Seborrheic Dermatitis
Introduction
Seborrhoeic Dermatitis (seb-eh-ree-ik dur-muh-tye-tis) is a common skin condition that causes itchy, flaky and sometimes red skin usually around the scalp, face, neck, nappy area, and skin folds. In babies, it is also known as cradle cap when it appears on the scalp. In older children, this flaking of the scalp which is referred to as “dandruff” is also thought to be a type of seborrheic dermatitis. Seborrheic dermatitis is also known as seborrheic eczema.
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Cradle cap or seborrhoiec dermatitis with waxy yellow rash on forehead and eyebrows
Who gets it?
Anyone can get seborrheic dermatitis. Cradel cap, a form of seborrhoeic dermatitis, affects babies under 3 months of age and often resolves by 6-12 months of age.
What causes it?
We are not completely sure why or what causes this rash in children, however, it is thought to be due to an inflammatory reaction of the skin to a yeast that normally lives on the skin. Some reasons why the skin is reacting to this yeast could be due to some of the following:
Hormones: Given from mum during pregnancy, these hormones can increase how much oil your child’s body makes.
Genetics: Children from families with generally oily skin or other skin conditions are more likely to devlop this problem.
Immune system: Children with weakened immune systems have shown to be more at risk.
What does it look and feel like?
Looks like…
● The scalp may look crusted with thick, yellow waxy/ oily flaky patches (cradle cap).
● The surrounding skin may also look pink or red in colour.
● It can occur anywhere on the body, but most commonly on the scalp, face, neck, nappy area and skin folds.
Feels like…
● It may itch, but for most children is usually not itchy or bothersome at all.
● The patches may feel very rough and oily.
What tests might be needed?
Generally, no tests are needed for diagnosing the condition. Your family doctor or dermatologist will ask you some questions about your child and family and perform a skin exam where they take a closer look at and feel the skin.
What treatments are available?
What can I do?
● Shampoo: Wash your child's scalp daily with a gentle shampoo for infants and use a soft toothbrush or soft bristled baby hair brush to gently massage and wash the crusty patches away.
● Moisturiser: You can also apply a thick moisturiser (or petroleum jelly) to the scalp overnight to help soften the crusty patch before brushing and shampooing. Be aware that some creams and shampoos may make the condition worse.
Medical therapies
Your family doctor or dermatologist may recommend creams or medicated shampoos to help. Follow your doctor’s instructions when using these medications.
● Medicated shampoo: These shampoos may contain an anti-fungal treatment to help remove some of the yeast on your child's skin.
● Creams: steroid creams are usually helpful in reducing itching that your child is experiencing and are usually used for a short time. Anti-fungal creams like those in medicated shampoos may be helpful for rashes on the body.
● Other treatments: Sometimes the skin under the crusts of cradle cap becomes infected and may look inflamed and start weeping. Your child may need antibiotics to treat this bacterial infection.
What happens after treatment?
In most cases cradle cap or seborrhoeic dermatitis will resolve with or without treatment by the time child reaches 6-12 months of age. In some children the rash may return as dandruff in adolecense or adult life.
Rarely, children with severe cradle cap may develop atopic dermatitis or atopic eczema (see Atopic Dermatitis fact sheet).
What support is available?
If you have any concerns or any questions, please see your family doctor or dermatologist to help manage your child's skin condition.
Authors/Reviewers:
Author: Dr Kevin Lam
Paediatric Reviewer: Dr Mayuri Sivagnanam
Editor in Chief: Dr Tevi Wain
