Seborrheic Dermatitis on the Face: What It Is, What It Looks Like, and Where It Comes From

Flaking on the sides of the nose and eyebrows is rarely perceived as a disease: it seems that the skin has simply dried out. Seborrheic dermatitis on the face looks exactly like this, but it is an inflammatory skin condition that has its own mechanics, typical areas, and limits of control. Below is what is known about the causes, appearance, and diagnosis of this condition.

What seborrheic dermatitis and seborrhea on the face are

Seborrheic dermatitis is a common inflammatory skin disease. It produces scales ranging from white to yellowish in areas with many sebaceous glands: on the scalp, on the face, and in the external ear. The rash may or may not be accompanied by redness.

In everyday usage, the word "seborrhea" is associated with oily skin; seborrheic dermatitis itself is an inflammatory condition that occurs where the skin is oily.

The course is chronic: the condition comes in waves and goes away, it cannot be eliminated completely, but it can be controlled. Dandruff, which belongs to the same group of conditions, is not contagious.

What seborrheic dermatitis looks like: typical areas on the face

The classic sites are the eyebrows, eyelids, folds near the nose, skin around the lips, the area behind the ears, and the external auditory canal. Outside the face, they are the scalp and the middle of the chest.

The picture is recognizable: white scales that flake off, or yellowish, greasy, and sticky ones; plaques, sometimes over a large area; areas of skin that feel greasy; mild redness; itching that intensifies if an infection is added.

Possible causes and factors that trigger flare-ups

The exact cause is unknown. A combination of factors is discussed: the activity of sebaceous glands, Malassezia yeasts that live on the skin and gravitate toward areas with a large number of sebaceous glands, changes in the skin's barrier function, and heredity.

Flare-ups are associated with stress and fatigue, sudden weather changes, oily skin and acne, heavy alcohol use and alcohol-based lotions, obesity, diseases of the nervous system — including Parkinson's disease, traumatic brain injury, and stroke — as well as HIV/AIDS.

Poor hygiene does not cause dermatitis, although with infrequent hair washing the scales are more visible. Cold and stress make the picture more pronounced; in some people, the skin looks calmer in summer and after time in the sun.

How seborrheic dermatitis differs from other skin diseases

The conditions are distinguished by the type of scales, localization, and additional signs. Seborrheic dermatitis — greasy yellowish scales in "sebaceous" areas. Ringworm — a red or silvery rash on the head, sometimes with patchy hair loss. Eczema — dry, red, very itchy skin. Contact dermatitis — a reaction to dyes, sprays, gels, sometimes with blisters and cracks. Psoriasis — red, scaly, painful lesions with silvery scales. In infants, greasy yellowish crusts on the head, eyebrows, and diaper area are called cradle cap.

How the doctor makes the diagnosis

The diagnosis is based on the appearance and localization of the lesions. Additional examinations, including a skin biopsy, are rarely needed. The doctor examines the skin of the scalp and face and checks whether there is another condition with a similar picture.

When to see a dermatologist

The reason for a visit is not the flaking itself but how it behaves.

• symptoms persist after an anti-dandruff product that you used for at least 4 weeks;
• there are many scales, and the scalp or face is very itchy;
• the skin is red or swollen;
• scaly itchy spots have appeared on the face and other parts of the body;
• the lesions ooze, discharge pus or fluid, become covered with crusts, and have become very red and painful.

The condition also has a second line of consequences: psychological discomfort, reduced self-esteem, embarrassment. The addition of a secondary bacterial or fungal infection is also a real risk, and it is precisely this that turns a cosmetic complaint into a medical one.

Seborrheic dermatitis by itself is not a reason to call an ambulance. 103/112 — for a life-threatening condition, for example loss of consciousness, difficulty breathing, or severe chest pain; for oozing lesions, pus, and crusts, you should see a doctor in the usual manner.

This material is for reference: it explains the logic of the condition but does not replace a consultation with a doctor who sees your skin.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer