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Seborrheic Dermatitis (Dandruff)

What is Seborrheic Dermatitis?

Seborrheic dermatitis is a common skin condition that causes a flaky, red and sometimes greasy rash. Many people refer to it as “dandruff” when it affects the scalp. In infants, the condition is known as cradle cap.

Seborrheic dermatitis signs and symptoms may include flaking (dandruff), itching and redness on your scalp, ears and central face.  Patches of greasy skin covered with flaky white or yellow scales or crust develop most commonly on the scalp, face, sides of the nose, eyebrows, ears, and eyelids.  Sometimes it can also be seen on the chest, armpits, groin area or under the breasts. Most commonly it feels itchy or causes sensitivity.

What Causes Seborrheic Dermatitis?

Doctors are still studying what causes this common skin disease. Many factors seem to work together to cause seborrheic dermatitis. These factors may include a yeast, called Malassezia, that normally lives on our skin, an “over reaction” of our immune system, our genetics, living in a cold and dry climate, stress, and a person’s overall health.

Individuals who may be at greater risk include those with neurologic and psychiatric conditions, such as Parkinson’s disease and depression. Other risk factors include a weakened immune system, such as seen in organ transplant recipients and people with HIV/AIDS, alcoholic pancreatitis and some cancers. However, the majority of people with seborrheic dermatitis are healthy and have no underlying health conditions.

How do You Treat Seborrheic Dermatitis?

Your dermatologist will likely be able to determine whether you have seborrheic dermatitis by examining your skin. She may scrape off skin cells for examination (biopsy) to rule out conditions with symptoms similar to seborrheic dermatitis, such as psoriasis and eczema.

Your doctor will likely recommend you try over-the-counter remedies, before considering prescription treatments. Wash your scalp regularly with over-the-counter dandruff shampoos. For the best results, look for the following active ingredients: pyrithione zinc, selenium sulfide, ketoconazole, tar, or salicylic acid.

Use a product daily until your signs and symptoms begin to subside, and then use it one to three times a week as needed. If one type of shampoo works for a time and then seems to lose its effectiveness, try alternating between two or more types. Be sure to leave your shampoo on for the full recommended time to allow its ingredients to work. These shampoos may be rubbed gently on the face, ears and chest and rinsed off completely. Over the counter hydrocortisone can also be used sparingly on these areas. Even if your condition clears up, it is likely to come back at some point. Watch for the symptoms and resume treating the condition when it recurs.

When home remedies are unsuccessful, your doctor will recommend prescription-strength creams and shampoos.  The selection will depend on the affected area and the severity of your symptoms. These are often corticosteroids you apply to the scalp or other affected areas. They are effective and easy to use, but should be used sparingly. If used for many weeks or months without a break, they can cause side effects, such as thinning skin, stretch marks or discoloration.  Anti-fungal gels, creams or shampoos are also commonly used. Frequently, they are alternated with another medication.  

Additional Seborrheic Dermatitis Resources

Links to Additional Information:

American Academy of Dermatology Seborrheic Dermatitis Videos:

Why Iowa Dermatology Consultants?

Iowa Dermatology Consultants believes in a patient focused approach to care.  We work with patients forming an active partnership in treatment to help repair the physical and emotional damage of skin disease.  Our Ankeny and Ames locations allow us to conveniently treat patients across the Des Moines metro area and all of Central Iowa including Ames, Carroll, Fort Dodge, Iowa Falls, Marshalltown, Huxley, Slater, and Indianola.  

At Iowa Dermatology Consultants, all of our physicians are board-certified dermatologists. Your care provided by Dr. Snider, Dr. Smith, or Dr. Myers is founded in knowledge and experience which exceeds that of a general practitioner.  Together they have almost 50 years of combined experience in diagnosing and treating a vast array of skin conditions.  This includes over 16,000 hours of patient care training to ensure that a board-certified dermatologist can expertly diagnosis and treat over 3000 dermatologic conditions.

Whether you’re coming to us for help with skin cancer or diseases like acne, psoriasis, and eczema; or to reverse the signs of aging with Botox, chemical peels or other cosmetic procedures, at Iowa Dermatology Consultants you will be getting the best dermatologic care in Central Iowa.