Seborrheic dermatitis often creeps into our lives with frustrating symptoms like persistent dandruff, red patches, and itching that refuses to subside. It can significantly impact daily comfort and confidence. Understanding the condition—from its causes and triggers to effective management techniques—can empower you to regain control of your skin and overall well-being.

Dr Saroj Poudel, a dermatologist and hair transplant surgeon, is the director and co-founder of Nirvana Skin Clinic and Hair Transplant Centre, Lazimpat, Kathmandu. He explains the causes, treatments, and lifestyle strategies for managing the condition.

What is seborrheic dermatitis?

It is a chronic form of eczema that causes itchy red patches, greasy scales on the skin, and white or yellow crusty or powdery flakes on the scalp. Seborrheic refers to the ‘sebaceous’ glands, while ‘derm’ means ‘skin’.

It commonly affects the scalp but can occur in other areas of your body. The areas with the most sebaceous (oil) gland activity are your upper back and chest, face/forehead, the creases at the base of your nose, behind your ears, navel (belly button), and eyebrows.

The exact cause of seborrheic dermatitis is unknown, but two main factors are thought to contribute. One is the overproduction of oil, which can irritate the skin, making it red, discoloured, and greasy. This may be linked to hormone production. The other factor is Malassezia, a yeast naturally found in skin oils, which can multiply excessively and trigger inflammation. Together, these factors increase oil production, leading to seborrheic dermatitis.

Other factors that trigger or worsen seborrheic dermatitis include stress, cold and dry climate, oily skin, using alcohol-based lotions, and a history of other skin disorders, including rosacea, psoriasis, and acne.

What are the common symptoms of this condition?

Seborrheic dermatitis is marked by flaky, scaly patches that may be white or yellowish, often called dandruff on the scalp. In severe cases, it can also cause erythematous plaques—thick, raised skin that may become crusted and greasy with a yellowish tint. The affected skin may appear discoloured or hypopigmented, especially in those with darker skin tones, and may itch. These symptoms typically occur in areas with oil-producing glands, like the scalp, face, chest, and back. Early recognition can help in seeking effective treatment.

Can seasonal changes affect seborrheic dermatitis?

The condition often worsens during the colder months, particularly in winter, when the air is dry and lacks humidity. This dryness can exacerbate the flakiness, itching, and irritation associated with seborrheic dermatitis, making symptoms more uncomfortable and pronounced.

Seborrheic dermatitis often improves during the summer months, as sunlight's UV-A and UV-B rays help reduce the yeast overgrowth that triggers the condition. However, it’s important to balance sun exposure, as too much can cause sunburn, irritating the skin and potentially leading to other complications.

Does diet play a role in managing the condition?

Although there are theories, true experts have yet to find that food causes or reduces seborrheic dermatitis.

Can seborrheic dermatitis be cured, or is it a chronic condition?

Seborrheic dermatitis may clear up on its own, but it often recurs and requires ongoing care. Good skin care can usually control it. Consult your dermatologist, who may recommend over-the-counter treatments. Try dandruff shampoos with ingredients like coal tar, ketoconazole, salicylic acid, selenium sulfide, or zinc pyrithione for scalp seborrheic dermatitis. Other treatments include antifungal products, corticosteroid lotions, or sulfur products. For babies with cradle caps, daily shampooing with warm water and baby shampoo usually helps, and it typically resolves on its own within a few months.

Do you think stress-management techniques like mindfulness or yoga can impact flare-ups?

Healthy lifestyle habits, such as managing stress and getting enough sleep, can improve seborrheic dermatitis. Stress relief, in particular, can have a significant impact. Effective techniques include light exercises like yoga or walking, journaling to express stress and negative feelings, practising meditation or breathwork, and spending time in nature, even for just five minutes. The key is finding a stress-reducing activity you enjoy that helps you slow down and prioritise self-care.