Seborrheic dermatitis is a common, chronic skin condition that primarily affects areas with oiliness and high activity of the sebaceous glands, leading to inflammation in the affected region.
It is characterized by periods of flare-ups and remissions and causes redness (erythema) and flaking of the affected skin.
It affects approximately 5% of the population and is more commonly seen in men.
No specific cause has been identified that causes seborrheic dermatitis and it is most likely a multifactorial disease.
However, certain factors play a significant role in the development of the condition, such as the lipophilic fungus Malassezia, which is isolated at a high rate on the skin of individuals with seborrheic dermatitis. Genetics, hormonal and environmental factors (e.g., climate), as well as psychological factors (e.g., stress), also contribute to the manifestation of the disease.
Seborrheic dermatitis primarily appears on the scalp, face (around the nose, behind the ears, and on the eyebrows), and upper torso. Some characteristic features of the condition include:
Winter flare-ups with improvement in summer following sun exposure (a relapsing disease)
Usually mild and manageable itching
A combination of oiliness and dryness on the facial skin
Localized or diffuse fine, dandruff-like scaling on the scalp
Pale red, scaly, and poorly defined patches in skin folds and on both sides of the face
Slightly red, thin plaques with unclear borders and mild flaking on facial folds and the eyebrows
Rash in the armpits, under the breasts, in the groin folds, and around the genitals, among other areas
In infants, the condition typically presents within the first three months of life, with greasy yellow scales symmetrically attached to the scalp, eyebrows, and eyelids. Less commonly, erythematous and scaly lesions may appear on the face and in the diaper area.
Among other things, it must be differentiated from atopic dermatitis, psoriasis, Langerhans' histiocytosis, dermatophytosis, dermatitis, as well as tinea corporis.
Individuals with seborrheic dermatitis should follow a regular skincare and moisturizing routine to help keep symptoms under control. Treatment for seborrheic dermatitis often includes one or a combination of the following options:
Keratolytics to remove scales (when necessary)
Antifungal agents to reduce the load of pathogenic fungi on the skin
Mild topical corticosteroids for 1–3 weeks to reduce inflammation during acute flare-ups
Calcineurin inhibitors
In resistant cases in adults, oral itraconazole, antibiotics, or phototherapy may be recommended.
Additionally, high levels of stress and anxiety should be managed, as they contribute to the worsening of the condition.
The main difference between dandruff and seborrheic dermatitis is that the former represents mild, non-inflammatory flaking, whereas the latter is an inflammatory condition.
Dandruff could be considered an early stage of seborrheic dermatitis, as the issue often begins with a disruption in the skin’s natural shedding process—possibly due to stress, poor diet, overuse of styling products, or infrequent hair washing.
This disruption leads to an increase in the population of the fungus Malassezia globosa, which feeds on fatty acids produced by the scalp, eventually triggering localized inflammation and more intense flaking.
Another noticeable difference is the appearance of the flakes: in seborrheic dermatitis, the scales are oily and yellowish, while in dandruff, they are dry and whiter.
Finally, dandruff is limited to the scalp, whereas seborrheic dermatitis may also affect areas such as the eyebrows and around the nose.