Seborrheic dermatitis: Diagnosis, treatment and outcome

Seborrheic dermatitis: Diagnosis, treatment and outcome

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Seborrheic dermatitis is a condition that dermatologists frequently diagnose and treat.

If you think you might have seborrheic dermatitis, you should see a dermatologist for a diagnosis. This common skin condition can look like psoriasis, eczema, or an allergic reaction. Each of these skin diseases requires different treatment.

Diagnosis

A dermatologist diagnoses seborrheic dermatitis by:

  • Reviewing the patient’s medical history.
  • Examining the patient’s skin and looking closely at the rash.

Sometimes seborrheic dermatitis is a sign of an underlying medical condition. If your dermatologist suspects this, medical tests may be necessary.

Treatment

Although treatment cannot cure seborrheic dermatitis, treatment has benefits. Treatment can loosen and remove scale, prevent a skin infection, and reduce swelling and itch.

The type of treatment a dermatologist prescribes varies with age and where the seborrheic dermatitis appears on the skin.

Infants (scalp): Called cradle cap, this tends to completely disappear without treatment. If treatment is necessary, a dermatologist may recommend:

  • Shampooing the baby’s scalp daily with a baby shampoo.
  • Gently brushing away the scale, once scale starts to soften.
  • Applying a medication to the infant’s scalp.

Infants (skin beyond the scalp): This, too, will clear. If treatment is needed, a dermatologist may prescribe a medicine that can be applied to the child’s skin.

Adolescents and adults (scalp and rest of body): After infancy, seborrheic dermatitis usually does not go away without treatment. For the best results, a dermatologist will consider many factors before creating a treatment plan. Treatment may include:

  • Dandruff shampoos.
  • Medicine to apply to the skin for short periods of time.
  • Barrier-repair cream.

Dandruff shampoos can be helpful on the skin as well as the scalp. Your dermatologist can explain how to use these shampoos on the skin.

Often the best results come from combining two or more treatments. Your dermatologist can create a treatment plan to meet your needs. Most plans include medication and skin care.

Always follow your dermatologist’s instructions. Using a treatment more often than prescribed or longer than prescribed can cause side effects.

Outcome

Infant: Seborrheic dermatitis often completely disappears by 6 months to 1 year of age. It can return when the child reaches puberty.

Adolescent or adult: A few people see seborrheic dermatitis clear without treatment. More often, seborrheic dermatitis lasts for years. It tends to clear and flare without warning. Treatment often is necessary to control it.

Learn more about seborrheic dermatitis:

References:

Del Rosso JQ (March 2004) “Evaluating physician & patient perspectives regarding management of seborrheic dermatitis: focus on antifungal shampoo therapy with ciclopirox.” J Am Acad Dermatol 50(3): Supplement, P173 sponsored by Medicis.

Finnish Medical Society Duodecim. “Seborrhoeic dermatitis.” In: EBM Guidelines. Evidence-Based Medicine [Internet]. Helsinki, Finland: Wiley Interscience. John Wiley & Sons; 2007 Apr 19 [Various].

Habif TP, Campbell JL, et al. “Seborrheic dermatitis.” In: Dermatology DDxDeck.China, Mosby Elsevier: 2006, p. 40.

Johnson BA et al. (May 1, 2000) “Treatment of Seborrheic Dermatitis.” American Family Physician. 61(9):2703-2710.

Meshkinpour, A, Sun J, et al. (July 2003). "An open pilot study using tacrolimus ointment in the treatment of seborrheic dermatitis." J Am Acad Dermatol 49(1): 145-147.

Naldi, L. and Rebora A. (January 22, 2009). "Clinical practice. Seborrheic dermatitis." N Engl J Med 360(4): 387-396.         

Papp, KA, Papp A, et al. (November 2011). "Single-blind, randomized controlled trial evaluating the treatment of facial seborrheic dermatitis with hydrocortisone 1% ointment compared with tacrolimus 0.1% ointment in adults." J Am Acad Dermatol 10.1016/j.jaad.2011.02.032.

Plewig G Jansen T. “Seborrheic Dermatitis.” In: Wolff K, Goldsmith LA, Katz SI, et al. editors. Fitzpatrick’s Dermatology in General Medicine, 7th ed. United States of America, McGraw Hill Medical; 2008. p.219-25.