Seborrhoeic dermatitis is an inflammatory skin condition that affects the sebaceous glands. The sebaceous glands are the oil producing glands in the skin. It affects areas that have a lot of these glands, such as the scalp, nasolabial folds and eyebrows. It causes erythema, dermatitis and crusted dry skin. In infants it causes a crusted dry flaky scalp, often called cradle cap. It is thought that Malassezia yeast colonisation has a role to play in the development of seborrhoeic dermatitis, and the condition improves with anti-fungal treatment.
Infantile Seborrhoeic Dermatitis
Infantile seborrhoeic dermatitis (cradle cap) causes a crusted flaky scalp. It is a self limiting condition and usually resolves by 4 months of age, but can last until 12 months.
First line treatment is by applying baby oil, vegetable oil or olive oil, gently brushing the scalp then washing off. When this is not effective, white petroleum jelly can be used overnight to soften the crusted areas before washing off in the morning.
The next step is a topical anti-fungal cream such as clotrimazole or miconazole, used for up to 4 weeks. Severe or unresponsive cases may need referral to a dermatologist.
Seborrhoeic Dermatitis of the Scalp
Mild seborrhoeic dermatitis of the scalp presents with flaky itchy skin on the scalp (dandruff). More severe cases cause more dense oily scaly brown crusting. This commonly occurs in adolescents and adults rather than children.
First line treatment is with ketoconazole shampoo, left on for 5 minutes before washing off. Topical steroids may be used if there is severe itching. It often reoccurs after successful treatment.
Seborrhoeic Dermatitis of the Face and Body
Seborrhoeic dermatitis of the face and body presents with red, flaky, crusted, itchy skin. It commonly affects the eyelids, nasolabial folds, ears, upper chest and back.
First line treatment is with an anti fungal cream, such as clotrimazole or miconazole, used for up to 4 weeks. Localised inflamed areas may benefit from a topical steroids, such as hydrocortisone 1%.
Severe or unresponsive cases should be referred to a dermatologist or paediatrician.
Last updated January 2020