Seborrhea

Seborrhea is a skin condition that is characterized by greasy or dry, white flaking scales over reddish patches on the skin. The areas may itch, but they are usually painless unless an infection occurs.

The cause of seborrhea is not fully understood. A number of factors, such as hormones and stress, are associated with seborrhea. Seborrhea tends to run in families. It is not contagious. A yeast-like organism plays an important role in this condition and may make it worse.

Seborrhea can affect anyone, from infants to the elderly. It is more common in children under 3 months of age and in adults from 30 to 60 years of age. Men are affected more often than women. It is more commonly seen in winter and early spring, with fewer cases during the summer. It is often found in patients with Parkinson's disease or AIDS.

Seborrhea occurs in various forms:

• In infants it is known as "cradle cap." This appears as oily, yellowish scales or crusts on the scalp, or behind the ears or on the eyebrows. It is usually not itchy or uncomfortable. Cradle cap is typically worse in the first year and disappears on its own.
• In older children and adults, seborrhea of the scalp is known as "dandruff" and produces white, dry flakes. Seborrhea is commonly found in the folds of the skin, such as under the arms or breasts, in the groin or buttocks, around the navel, and behind the ears. The face, forehead, eyebrows, eyelids, and middle of the chest can also be affected. Some people experience an itchy, burning sensation, while others have no discomfort.
• When skin inflammation occurs, it is called seborrheic dermatitis. This more severe form has thick, oily, yellowish-brown crusts with severe inflammation, redness, scaling, and itching. Seborrheic dermatitis is more common in people with acne or oily skin or hair. In some patients, flare-ups can be triggered by stress. Seborrheic dermatitis tends to be a chronic condition. It may lead to psoriasis in some patients. A severe, explosive case of seborrheic dermatitis should be evaluated by a healthcare provider, since it may be linked to a more serious disease, such as HIV or AIDS.

Since doctors do not know what causes seborrhea, there is no prevention or cure. So the only thing you can do is try to control it. Seborrhea often comes and goes, without any treatment, but it re-occurs. Frequent shampooing with an anti-seborrhea shampoo can help prevent flare-ups. If treatment is necessary, it is aimed at reducing the inflammation and yeast build-up on the skin, minimizing the itching and preventing infection.

To treat infant cradle cap:

• apply baby oil to the patches to soften them
• use a mild, non-medicated baby shampoo
• brush your baby's scalp with a soft brush, like a toothbrush, to help loosen scales or flakes (Be gentle when massaging or brushing the scalp. A break in the skin can lead to an infection.)
• if this does not work, your provider may suggest using a non- prescription shampoo that contains tar. In more stubborn cases, a prescription containing 2 percent ketoconazole, such as Nizoral, may be necessary. Use only as directed, as stronger preparations or overuse can cause side effects.

To treat adult scalp seborrhea:

• use a non-prescription shampoo containing tar, zinc, selenium, sulfur and/or salicylic acid to control symptoms. Use only as directed, as stronger preparations or over-use can cause side effects
• continue to use shampoo until seborrhea subsides

To treat other skin areas:

• moisturize with lotions and use anti-perspirants to help the scaling and itching (But this may also aggravate the seborrhea and make the patches look redder.)
• shave the area around a beard or moustache (This will often make the rash go away.)
• your provider may prescribe hydrocortisone or an anti-yeast cream to rub directly onto the scaly patches of skin

To treat seborrhea of the eyelashes:

• try scrubbing the lashes with baby shampoo on a cotton swab. However, this method is often not effective.
• do not apply cortisone-based lotions around the eyes unless directed to do so by your health care provider. Cortisone coming in contact with the eye, can cause serious eye problems.

When the seborrhea comes back (and it will), use the shampoo or cream again.

See your provider if you cannot control seborrheic dermatitis or are concerned about an area becoming infected.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File SKIN4977.RF2 VRS# 4977 Data Version 7.0 Copyright 1999, 2002-2003 McKesson Health Solutions LLC. All rights reserved.