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Seborrheic Dermatitis

Itchy Scalp, Atlanta | Dermatology Specialists of AtlantaSeborrheic Dermatitis is a common disorder that often affects the scalp. Researchers believe it’s caused when the body produces too much oil. Malessizia, a type of yeast, causes the skin to become irritated. Infants may have a form of the condition that’s known as “cradle cap.” A board-certified dermatologist should be enlisted to diagnose the condition because it’s frequently mistaken for other skin conditions, including psoriasis, seborrheic folliculitis, or eczema. Dermatology Specialists of Atlanta evaluates and recommends treatment options after diagnosis.

According to Harvard University School of Medicine, recurrent, superficial or chronic forms can present as an itchy, inflammatory rash on eyebrows, face, or any part of the hair-covered skin area. About three to five percent of the U.S. population experiences the condition. Genetics may play a role in developing the symptoms. Some factors create predisposition, including stress, Parkinson’s Disease, and immune deficiency conditions, e.g. HIV/AIDS.

Triggers and Immune Response

In addition, taking some medicines, including trioxsalen, Auranofin, buspirone, cimetidine, griseofulvin, interferon-alpha, psoralen, thiothixene, aurothioglucose, chlorpromazine, methyldopa, ethionamide, stanozolol, and lithium can trigger the condition. Researchers note an immune system relationship to the condition: Helper T Cells, antibody titers, phytohemagglutinin, and concanavalin differ from healthy control individuals. Dermatology Specialists of Atlanta will take a complete patient history to determine the factors related to the disease.

It’s important to bring a complete list of all medicines (or simply bring along medicine bottles or blister packs), including over-the-counter, vitamins, herbs or nutraceuticals, to the appointment, because drugs can stimulate the development of the condition.

Other Factors

Malessizia may play a role the suppression of T-cells. Demodex folliculorum, a mite, is also implicated in the disease. Patients with cradle cap in infancy have a stronger likelihood of developing acne in their teen years. Some patients develop the condition in response to taking some medicines prescribed for acne.


Physical examination and genetic predisposition to the condition are usually sufficient to confirm diagnosis. The patient may have episodes or flares which cause itchy, burning, or scaling of the scalp. Some patients experience more episodes during winter or spring months.

Infants may present with both cradle cap and associated erythema along with diaper rash. The condition may first present in the first month of life and may spontaneously resolve by eight to twelve months of age.

Adults present with inflamed, scaly, oily symmetrical scaly lesions in patches of the scalp. Plaques present but are rare. It may appear in folds of the skin or spread from the scalp to the patient’s forehead, posterior portion of the neck, or post auricular tissues, similar to psoriasis. The condition also commonly presents in patient’s nasolabial folds, eyebrows, margins of the eyelids, retroauricular folds, ears, mid to upper back, buttocks crease, genitals, under the arms, sternum, or inguinal areas. Dark-skinned patients may exhibit hypopigmentation areas as a result of the condition. Secondary infections, including oozing or crusting eczematoid dermatitis, may result. Seborrheic blepharitis of the eyes and eyelids may occur with or without seborrheic dermatitis.

Dermatology Specialists of Atlanta may rarely perform a biopsy in certain situations, including petechia (broken capillaries causing small red spots under the skin), Langerhans cell histiocytosis (LCH), resistance to previous treatments, hair loss, or pustules in the skin. Dr. Kathleen J. Smith may request a culture to confirm the presence of fungal infection.


Patients with cradle cap are normally sent home with prescription tar or ketokonazole shampoos.

Adults may benefit from topical ketakonazole foam/shampoo used to clear, then maintain, the patient’s condition. Topical corticosteroids or lithium succinate are sometimes prescribed. A second line of treatment may include calcineuric inhibitors or systemic fungal therapies. These are strong medicines. Use of anti-fungal medicines requires simultaneous monitor of the patient’s liver health as recommended. Most patients are free of symptoms within one to months of treatment.

Once the patient’s condition is considered controlled, Dr. Kathleen J. Smith may prescribe treatment products, e.g. shampoos, soaps, lotions, or creams to maintain clear skin. Daily shampooing and cleansing may help to keep some patients symptom-free.

Since recurrence of the condition is possible or likely in adults, follow-up appointments and additional treatments may be recommended.


Sebhorreic Dermatitis is a treatable skin condition in adults. Patients with concerns about the condition don’t need to suffer embarrassment. Dermatology Specialists of Atlanta welcomes patients in the greater Atlanta metro area, including Decatur, North Decatur, Gresham Park, North Atlanta, Tucker, Chamblee, East Point, and Forest Park, GA, to make an appointment with Dr. Kathleen J. Smith today at 678-904-4932.

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