Seborrheic eczema, also known as seborrheic dermatitis, is a very common skin condition that causes redness, scaly patches, and dandruff. It most often affects the scalp, but it can also develop in oily areas of the body, such as the face, upper chest, and back. When infants develop this condition, it’s known as crib cap. It typically develops within the first few weeks of life and gradually disappears over several weeks or months.
The exact cause of seborrheic eczema isn’t known. However, doctors believe there are two main factors that can contribute to the development of the condition. The first factor is an overproduction of oil. An excess amount of oil in the skin might act as an irritant, causing the skin to become red and greasy. The second contributing factor is Malassezia, which is a type of fungus that’s naturally found in the skin’s oils. It can sometimes grow abnormally, causing the skin to secrete more oil than usual. The increased production of oil can lead to seborrheic eczema.
The condition might also develop in infants due to hormonal changes that occur in the mother during pregnancy. The fluctuating hormone levels are believed to stimulate the infant's oil glands, leading to an overproduction of oil that may irritate the skin.
Seborrheic eczema is a long-term skin condition that requires ongoing treatment. However, developing a good skin care routine and learning to recognize and eliminate triggers can help you manage the condition effectively.
The symptoms of seborrheic eczema are often aggravated by various factors, including stress, change of seasons, and heavy alcohol use. The types of symptoms that develop can vary from person-to-person. It’s also possible for symptoms to occur in different parts of the body.
Seborrheic eczema tends to develop in oily areas of the body. It most often affects the scalp, but it can also occur in the following areas:
- in and around the ears
- on the eyebrows
- on the nose
- on the back
- on the upper portion of the chest
Seborrheic eczema has a distinct appearance and set of symptoms:
- Skin develops scaly patches that flake off. The patches may be white or yellowish in color. This problem is commonly known as dandruff. It can occur in the scalp, hair, eyebrows, or beard.
- Skin in the affected area tends to be greasy and oily.
- Skin in the affected area may be red.
- Skin in the affected area may be itchy.
- Hair loss may occur in the affected area.
Doctors aren’t exactly sure why some people develop seborrheic eczema while others don’t. However, it does appear that your risk of developing the condition increases if a close family member has it.
Other factors thought to increase risk include:
- poor skin care
- environmental factors, such as pollution
- the presence of other skin issues, such as acne
- the use of certain skin care products, particularly those containing alcohol
- certain medical conditions, such as a stroke, HIV, or Parkinson’s disease
The symptoms of seborrheic eczema are similar to those of other skin conditions, including rosacea and psoriasis. To make an accurate diagnosis, your doctor will perform a physical examination and carefully inspect the affected areas. They’ll also ask you about your symptoms, including when they started and how often you experience them.
Your doctor may also want to perform a biopsy before making a diagnosis. During this procedure, your doctor will scrape off skin cells from the affected area. These samples will then be sent to a laboratory for analysis. The results will help to rule out other conditions that may be causing your symptoms.
Your doctor will likely recommend that you try home remedies before considering medical treatments. Dandruff shampoos are frequently used to treat seborrheic eczema on the scalp. They usually need to be used every day for optimal results. Make sure to follow all instructions on the bottle carefully.
Other home treatments that may help you manage seborrheic eczema include:
- using over-the-counter (OTC) antifungal and anti-itch creams
- using hypoallergenic soap and detergent
- thoroughly rinsing soap and shampoo off the skin and scalp
- shaving off a mustache or beard
- wearing loose cotton clothing to avoid skin irritation
If your symptoms don’t improve with the home remedies listed, talk to your doctor about trying the following treatments:
- Prescription-strength shampoos and ointments for seborrheic eczema contain hydrocortisone, fluocinolone, or desonide. These medications can be applied directly to the affected area. While these medicines are very effective in treating seborrheic eczema, they may cause side effects when they’re used for an extended period.
- In some cases, an antifungal medication called terbinafine might be prescribed. However, this drug usually isn’t recommended since it can cause serious side effects, including allergic reactions and liver problems.
- Metronidazole is another type of treatment that can relieve symptoms by fighting bacteria. It comes in both cream and gel forms. The medication can be applied to the skin once or twice daily until symptoms improve.
- Your doctor can use a combination of psoralen and light therapy to help manage your seborrheic eczema symptoms. Psoralen may be taken by mouth or applied directly onto the skin. After psoralen has been ingested or applied, the affected skin area is exposed to ultraviolet light for a short period.
Crib cap usually doesn't require medical treatment. It often goes away without medical treatment within six months. In the meantime, you can try the following daily routine to help manage your child’s symptoms:
- Loosen scaly patches by massaging your baby’s scalp or using a soft-bristled brush.
- Wash your baby’s hair with a mild shampoo.
- Rinse the hair and scalp thoroughly.
- Brush your baby’s hair with a clean, soft-bristled brush.
If it’s difficult to loosen and wash off scales, massage your baby’s scalp with olive oil before shampooing.
Make sure to check with your child’s doctor before using any OTC cortisone or antifungal creams. Some can be toxic for infants when they’re absorbed through the skin. Dandruff shampoos that contain salicylic acid aren’t usually recommended for infants either.
When to See Your Doctor
Not all cases of seborrheic eczema can be managed solely through the use of OTC dandruff shampoos. Oral medications, prescription shampoos, and medicinal creams or gels for the scalp and other areas of the body can be used for severe symptoms and more serious cases.
In general, you should schedule an appointment with your doctor if:
- you aren’t getting relief from a regular dandruff shampoo
- you have areas that are extremely red
- you have areas that are very painful
- you have areas that are producing pus, draining fluid, or crusting
- you’re experiencing significant discomfort and believe medical intervention may be needed
You should also contact your child’s doctor if crib cap symptoms are severe or persist. They may recommend certain medicated shampoos or lotions.
Seborrheic eczema is a long-term condition, so you’ll need to cope with it on some level for the rest of your life. You may go through extended periods where there are little to no symptoms. You will also likely experience flare-ups, which are episodes when symptoms become more severe.
Over time, you can find a skin care routine that works for you and that minimizes the impact of the condition. Learning to recognize and eliminate triggers can also help you manage seborrheic eczema effectively. The condition doesn’t lead to any serious medical conditions or other complications.
Crib cap usually goes away without treatment within six months.