The signs and symptoms may be more severe if you're stressed, and they tend to flare in cold, dry seasons.
When to see a doctor
See your doctor if:
- You're so uncomfortable that you're losing sleep or being distracted from your daily routines
- Your condition is causing embarrassment and anxiety
- You suspect your skin is infected
- You've tried self-care steps without success
Causes
Doctors don't yet know the exact cause of seborrheic dermatitis. It may be related to:
- A yeast (fungus) called malassezia that is in the oil secretion on the skin
- An irregular response of the immune system
Risk factors
A number of factors increase your risk of developing seborrheic dermatitis, including:
- Neurologic and psychiatric conditions, such as Parkinson's disease and depression
- A weakened immune system, such as seen in organ transplant recipients and people with HIV/AIDS, alcoholic pancreatitis and some cancers
- Recovery from stressful medical conditions, such as a heart attack
- Some medications
Diagnosis
Your doctor will likely be able to determine whether you have seborrheic dermatitis by examining your skin. He or she may scrape off skin cells for examination (biopsy) to rule out conditions with symptoms similar to seborrheic dermatitis, including:
- Psoriasis. This disorder also causes dandruff and red skin covered with flakes and scales. With psoriasis, usually you'll have more scales, and they'll be silvery white.
- Atopic dermatitis (eczema). This skin reaction causes itchy, inflamed skin in the folds of the elbows, on the backs of the knees or on the front of the neck. It often recurs.
- Tinea versicolor. This rash appears on the trunk but usually isn't red like seborrheic dermatitis patches.
- Rosacea. This condition usually occurs on the face and has very little scaliness.
Treatment
Medicated shampoos, creams and lotions are the main treatments for seborrheic dermatitis. Your doctor will likely recommend you try home remedies, such as over-the-counter dandruff shampoos, before considering prescription remedies. If home remedies don't help, talk with your doctor about trying these treatments.
- Creams, shampoos or ointments that control inflammation. Prescription-strength hydrocortisone, fluocinolone (Capex, Synalar), clobetasol (Clobex, Cormax) and desonide (Desowen, Desonate) are corticosteroids you apply to the scalp or other affected area. They are effective and easy to use, but should be used sparingly. If used for many weeks or months without a break, they can cause side effects, such as thinning skin or skin showing streaks or lines.Creams or lotions containing the calcineurin inhibitors tacrolimus (Protopic) and pimecrolimus (Elidel) may be effective and have fewer side effects than corticosteroids do. But they are not first-choice treatments because the Food and Drug Administration has concerns about a possible association with cancer. In addition, tacrolimus and pimecrolimus cost more than mild corticosteroid medications.
- Antifungal gels, creams or shampoos alternated with another medication.Depending on the affected area and the severity of your symptoms, your doctor might prescribe a product with 2 percent ketoconazole (Nizoral) or 1 percent ciclopirox. Or you doctor may prescribe both products to be used alternately.
- Antifungal medication you take as a pill. If your condition isn't improving with other treatments, your doctor may recommend an antifungal medication in pill form. These aren't a first choice for treatment because of possible side effects and drug interactions.
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