Seborrheic Dermatitis: Diagnosis and Treatment

Seborrheic dermatitis is a common, chronic relapsing skin condition that predominantly affects areas of the body that are rich in sebaceous glands. Clinically, seborrheic dermatitis presents as symmetric, poorly defined erythematous patches with yellow, oily scales and fine, superficial desquamation (flaking). In people who have darker skin, erythema may be less apparent, and postinflammatory pigmentary changes might be a presenting sign with hypopigmented, slightly scaly areas. Seborrheic dermatitis of the scalp can be effectively treated with topical over-the-counter antifungal shampoos and prescription-strength antifungal or corticosteroid solutions, foams, or oils. Thick, scaly areas can be treated with keratolytic shampoos and lotions. Seborrheic dermatitis of the face and body can be treated with over-the-counter and prescription-strength antifungal creams, over-the-counter and prescription-strength corticosteroid creams and ointments, and calcineurin inhibitor cream or ointment. Neonatal seborrheic dermatitis is common and typically self-resolves by 6 months of age. Mild cases of the scalp (cradle cap) may be treated conservatively with mineral oil to loosen scale and gentle combing. More severe cases may overlap with atopic dermatitis and can be treated with topical antifungals or topical corticosteroids.