A pediatrician’s guide to skin & scalp care
A guide to flakes, scale, and skin changes, with practical care for babies, children, and adults.
Quick answer
Seborrheic dermatitis is a common inflammatory skin condition that causes flakes, scales, and sometimes itching. It often affects the scalp, eyebrows, sides of the nose, ears, or chest. On a baby’s scalp, it is commonly called cradle cap. It is not contagious or a sign of poor hygiene. Care depends on age, location, and severity.
In this guide
What is seborrheic dermatitis?
Seborrheic dermatitis is an inflammatory condition that tends to affect skin rich in oil glands. It can produce fine flakes or thicker, greasy scale. Dandruff is the milder scalp form, usually with little visible inflammation. You may also see the spelling seborrhoeic dermatitis or the name seborrheic eczema.
Pronunciation: seb-uh-REE-ik der-muh-TY-tis.
Seborrheic dermatitis symptoms and pictures
Common symptoms include white or yellow flakes, greasy or dry-looking scales, and patches of irritated skin. Itching varies from minimal to troublesome. The rash may improve and then flare again; its location and behavior help with recognition.
Scalp
Loose flakes or patches of scale, sometimes extending to the hairline.
Face & ears
Eyebrows, sides of the nose, beard area, and behind the ears.
Body
The chest and some skin folds can also develop a scaly rash.
Seborrheic dermatitis on darker skin
On lighter skin, inflammation may look pink or red. On darker skin, patches can look darker, purple, grayish, or lighter than the surrounding skin. Some people develop curved or petal-shaped patches near the hairline. Color alone cannot confirm or rule out the condition.
In babies, seborrheic dermatitis can also involve the eyebrows, areas behind the ears, neck folds, armpits, or diaper folds. In older children and adults, the scalp, central face, ears, chest, and other skin folds are common sites. 1
Find help for the area that is bothering you
What causes seborrheic dermatitis?
The cause is not fully understood. Researchers point to a combination of skin oils, Malassezia yeast that normally lives on skin, and the skin’s inflammatory response. Having this yeast on your skin is normal; not everyone develops seborrheic dermatitis.
Hormones influence how much oil the skin makes, which helps explain the peaks in infancy and after puberty. An oily scalp alone does not explain every case: the skin barrier and the way the immune system responds also matter.
What can trigger a flare?
Stress, tiredness, cold or dry weather, and irritating products can contribute to flares. Triggers differ, so note changes to your routine when symptoms return. A flare does not mean the condition has become contagious.
Who is more likely to develop it?
It is common in early infancy, becomes more common again around adolescence, and can recur throughout adulthood. Adults with oily skin or a family tendency may be more susceptible, and it is more common in men.
Some health conditions are associated with a higher risk or more severe disease, including Parkinson’s disease and other neurologic disorders, HIV or other causes of immune suppression, and Down syndrome. Seborrheic dermatitis can also coexist with psoriasis or rosacea. Some medications can contribute to flares.
Most people with seborrheic dermatitis are otherwise healthy. Having it does not mean that you have one of these conditions, and a risk factor does not predict whether an individual will develop it. If symptoms began after a medication change, discuss that with the prescriber. 2,3
Babies, older children, and adults need different approaches
Babies: start with gentle cradle-cap care
Cradle cap is the common name for seborrheic dermatitis on a baby’s scalp. It often appears in the first few months of life.
The scales may look dramatic, but babies are usually comfortable. It commonly improves over a few months. Gentle washing and a soft brush can help lift scales that have already loosened. Avoid picking or scraping attached crusts.
If the rash is widespread, swollen, bleeding, oozing, or making your baby uncomfortable, ask your pediatrician to examine it. For a young baby, discuss medicated products with the pediatrician before starting a treatment routine.
Read the complete cradle cap guide →Older children, teenagers, and adults
Seborrheic dermatitis becomes more common again around adolescence and can recur in adulthood. A routine may need to treat an active flare and then maintain control. In a school-age child, a scaly scalp with broken hairs or bald patches needs evaluation for other causes, including scalp ringworm. 4,5
Seborrheic dermatitis treatment and daily care
The goal is to control flaking, scaling, and irritation, then reduce returning symptoms. The right treatment depends on where the rash is, the person’s age, and how inflamed the skin is.
Choose a medicated shampoo or treatment for the area
Medicated shampoos can help scalp symptoms. Examples of active ingredients include pyrithione zinc, ketoconazole, and selenium sulfide; strengths, age limits, and directions differ. Some washes can also be used on affected skin when the label or clinician recommends it. Eyelids need care appropriate for that sensitive area.
Keep everyday cleansing gentle
Use lukewarm water, avoid scrubbing, and rinse thoroughly. Choose fragrance-free products that your skin tolerates. A soft brush may help remove loose scales; it should not scrape or hurt the skin.
Moisturize skin that feels dry
A fragrance-free moisturizer can support comfortable skin between treatments. A cleanser and moisturizer each have a role, while medication addresses active symptoms when needed.
Reassess if the routine is not enough
If a routine is not helping, a clinician can check the diagnosis and decide whether prescription treatment is needed. Avoid repeatedly switching or combining treatments without a clear plan.
When prescription treatment helps
A clinician may add a topical antifungal such as ketoconazole or ciclopirox, or a short course of an appropriate corticosteroid for inflammation. Sensitive areas may need a steroid-sparing treatment such as a topical calcineurin inhibitor. Roflumilast foam is another prescription option. Product, strength, age, and body area all matter; persistent symptoms may also mean the diagnosis needs another look. 6,7
For the routine in more detail: how often to wash your hair and what to expect as a dandruff shampoo starts working.
For loose scales, a soft silicone Beanie Brush can help with gentle removal. Stop if brushing causes discomfort.
What can be mistaken for seborrheic dermatitis?
These clues can help explain why an examination matters. Conditions can overlap, and a single feature does not settle the diagnosis.
| Condition | A useful clue |
|---|---|
| Seborrheic dermatitis | Flakes or scale in oil-rich areas such as the scalp, eyebrows, and sides of the nose. |
| Atopic dermatitis | Dryness and prominent itching; age and the rash’s distribution help distinguish it. |
| Psoriasis | More clearly defined, thicker patches; it can coexist with seborrheic dermatitis. |
| Scalp ringworm | Broken hairs or patchy hair loss with scaling. It needs medical treatment; shampoo alone is not enough. |
| Contact dermatitis | A rash after exposure to an irritating product or an ingredient the person is allergic to. |
| Rosacea | Flushing, persistent central-face color changes, or acne-like bumps; it may coexist with seborrheic dermatitis. |
| Seborrheic keratosis | A discrete, often waxy or rough skin growth rather than a recurring flaky rash. |
Tinea capitis vs. seborrheic dermatitis
Tinea capitis is scalp ringworm: a contagious infection involving the scalp and hair shafts. It can cause scale, broken hairs, black dots where hairs have broken, or patchy hair loss. Some cases look more like diffuse dandruff, so a neat ring is not required.
A clinician may examine affected hairs or scalp scrapings to distinguish the conditions. Scalp ringworm usually needs an antifungal medicine taken by mouth; shampoo alone does not reach the infection within the hair. Seborrheic dermatitis is not contagious and is treated with a different routine. 9
Seborrheic dermatitis vs. seborrheic keratosis
The similar names describe different conditions. Seborrheic dermatitis is a flaky, inflammatory rash. A seborrheic keratosis is a benign skin growth, often with a waxy, rough, or “stuck-on” appearance. It is more common as people get older and may be skin-colored, brown, or black.
Dandruff shampoo does not remove a seborrheic keratosis. Have a clinician examine a new, changing, bleeding, or uncertain growth rather than assuming that every scaly spot is dermatitis. 10
Rosacea vs. seborrheic dermatitis
Rosacea often causes recurring flushing, persistent facial color changes, visible small vessels, or acne-like bumps on the central face. Seborrheic dermatitis more often produces scale around the eyebrows, sides of the nose, ears, and scalp. They can occur together, so a face rash may need care for both conditions. 11
What about hair loss?
Seborrheic dermatitis usually does not cause permanent hair loss. Inflammation, scratching, or pulling off attached scales can contribute to temporary shedding or breakage. Distinct bald patches, broken hairs, or ongoing shedding should be examined, especially in a child.
When should you see a clinician?
Ask for an examination if you are unsure of the diagnosis, the rash keeps returning despite your care plan, or treatment is not helping. Also check in if itching is disrupting sleep or daily life.
Get medical advice promptly for:
The questions that come up most
Can seborrheic dermatitis spread or pass to another person?
It can affect more than one area on the same person, or appear in another oil-rich area during a flare. That is different from an infection spreading between people: seborrheic dermatitis is not contagious.
Is seborrheic dermatitis the same as dandruff?
Dandruff is generally considered a mild form of scalp seborrheic dermatitis, with flaking and little visible inflammation. Pityriasis capitis is another term used for dandruff. Seborrheic dermatitis can also affect the face and body; cradle cap refers to the condition on a baby’s scalp.
Will it go away permanently?
Cradle cap commonly settles as a baby grows. In teenagers and adults, seborrheic dermatitis often comes and goes. Ongoing care can help control symptoms and reduce recurring flares.
Should I wash my hair every day?
There is no single schedule for everyone. Follow your shampoo’s directions and the plan from your clinician. Hair texture, scalp symptoms, and the particular product all affect the routine. Happy Cappy Medicated’s label directs use at least twice weekly or as directed by a doctor.
Can I use moisturizer?
Yes. A fragrance-free moisturizer can help dry or uncomfortable skin. Moisturizing supports skin care; active seborrheic dermatitis may also need medicated treatment.
Do oils or home remedies cure it?
An ingredient that softens scales does not necessarily control seborrheic dermatitis. Oils and home remedies are not interchangeable, and vinegar or other irritating mixtures can aggravate sensitive skin. Stop any product that stings or worsens the rash, and ask your clinician about a suitable scale-softening approach.
Is seborrheic dermatitis a fungus?
It is an inflammatory skin condition. Malassezia is a yeast that normally lives on skin and can contribute to symptoms in susceptible people. Antifungal treatment may help by reducing that yeast; this does not make seborrheic dermatitis the same as contagious scalp ringworm.
Choose your next guide
Sources & further reading
- American Academy of Dermatology: Seborrheic dermatitis: signs and symptoms.
- American Academy of Dermatology: Seborrheic dermatitis: causes and risk factors.
- British Association of Dermatologists: Seborrhoeic dermatitis patient information.
- NHS: Cradle cap.
- DermNet: Seborrhoeic dermatitis.
- American Academy of Dermatology: Seborrheic dermatitis: diagnosis and treatment.
- American Academy of Dermatology: Seborrheic dermatitis: self-care.
- DailyMed: Happy Cappy Drug Facts and ingredient label.
- DermNet: Tinea capitis.
- DermNet: Seborrhoeic keratosis.
- DermNet: Rosacea.
- NHS: Blepharitis.
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