• Clinical science

Seborrheic dermatitis (Seborrheic eczema)


Seborrheic dermatitis is a common chronic inflammatory skin condition that affects areas with high sebaceous activity (e.g., scalp). The etiology remains unknown, but microbial colonization of the skin (esp. Malassezia), immunological factors, climate, or stress have been implicated. This condition is characterized by intermittent flares with intervening asymptomatic periods. Patients may exhibit either an erythematous, patchy scaling, or greasy yellow crusts, both of which could be associated with burning or itching. Early treatment of acute flares with topical glucocorticosteroids is recommended. Topical ketoconazole is used to relieve symptoms. The condition tends to recur over a lifetime despite treatment. Infantile seborrheic dermatitis (also referred to as “cradle cap”) is a subtype of seborrheic dermatitis and appears shortly after birth, primarily affecting the scalp. As opposed to seborrheic dermatitis in adults, it usually heals without treatment after a few months.



Epidemiological data refers to the US, unless otherwise specified.




  • The pathophysiology is not yet fully understood
  • Endogenous precipitants; : psychological stress; , fatigue, sleep deprivation, and hormonal changes
  • Exogenous precipitants; : climate (the condition improves in the summer months and worsens in winter; ), trauma (e.g., excoriation of the skin from scratching), medication


Clinical features

  • Chronic course with episodic, active phases (associated burning and itching) alternating with inactive, asymptomatic periods
  • Ranges from erythematous plaques with patchy scaling → greasy yellow crusts, distributed along areas with hair and oily skin:
    • Scalp (dandruff and itching)
    • Forehead/hairline and retroauricular area
    • Nasolabial fold, eyebrows and periocular region (blepharitis: scaly red eyelid margins)
    • Cheeks and chin
    • Presternal and interscapular regions
    • Axillae, under breasts, umbilicus, and groin area



  • Primarily a clinical diagnosis

Consider HIV or Parkinson's disease if there is a marked or unusual distribution of seborrheic dermatitis!References:[5]

Differential diagnoses

The differential diagnoses listed here are not exhaustive.


Local use of steroidal creams is not advised for long term use because it increases the risk of recurrences and can lead to dependence!




We list the most important complications. The selection is not exhaustive.


  • No cure: often a chronic, recurrent course
  • The active phases of seborrheic dermatitis are easily controllable with treatment


Special patient groups

Infantile seborrheic dermatitis


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  • 15. Ngan V. Leiner Disease. http://www.dermnetnz.org/topics/leiner-disease/. Updated January 1, 2003. Accessed May 16, 2017.
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last updated 05/08/2020
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