Seborrhea is a condition that affects oil production by the sebaceous glands in the skin. Seborrhea can produce symptoms of flaky skin in areas of the body that produce oil, such as the scalp and ears. The symptoms can be controlled by using specially formulated shampoos or medicated lotions. Anti-fungal medications and steroids may also help ease skin irritation.
The flaky dry scalp caused by seborrhea can be treated with shampoos that contain coal tar, salicylic acid, zinc, resorcinol, ciclopirox, ketoconazole, or selenium. These shampoos are available over the counter. The shampoo should be used daily, if possible, and the scalp should be scrubbed vigorously for five minutes to loosen the dandruff before being rinsed thoroughly. Shampoos can be alternated, because a single shampoo can sometimes lose its effectiveness over time. A doctor can prescribe a stronger-strength shampoo or a steroid treatment if the over-the-counter shampoos do not control the dermatitis after several weeks.
Seborrheic dermatitis is thought to be caused by a combination of sebum overproduction and irritation stemming from Malassezia yeast. Effective treatment for flaky skin on areas other than the scalp can be provided by anti-itch creams or antifungal creams available over the counter. Stubborn cases can be treated with prescription creams or oral medication.
A doctor may prescribe a corticosteroid cream, an anti-fungal cream, or a mixture of both to help control the symptoms and inflammation. A common course of prescription treatment is a combination of ketoconazole and desonide rubbed daily into the skin. If the dermatitis is extensive, patients may be able to take oral anti-fungal medication such as terbinafine to tackle the inflammation.
When all other options have failed, medicines called immunomodulators can help control the seborrhea symptoms. These medications are anti-inflammatory and anti-fungal but are not recommended for long-term use, because of concerns about potential side effects to the immune system. Immunomodulators include tacrolimus and pimecrolimus, marketed as Protopic® and Elidel®, respectively.
Newborn babies and children under 3 years of age may have a form of seborrheic dermatitis called cradle cap, which leaves the scalp skin thick and flaky. Cradle cap is not dangerous but can be removed through daily shampooing with a mild shampoo and gently brushing the child's hair or scalp several times a day. Stubborn flakes can be removed by applying mineral oil to the scalp and wrapping the child's head in a warm, wet towel for up to an hour before shampooing.
Seborrheic dermatitis may be influenced by stress, weather conditions, fatigue and obesity. Symptoms may also occur because of poor hygiene and infrequent shampooing. Another cause of symptoms is the use of lotions that contain alcohol.