the form of scaling on the exposed areas of the body like face, scalp, folds around the nose etc along with severe itching many a times. Neither is it a communicable condition, nor an evidence of low personal hygiene.

The true cause of the disease is not known but many theories have been put forth and hence it’s advisable to maintain personal hygiene to keep it at bay or under control like washing your skin regularly and rinsing off the soap completely from the body. Avoid using harsh soaps and use a moisturizer regularly. Avoid products that contain alcohol as they can cause a flare up. Wear pure cotton clothing as it reduces irritation. Avoid scratching as it tends to increase skin irritation and the chances of infection. Along with these measures, you can always seek medical help from a professional who can prescribe medicated creams, lotions, shampoos etc. to treat this condition. Sometimes even meditation, yoga and other stress relieving techniques can help in easing this skin condition.

1. Gupta AK, Kogan N. Seborrheic dermatitis: current treatment practices. Expert Opin Pharmacother. 2004 Aug;5(8):1755-65. Review.
2. Hay RJ, Graham-Brown RA. Dandruff and seborrheic dermatitis: causes and management. Clin Exp Dermatol. 1997 Jan; 22 (1): 3–6.
3. Nowicki R. Modern management of dandruff. Pol Merkur Lekarski (in Polish). 2006 Jan; 20 (115): 121–4.
4. Johnson BA, Nunley JR. Treatment of seborrheic dermatitis. Am Fam Physician. 2000 May 1;61 (9): 2703–10, 2713–4.
5. Janniger CK, Schwartz RA. Seborrheic dermatitis. Am Fam Physician. 1995 Jul; 52 (1): 149–55, 159–60.
6. Schwartz RA, Janusz CA, Janniger CK. Seborrheic dermatitis: an overview. Am Fam Physician. 2006 Jul; 74 (1): 125–30.
7. Stone OJ. Pyridoxine deficiency and antagonism produce increased ground substance viscosity with resulting seborrheic dermatitis and increased tumor resistance. Med Hypotheses. 1989 Dec;30(4):277-80.
8. Ippolito F, Passi S, Di Carlo A. Is seborrheic dermatitis a clinical marker of HIV disease? Minerva Ginecol. 2000 Dec;52(12 Suppl 1):54-8.
9. Grob JJ, Castelain M, Richard MA, Bonniol JP, et al. Antiinflammatory properties of cetirizine in a human contact dermatitis model. Clinical evaluation of patch tests is not hampered by antihistamines. Acta Derm Venereol. 1998 May; 78 (3): 194–7.
10. Wikler JR, Janssen N, Bruynzeel DP, Nieboer C. The effect of UV-light on pityrosporum yeasts: ultrastructural changes and inhibition of growth. Acta derm venereol (Stockholm). 1990; 70 (1): 69–71.