Seborrhoeic dermatitis and cradle cap

It is not known exactly why people get seborrhoeic dermatitis.

It is thought to be associated with a yeast on your skin called Malassezia. People with seborrhoeic dermatitis appear to have more of this yeast than others or are more sensitive to it. This causes an inflammatory reaction in areas of skin where there are lots of oil-producing glands (sebaceous glands).

Seborrhoeic dermatitis most commonly affects male rangatahi, and adults between the ages of 30 and 70.

It is also common for pēpi under 3 months old to get a short-lived form of seborrhoeic dermatitis on their scalps called cradle cap. This usually clears up by the time the pēpi is 6 to 12 months old.

Seborrhoeic dermatitis is not contagious, meaning you cannot catch it from other people.

Seborrhoeic dermatitis can affect any area of your body but mainly affects oily areas such as your face, scalp and chest.

Symptoms in rangatahi and adults include red, flaky or scaly patches on the skin that may be itchy and sore. The most commonly affected areas include:

• scalp — white flakes of skin (known as dandruff) that may be itchy
• face — between your eyebrows, on your cheeks and in the folds at the sides of your nose
• eyelids — may be red, swollen and flaky
• ears — the skin inside and behind your ear and outer ear may become red and inflamed
• upper chest and back — you may have pink or red, scaly patches
• skin folds such as your armpits, under your breasts and groin — your skin may be pink, shiny and cracked.

Images of seborrhoeic dermatitis — DermNet

Symptoms in pēpi include:

• head — crusty or greasy yellow scaly patches on their head (called cradle cap)
• face, behind ears, in skin folds and in the nappy area — the skin is drier, and scales are whiter than those on their scalp.

Images of cradle cap — DermNet

If you have darker skin, you may notice pale patches. Pēpi with dark skin may have redness, flaking and pale patches.

Seborrhoeic dermatitis can get infected, especially if it is very itchy and you scratch it.

If your dermatitis has become redder and is painful, you should see your healthcare provider. 

Your healthcare provider can usually diagnose seborrhoeic dermatitis and cradle cap by looking at your skin. They will ask you questions about your symptoms.

Sometimes seborrhoeic dermatitis can look similar to psoriasis.

Psoriasis

There are things you can do to help manage seborrhoeic dermatitis:

• keep your skin clean and dry
• do not use any soaps or lotions if they irritate your skin
• use soap substitutes such as Aqueous

Ask your pharmacist or healthcare provider for advice. They may recommend an antifungal cream such as miconazole or clotrimazole. These are often used in combination with a steroid cream.

In severe cases, your healthcare provider may prescribe medication to help control the rash.

Sometime stress can make your symptoms worse. There are things you can do to help you cope with stress.

Managing stress

Treating seborrhoeic dermatitis of the scalp

Rangatahi and adults

Use an anti-dandruff shampoo. You can buy these at pharmacies and supermarkets.

To start with, use it every day for one week, leaving it on for 30 minutes before rinsing it off. Then continue using it twice a week, leaving it on for 5 to 10 minutes.

Steroid scalp lotions are also used for flare-ups to reduce inflammation.

Coco-scalp is a non-steroid treatment option for removing scale and reducing irritation.

Pēpi

Gently apply a moisturiser (emollient) or repeatedly wash with a mild shampoo to help loosen and remove the scales. Olive oil or vegetable oil can also help soften the scales. Sometimes you can follow this by carefully removing the scales using a soft toothbrush or comb.

If seborrhoeic dermatitis affects other areas of your baby's skin, such as where their nappy is, change their nappy often and use a barrier cream.