Seborrheic dermatitis is a skin condition characterized by discoloration and greasy scales on the skin. However, seborrheic dermatitis may appear differently on people with dark skin than on people with light skin.
Read on to learn more about seborrheic dermatitis, how it presents on dark skin, and how someone can treat it.
Seborrheic dermatitis is an inflammatory skin disorder that causes a person to develop a discolored, scaly rash on their skin. This rash occurs in areas that contain a lot of oil-producing glands. Areas that seborrheic dermatitis affects
- upper back
A form of seborrheic dermatitis that people call cradle cap can occur in infants. Cradle cap can develop on the scalp. The cradle cap rash is scaly and greasy but can become thick and crusty. With infants, seborrheic dermatitis also
Causes of seborrheic dermatitis
Experts do not yet know the exact cause of seborrheic dermatitis. However, researchers believe it may have a link to an inflammatory reaction to Malassezia yeast or a reaction to excessive amounts of the yeast.
Malassezia yeast is a normally harmless fungus that occurs naturally on a person’s skin. If too much Malassezia yeast grows on a person’s skin, their immune system may react to it. This can result in inflammation of a person’s skin.
Certain conditions or outside factors can increase a person’s chances of developing seborrheic dermatitis, such as:
- increased sebaceous gland activity
- conditions that weaken the immune system, such as HIV
- Parkinson’s disease
- Alzheimer’s disease and dementia
- stress and lack of sleep
- cold, dry weather
- certain medications, including dopamine antagonists, psoralen, and lithium
Research from 2019 looked at a study of skin conditions among various ethnic groups. This study noted that seborrheic dermatitis was in the five most common skin conditions that doctors observe in skin of color individuals.
Although seborrheic dermatitis is commonly described as a red scaly rash, it can appear differently on dark skin. A person with dark skin who has seborrheic dermatitis may notice the previous symptoms, as well as symptoms such as:
- patches of hypopigmentation, which is the loss of skin color
- curved or petal-shaped lesions around the hairline or other areas of the face
- redness, flaking, and hypopigmentation in infants
A study from 2019 found that seborrheic dermatitis was common among Black females. Researchers also noted that excessive pomade and hair oil use could worsen seborrheic dermatitis symptoms. Infrequent use of shampoo could also worsen seborrheic dermatitis symptoms.
Receiving a diagnosis of seborrheic dermatitis can be difficult. It may be particularly distressing in skin of color due to the pigmentary changes that it can cause.
If a physician is unfamiliar with the different ways that seborrheic dermatitis can present in skin of color, they could make an incorrect diagnosis. This can lead to inequalities in the treatment of this condition.
Typically, a doctor will diagnose seborrheic dermatitis based on the location and appearance of the rash. If the doctor is unsure about the cause of a person’s rash, they may take a skin biopsy. This involves a healthcare professional taking a sample of a person’s tissue to test it.
Not all doctors will have experience diagnosing or treating seborrheic dermatitis in skin of color. Resources, such as the Skin of Color Society’s “Find a Doctor” tool, can help to connect people with doctors who have experience in treating skin issues in skin of color.
Once a person has been diagnosed with seborrheic dermatitis, they can begin treatment. There have been few studies on ideal treatments for seborrheic dermatitis on darker skin compared with white skin. Research from 2019 notes that, while certain treatments are the same, there are special therapeutic considerations regarding skin of color.
Research from 2015 lists the following as over-the-counter remedies for seborrheic dermatitis:
- coal tar shampoo to reduce inflammation and itching
- tea tree oil shampoo, which has antifungal properties
- antifungal creams
Mineral oil or petroleum jelly can help loosen scales in infants. According to the National Eczema Association, this is usually enough to treat the condition.
Antidandruff shampoos can also prove useful when treating seborrheic dermatitis. However, some antidandruff shampoos can be drying when used on Black hair. This is especially true for people who use heat or chemical relaxers on their hair.
Researchers from 2019 found that Black people preferred to use ointment or oil preparations to treat their seborrheic dermatitis.
Creams, lotions, or shampoos that contain antifungals can also help treat seborrheic dermatitis. These antifungals include:
- selenium sulfide
- zinc pyrithione
While ketoconazole can be a very effective treatment for seborrheic dermatitis, it can sometimes be more drying to the hair of Black people. Using a deep conditioner can be helpful, and treatment should focus on the scalp rather than the hair. Researchers in one 2014 study found that ketoconazole foam was preferable for use on Black hair.
If a person’s seborrheic dermatitis does not clear up with home treatments, they can talk with a doctor about prescription medication. Medical treatments for seborrheic dermatitis include:
- topical corticosteroids, a steroid applied to the skin to treat inflammation
- topical immunomodulators, which are ointments used to regulate the immune response of the skin
- phototherapy, which uses artificial light
- oral antifungal drugs
Certain lifestyle changes can help people reduce their chances of a seborrheic dermatitis flare-up. These changes include:
- washing hair frequently to reduce the buildup of product in the scalp
- reducing the use of pomades or hair oils to the scalp
- applying hair emollients to the hair shaft only
- keeping track of triggers that cause flare-ups and avoiding them
- trying to reduce stress levels
- avoiding cold, dry weather
Some research has noted that hair extensions may play a part in the development of seborrheic dermatitis. However, the authors note that further research is necessary to confirm this.
Seborrheic dermatitis is a condition that commonly presents as a discolored, scaly rash.
However, Black people and other individuals with dark skin may notice additional symptoms, such as skin discoloration or curved-looking lesions along the hairline and on the face.
Due to differences in how seborrheic dermatitis presents on dark skin, it can be challenging for doctors with limited experience of skin of color to diagnose correctly. This can result in inequalities in the treatment of the condition. A person can look for healthcare professionals experienced in treating People of Color by using online search tools.
There are various home and medical treatments for seborrheic dermatitis. As some treatments can be drying to the hair of Black people, it is important to exercise care and consult with a physician familiar with treating seborrheic dermatitis in people of color.
A person can reduce their chances of a seborrheic dermatitis flare-up by making certain changes to daily habits. If a person has concerns that they might have seborrheic dermatitis, they should consult a doctor.