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Facts about the skin from DermNet New Zealand Trust. Topic index: A B C D E F G H I J K L M N O P Q R S T U V W X Y Z



Seborrhoeic eczema

What is seborrhoeic eczema?

Seborrhoeic eczema (American spelling is ‘seborrheic’) is a common, chronic or relapsing form of eczema/dermatitis that mainly affects the scalp and face. There are infantile and adult forms of seborrhoeic eczema. It is sometimes associated with psoriasis (sebopsoriasis).

Dandruff (also called ‘pityriasis capitis’) is an uninflamed form of seborrhoeic dermatitis. Dandruff presents as bran-like scaly patches scattered within hair-bearing areas of the scalp.

What causes seborrhoeic eczema?

The cause of seborrhoeic eczema is not completely understood. It is associated with proliferation of various species of the skin commensal Malassezia in its yeast form. Its metabolites cause an inflammatory reaction. Differences in skin barrier function may account for individual presentation.

Who gets seborrhoeic eczema?

Infantile seborrhoeic eczema affects babies under the age of 3 months and usually resolves by 6–12 months of age.

Adult seborrhoeic eczema tends to begin in late adolescence. Prevalence is greatest in young adults and in the elderly. It is more common in males than in females.

The following factors are sometimes associated with severe adult seborrhoeic eczema:

What are the clinical features of seborrhoeic eczema?

Infantile seborrhoeic eczema

Infantile seborrhoeic eczema causes cradle cap (diffuse, greasy scaling on scalp). The rash may spread to affect armpit and groin folds (a type of napkin dermatitis).

Seborrhoeic dermatitis Seborrhoeic dermatitis Seborrhoeic dermatitis
Infantile seborrhoeic dermatitis

Adult seborrhoeic eczema

Seborrhoeic eczema affects scalp, face (creases around the nose, behind ears, within eyebrows) and upper trunk.

Typical features include:

Seborrhoeic dermatitis Seborrhoeic dermatitis Seborrhoeic dermatitis
Seborrhoeic dermatitis Seborrhoeic dermatitis Seborrhoeic dermatitis
Seborrhoeic dermatitis Seborrhoeic dermatitis Seborrhoeic dermatitis
Seborrhoeic dermatitis

How is seborrhoeic eczema diagnosed?

Seborrhoeic eczema is diagnosed by its clinical appearance and behaviour. As Malassezia is a normal component of skin flora, its presence on microscopy of skin scrapings is not diagnostic. Skin biopsy may be helpful but is rarely indicated.

What is the treatment for seborrhoeic eczema?

Treatment of seborrhoeic dermatitis often involves several of the following options.

In resistant cases in adults, oral itraconazole, tetracycline antibiotics or phototherapy may be recommended.

Scalp treatment

Face, ears, chest & back

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Author: A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand. Updated July 2014.

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If you have any concerns with your skin or its treatment, see a dermatologist for advice.