HealthInfo West Coast-Te Tai Poutini

Seborrhoeic dermatitis & cradle cap

Seborrhoeic dermatitis & cradle cap

Seborrhoeic dermatitis (also called seborrhoeic eczema) is common and harmless. It is a non-contagious skin condition that causes itchy, red, flaky or scaly patches on your skin.

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

Seborrhoeic dermatitis is quite common. It most commonly affects male rangatahi (teenagers) and adults between the ages of 30 and 70.

It is also common for pēpi (babies) 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.

Causes of seborrhoeic dermatitis

Health professionals do not clearly understand why people or pēpi 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).

Symptoms of seborrhoeic dermatitis

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. Your 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.

Symptoms in pēpi include:

• Head. Crusty or greasy yellow scaly patches on their head (this is 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.

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

Diagnosing seborrhoeic dermatitis

Your general practice team 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.

Treatment for 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 general practice team for advice.

Sometime stress can make your symptoms worse. Read about things you can do to help cope with stress.

Scalp seborrhoeic dermatitis:

• Rangatahi and adults. Use an anti-dandruff shampoo. You can buy these at pharmacies and supermarkets. To begin with, use it daily for 1 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.

• 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 frequently and use a barrier cream.

For other parts of your body, you can use an antifungal cream such as miconazole or clotrimazole. These are often used in combination with a steroid cream.

In severe cases, you may need a course of tablets to control the rash.

  HealthInfo recommends the following pages

• DermNet NZ
  • Seborrhoeic dermatitis

    This page explains what seborrhoeic dermatitis is, what causes it, who gets it and how it is treated.

  • Cradle cap (infantile seborrhoeic dermatitis)

    Information specifically about cradle cap.

• NHS – Dandruff

  Information about dandruff and how to treat it yourself.

Written by HealthInfo clinical advisers. Last reviewed February 2025.

Sources

Page reference: 142835

Review key: HICOD-326084