I Have Seborrheic Dermatitis and This Is How Derms Suggest Treating It

During an especially chaotic time in my life, my skin started to change. I didn’t know it then, but the stubborn, flaky rash that had set up camp around my eyebrows was seborrheic dermatitis. I initially brushed it off as a simple case of dry skin. After all, I had just moved to Chicago and was experiencing its harsh winters for the first time. I slathered it with Vaseline and Aquaphor—only to have the irritation spread to my scalp, chin, and underarms.

It was painful and beyond frustrating. My underarms felt like they were on fire every time I’d put on deodorant. My face was flaky and cracking and no amount of moisturizer could soothe it.

At this point, I thought my rash could be psoriasis. I got that diagnosis from TikTok. It was short-lived because I decided to visit my dermatologist. I wasn’t about to rely on my FYP for my treatment options.

Within seconds, he identified my issue as seborrheic dermatitis. I’d never heard of it until then, but it turns out that the condition is pretty common. According to a 2020 study, anywhere from 3 to 10 out of 100 people experience it at some point. So why was this the first time I’d heard of it? Ahead, experts weigh in on my elusive diagnosis.

• Nina Desai, MD, is a board-certified medical and cosmetic dermatologist in Manhattan Beach, California.
• Dina Elrashidy, MD, is a board-certified dermatologist in Chicago.
• Roopal V. Kundu, MD, is a board-certified dermatologist and founding director of the Northwestern Center for Ethnic Skin and Hair in Chicago.
• Mona Gohara, MD, is a board-certified dermatologist in Hamden, Connecticut.
• Debra Jaliman, MD, is a board-certified dermatologist in New York City.

• What exactly is seborrheic dermatitis?
• What triggers seborrheic dermatitis?
• How do I know if I have seborrheic dermatitis?
• How to treat seborrheic dermatitis
• What products should I avoid?
• Is seborrheic dermatitis curable?

Seborrheic dermatitis is the inflammation of skin caused by an overgrowth of malassezia, a yeast naturally present on the skin, explains Nina Desai, MD, a board-certified dermatologist in Manhattan Beach, California. You might recognize it as dandruff if it’s on your scalp, but it can extend across your face and body, specifically in areas with sebaceous (oil-producing) glands like your upper back, the sides of your nose, and your eyebrows.

It can also be accompanied by scaliness, redness, or greasy patches on your skin. How it manifests is largely based on your skin type, texture, and pigmentation, says Dina Elrashidy, MD, a board-certified dermatologist in Chicago. If you have a lighter skin tone, seborrheic dermatitis on your face and body can look scaly and slightly red. If you have darker skin, it might not appear as red, even if it’s just as inflamed, says Dr. Elrashidy.

Roopal V. Kundu, MD, a board-certified dermatologist in Chicago, adds that discoloration—slight hyper- or hypopigmentation—is also common among patients with deeper skin tones. She explains that Black individuals, who generally experience a more severe form of this condition, can also develop petal-shaped lesions. These ring-like patches often manifest as pink or hypopigmented rashes on the face, scalp, and hairline.

Seborrheic dermatitis has various triggers. Our experts highlight the following.

• Stress is a major trigger. “Malassezia tends to overgrow when the body is under some sort of stress,” Dr. Desai explains. That means anything from navigating a move to a new city to dealing with everyday pressures from your job could exacerbate your seborrheic dermatitis.
• Extreme temperatures and seasonal transitions can also cause flare-ups. Dr. Desai stresses the importance of being diligent with your hygiene if you’re in high heat, as sweat can worsen symptoms. While sweat isn’t inherently unhygienic, malassezia thrives in hot, moist conditions. When it builds up, it can cause flaking or itching.
• Harsh detergents and chemicals can provoke seborrheic dermatitis. This includes fragrance, sulfate-based shampoos, and harsh actives in facial skin-care products, says Mona Gohara, MD, a board-certified dermatologist in Hamden, Connecticut. (More on this later.)
• Severe cases have been associated with conditions like Parkinson’s and HIV, says Dr. Kundu. These occurrences are rare, but you should always consult with a board-certified dermatologist rather than self-diagnosing any new skin conditions

Truth be told, it’s hard to discern between seborrheic dermatitis and other skin conditions. It can look a lot like eczema (a.k.a., atopic dermatitis). “Seborrheic dermatitis is usually on the scalp and other hair-bearing areas such as the eyebrows, chest, groin, et cetera,” says Dr. Gohara. “Eczema, on the other hand, is generally very itchy and scaly and can appear on other parts of the body.” Seborrheic dermatitis may not itch but can still feel painful or uncomfortable. It’s possible, unfortunately, to have both conditions, says Dr. Desai.

To get an accurate diagnosis, you will want to visit a dermatologist. The time you carve out to see one is well worth the stress the appointment will save you in the long run. Think about it: Misdiagnosing seborrheic dermatitis can make it worse and lead to even more stress as I experienced, which can mean more flare-ups and ultimately more trial and error. It’s a vicious cycle and one that likely can be skipped with an hour-long appointment.

You visited your dermatologist to confirm you have it, right? Great. With that out of the way, here are some expert-recommended strategies and over-the-counter remedies you can try at home.

For your scalp, the first line of defense should be anti-yeast or antifungal medications like ciclopirox or ketoconazole shampoo, which your dermatologist can prescribe at your appointment. “I usually tell my patients to wash their scalp with the prescription shampoo two to three times a week, leave the shampoo in for 5 to 10 minutes, and then follow it with their regular shampoo and conditioner,” Dr. Elrashidy says.

When shopping for over-the-counter shampoos, look for antifungal ingredients like zinc pyrithione and selenium sulfide to combat malassezia overgrowth. Dr. Elrashidy recommends DermaZinc Shampoo, which contains zinc pyrithione. I swear by my dermatologist’s recommendation, Selsun Blue Daily Care, for its potent combination of zinc pyrithione, selenium sulfide, and salicylic acid—the ultimate trifecta. Plus, it lathers beautifully without leaving my hair feeling too dry.

But avoid using prescription and over-the-counter dandruff shampoos simultaneously. “If you’re using the ciclopirox shampoo, you don’t want to also use Head & Shoulders because that’s going to be too drying on your scalp,” Dr. Elrashidy says.

Exfoliating ingredients like salicylic acid can also help remove scales, but it can’t be the primary treatment, says Dr. Gohara. She recommends Neutrogena T/Sal Scalp Build-Up Control Therapeutic Shampoo, which contains 3% salicylic acid and relieves flaking without irritation. Allure editors also like the Briogeo MegaStrength+ Dandruff Relief Shampoo, which can leave the scalp feeling squeaky clean. Senior editor Jesa Marie Calaor, who has seborrheic dermatitis, uses it when her scalp flares up and is extra flaky.

If you are prescribed a topical medication for facial seborrheic dermatitis, like ketoconazole or steroid cream, make sure to apply it to clean, dry skin before layering on other skin-care products. Dr. Elrashidy recommends keeping the rest of your regimen simple because too many products can interfere with your medication’s effectiveness and irritate your already sensitive skin. She suggests limiting your routine to just your prescriptions, cleanser, moisturizer, and an SPF every two hours. “When things aren’t flaring, then you could try other products, but I don’t think you need a 15-step skin-care regimen.”

First and foremost, resist the urge to grab just any steroid cream you might have in your medicine cabinet. You shouldn’t be using old prescriptions to treat your current skin condition. “We don’t want to do anything to thin the skin or promote acne,” Dr. Kundu says. Your dermatologist will prescribe a potency and the duration of use for any medication that’s specific to your needs, so it’s important to follow their treatment instructions.

While experts recommend salicylic acid for your scalp, Debra Jaliman, MD, a board-certified dermatologist in New York City, says to cut it from your facial product lineup, as it could be too irritating for your face. If exfoliation is necessary, she suggests opting for lactic acid, which is gentler.

She also recommends being careful not to overdo it with store-bought hydrocortisone even though it can provide temporary relief. “You can use it for a week or two, but it thins out your skin and breaks the blood vessels in your skin,” Dr. Jaliman says.

Like many other skin conditions, seborrheic dermatitis is not curable, but it’s manageable with a consistent skin-care regimen and proper hygiene. In addition, the dermatologists I spoke to say that lifestyle habits to alleviate stress can help prevent some flare-ups. Dr. Jaliman recommends deep breathwork practices and listening to soothing music. Dr. Desai says she wishes she could prescribe a vacation, but anything that brings you joy will help.

More on scalp health:

• The 19 Best Scalp Products for Soothing Dryness and Irritation
• Why You’re Suddenly Getting Dandruff for the First Time
• Why You Shouldn’t Take Hot Showers, According to Dermatologists