Seborrheic dermatitis is a common skin condition in infants, adolescents, and adults. The characteristic symptoms—scaling, erythema, and itching—occur most often on the scalp, face, chest, back, axilla, and groin. Seborrheic dermatitis is a clinical diagnosis based on the location and appearance of the lesions. The skin changes are thought to result from an inflammatory response to a common skin organism, Malassezia yeast. Treatment with antifungal agents such as topical ketoconazole is the mainstay of therapy for seborrheic dermatitis of the face and body. Because of possible adverse effects, anti-inflammatory agents such as topical corticosteroids and calcineurin inhibitors should be used only for short durations. Several over-the-counter shampoos are available for treatment of seborrheic dermatitis of the scalp, and patients should be directed to initiate therapy with one of these agents. Antifungal shampoos (long-term) and topical corticosteroids (short-term) can be used as second-line agents for treatment of scalp seborrheic dermatitis.
Seborrheic dermatitis is a chronic inflammatory dermatologic condition that usually appears on areas of the body with a large density of sebaceous glands, such as the scalp, face, chest, back, axilla, and groin. Although it can be associated with human immunodeficiency virus infection and neurologic disease (e.g., cerebrovascular event, Parkinson disease),1 seborrheic dermatitis typically occurs in healthy persons. Its prevalence is 1% to 3% in the general population and 34% to 83% in immunocompromised persons.2 It has a bimodal distribution, with peaks at two to 12 months of age and in adolescence and early adulthood.2 It is more common in men and is typically more severe in cold and dry climates and during periods of increased stress.
Topical corticosteroids are effective in treating seborrheic dermatitis and should be used sparingly to avoid adverse effects.