seborrhoeic dermatitis

Seborrhoeic Dermatitis: The Scaly, Red Face Condition

Seborrhoeic dermatitis, often dubbed as the ugly twin sister of dandruff, presents a common yet bothersome challenge in dermatology practice. This article delves into its characteristics, causes, treatment options, and the significance of its manifestations.

Characteristic Features

Seborrhoeic dermatitis, also known as seborrhoeic eczema or seb derm, manifests as a red, scaly rash primarily observed in specific areas of the face, including the eyebrows, the folds between the cheeks and nose, and the inner ear. Its hallmark symptom is a dry, itchy scalp, accompanied by dandruff, akin to cutaneous confetti.

seborrhoeic dermatitis

Underlying Cause

The principal culprit behind seborrhoeic dermatitis and dandruff is the Malassesia yeast, a commensal organism found on most individuals’ skin. However, in susceptible individuals, an aberrant immune response triggers inflammation, giving rise to the characteristic rash.

Associated Conditions

While seborrhoeic dermatitis is typically benign, its presence may warrant consideration of underlying conditions, such as Parkinson’s disease or HIV infection. Severe cases may prompt HIV testing as a precautionary measure, highlighting the importance of early diagnosis and intervention.

Management Strategies

Although seborrhoeic dermatitis cannot be completely eradicated, effective symptom management is achievable. Daily use of facial moisturizers and post-shampoo conditioning can significantly alleviate symptoms. Anti-dandruff shampoos containing zinc pyrithone or selenium sulphide, as well as organic alternatives with tea tree oil, offer relief. Additionally, ketoconazole-based shampoos, available over the counter, prove efficacious when used 2-3 times weekly.

Treatment Options

Protopic ointment and Elidel cream emerge as preferred treatments for facial rash, offering rapid resolution within days. These non-steroidal options can be used intermittently to maintain remission. Alternatively, weak steroids like Eumovate cream, accessible over the counter, provide relief in smaller tubes.

Impact on Quality of Life

Beyond its physical manifestations, seborrhoeic dermatitis can significantly impact an individual’s emotional well-being and social interactions. The visible presence of flaky skin and persistent itching may lead to self-consciousness and embarrassment, affecting confidence and interpersonal relationships. Moreover, the chronic nature of the condition, with periods of exacerbation and remission, can impose a considerable psychological burden, necessitating holistic management approaches that address both the physical and emotional aspects of the condition.

Future Directions in Treatment

As our understanding of the pathophysiology of seborrhoeic dermatitis continues to evolve, novel therapeutic strategies are emerging on the horizon. Research efforts focused on targeting specific immune pathways involved in the inflammatory response to Malassesia yeast hold promise for the development of more targeted and efficacious treatments. Furthermore, advancements in topical drug delivery systems may enhance the efficacy and tolerability of existing treatments, optimizing outcomes for individuals affected by this common dermatological condition. Collaborative efforts between dermatologists, researchers, and pharmaceutical companies are essential to translate these scientific advancements into tangible clinical benefits, ultimately improving the lives of individuals battling seborrhoeic dermatitis.


Our dermatologists in London encounter numerous cases of seborrhoeic dermatitis, often referred to as the ugly twin sister of dandruff. Seborrhoeic dermatitis poses a common yet manageable challenge, with effective treatment options available to alleviate symptoms and improve quality of life. Early recognition of associated conditions is crucial, underscoring the importance of comprehensive dermatological evaluation and intervention.


Can seborrhoeic dermatitis spread to other parts of the body?

Seborrhoeic dermatitis typically remains localized to the areas it initially affects, such as the face and scalp. However, in some cases, it may spread to other areas, especially if left untreated.

Are there any dietary changes that can help manage seborrhoeic dermatitis?

While specific dietary changes may not directly treat seborrhoeic dermatitis, maintaining a healthy diet rich in vitamins and minerals can support overall skin health and may indirectly help manage symptoms.

How long does it take for treatment to show results?

The timeframe for improvement varies depending on the individual and the treatment used. Some treatments may provide relief within days, while others may take weeks to show significant improvement.

Can seborrhoeic dermatitis be cured permanently?

Seborrhoeic dermatitis cannot be cured permanently, but effective management strategies can help control symptoms and reduce flare-ups.