Seborrhoeic dermatitis presents with red well defined areas covered with greasy scale, affecting mainly the scalp, face and upper trunk, and often the flexures. Aetiology is linked to a harmless yeast Pityrosporum ovale.
Cradle cap in young baby
Facial Seborrhoeic dermatitis in adult
Treatment of cradle cap
Use bath emollients regularly and sponge scalp clean.
Avoid paraffin ointments and olive oil is not recommended.
If red, use mild topical steroid for intermittent treatment.
Treatment of dandruff/adult scalp involvement
Regular use of shampoos containing zinc pyrithione, selenenium sulphide, ciclopirox, tar or ketoconazole. If very inflamed, intermittent use of potent topical steroid lotions/gels.
Treatment of mild disease
Regular use of emollients for dry flaky skin
Mild topical steroid to face e.g. hydrocortisone 1% ointment or topical anti fungal therapy alone or combined with mild steroid e.g. clotrimazole, miconazole or nystatin.
Mild to moderate topical steroid e.g. clobetasone ointment to trunk or flexures
Treatment of moderate disease
Potent topical steroid ointment to torso and limbs e.g. betamethasone ointment until signs of improvement, then consider frequency reduction or step down in potency
Mild to moderate potency topical steroid to face then reduce frequency or potency.
Criteria for referral
Severe or extensive disease unresponsive to appropriate treatment for 4-6 weeks