Seborrheic dermatitis is a chronic inflammatory skin condition that causes redness, itching, and flaking, particularly on the scalp, eyebrows, sides of the nose, around the ears, and center of the chest.

It is sometimes described as a form of eczema affecting oily areas of the skin.

The condition can flare up periodically. Appropriate treatment can control symptoms, but they may return over time.

Seborrheic dermatitis is not contagious and is not caused by poor hygiene.

What Causes Seborrheic Dermatitis?

Naturally occurring Malassezia yeasts, skin oils, and the individual’s immune response are thought to contribute to seborrheic dermatitis.

The condition is not simply caused by excessively oily skin.

Genetic predisposition, cold and dry weather, stress, certain neurological conditions, and conditions affecting the immune system may influence its course.

What Are the Symptoms?

Common symptoms include:

• Scalp flaking and itching
• Redness around the eyebrows and sides of the nose
• Scaling in and behind the ears
• Scale buildup along the hairline
• Flaking in the beard and mustache area
• Red, scaly patches in the center of the chest

The flakes may be fine and white or appear yellowish and greasy.

How Does Seborrheic Dermatitis Differ From Psoriasis?

Both conditions can cause scalp redness and scaling.

Psoriasis usually produces thicker, well-defined plaques. Seborrheic dermatitis more often causes thinner scales that may appear greasy.

The two conditions can sometimes occur together. A dermatologic examination is important for an accurate diagnosis.

Current Treatments for Seborrheic Dermatitis

Treatment aims to reduce yeast levels and inflammation, relieve itching, and control recurrences.

1. Medicated Shampoos

Shampoos containing ingredients such as ketoconazole, ciclopirox, or selenium sulfide may be used for scalp involvement.

At the start of treatment, they are typically used several times a week, depending on the product.

The shampoo should reach the scalp and remain in contact for the recommended amount of time.

Once symptoms are controlled, weekly or intermittent maintenance use may be recommended for some patients.

2. Treatments for the Face and Ears

Topical antifungal medications containing ketoconazole or ciclopirox may be used for facial redness and scaling.

For significant inflammation, a short course of a low-potency topical corticosteroid or, in suitable patients, a calcineurin inhibitor such as tacrolimus or pimecrolimus may be considered.

Prolonged use of corticosteroid creams on the face without medical supervision is not recommended.

3. Softening Thick Scales

Appropriate preparations containing keratolytic ingredients such as salicylic acid may help with heavy scalp scale buildup.

The aim is to soften scales without forcibly removing them and make other treatments easier to apply.

This approach should be planned according to the condition of the scalp.

4. Newer Treatments

New topical medications targeting inflammation in seborrheic dermatitis have been developed in recent years.

One option is roflumilast 0.3% foam, a PDE-4 inhibitor approved in the United States for treating seborrheic dermatitis in patients ages 9 and older.

Clinical studies have shown that it can reduce redness, scaling, and itching.

Its regulatory approval status and availability in Türkiye require separate assessment.

5. Treatment-Resistant Seborrheic Dermatitis

The diagnosis is reassessed when symptoms are widespread, severe, or resistant to standard treatment.

Systemic antifungal medications or other dermatologic approaches may be considered for selected patients.

Can Seborrheic Dermatitis Go Away Completely?

Seborrheic dermatitis can be chronic and recurring, particularly in adults.

Symptoms may clear completely with treatment, but this does not mean they will never return.

Consistent skincare and maintenance treatment when needed may help reduce the frequency of flare-ups.

Daily Care Tips

• Wash your scalp at a frequency suited to its needs.
• Use medicated shampoos as directed.
• Avoid washing with very hot water.
• Avoid abrasive washcloths and irritating exfoliating treatments.
• Choose a gentle facial cleanser.
• Use a suitable moisturizer that does not irritate your skin.
• Do not scrape off flakes with your fingernails.
• If flare-ups recur frequently, ask your dermatologist about a maintenance treatment plan.

When Should You See a Dermatologist?

A dermatologic evaluation is recommended if flaking and redness keep returning, itching or scale buildup becomes significant, or shampoos do not improve symptoms.

Pain, drainage, noticeable hair loss, or widespread inflammation may require investigation for other conditions.

Dermatologic Evaluation and Treatment

At Dr. Armin Müştak’s private dermatology practice, scalp and facial flaking, redness, and inflammatory lesions are assessed through a dermatologic examination.

A treatment and care plan is developed based on the areas affected, severity, frequency of flare-ups, and previous treatments.

Effective management of seborrheic dermatitis involves clearing existing flakes and establishing a care routine that helps control recurrences.