Dermatitis

What is dermatitis?

If you have seborrhoeic dermatitis, you get inflamed or flaky skin. The inflamed skin is usually on parts of your body that have hair, or where there are folds or creases in your skin. These are the areas of skin with lots of sebaceous glands. These glands make oil to lubricate your skin.

Some types of yeast grow naturally on oily parts of the body. It might be that some people's immune systems are particularly sensitive to yeasts, and this may play a part in causing seborrhoeic dermatitis. Your immune system is your body’s defence against infection. If your immune system over-reacts to something, it can cause irritation.

What are the symptoms?

The main symptom of seborrhoeic dermatitis is irritated or flaky skin. The flakes may be greasy, and are often white or yellowish. Irritated patches of skin look a bit like sunburn.

Dermatitis tends to affect the face and nose, especially between your nose and the corners of your mouth. It may also affect your eyebrows, ears, chest, armpits or groin. Dermatitis can affect your scalp and cause severe dandruff.

Skin affected by dermatitis may be itchy. Try not to scratch too much, as you could break the skin and cause an infection.

What treatments work?

Although seborrhoeic dermatitis isn't usually harmful, most people don't like the way it looks. Fortunately, treatment can help to control the symptoms.

Antifungal creams that you put on your skin can kill yeasts and help clear up dermatitis. One cream you can get on prescription is called ketoconazole. The brand name is Nizoral. You can also get a ketoconazole shampoo, which some doctors recommend using as a face wash if you have dermatitis on your face.

In one study, 6 in 10 people using ketoconazole found their dermatitis had cleared up after four weeks. Most people didn't get any side effects from ketoconazole. Occasionally, people find that it irritates their skin. There's a bigger risk of getting skin irritation with ketoconazole creams if you've recently used a steroid treatment on your skin. Try not to get ketoconazole treatments in your eyes.

For more severe dermatitis, your doctor may suggest a steroid cream or ointment, usually as well as an antifungal treatment. One example of a steroid is hydrocortisone cream. Your doctor can prescribe this in combination with an antifungal cream called miconazole. The brand name for this combination is Daktacort. Another steroid cream is betamethasone (brand name Betnovate).

There hasn't been any good-quality research looking at whether steroids help people with seborrhoeic dermatitis. But steroids are a common treatment for skin inflammation, and doctors think they can help. Steroids do have side effects, but using a steroid cream for a short time shouldn't cause serious problems. Possible side effects include thinning of your skin, slight changes of skin colour and spots. If you're using a steroid cream on your face, make sure you keep it out of your eyes.

If your dermatitis is widespread and creams don’t work, your doctor may suggest antifungal tablets. These are usually prescribed by a specialist. Possible side effects include feeling sick or getting stomach pain. Antifungal tablets aren't suitable for everyone. For example, you may not be able to take them if you have liver problems, as in rare cases antifungal tablets can damage your liver.

Creams that calm down your immune system, called tacrolimus and pimecrolimus, aim to reduce the inflammation in your skin. Specialists sometimes recommend these treatments for dermatitis, but only as a last resort, since they may have serious side effects. In the long term, doctors are worried that tacrolimus or pimecrolimus could increase your risk of skin cancer, but there's not enough research to know for certain.

Some people find that simple moisturisers can soothe dry or itchy skin. You're probably familiar with common brands like Vaseline or E45. If ordinary bath products, such as soap, dry or irritate your skin, you may find that moisturising alternatives are better.

What will happen to me?

For many people, seborrhoeic dermatitis comes and goes over time. Treatment can help, but you might need to have more treatment from time to time. Some treatments can be used regularly, to help stop dermatitis coming back. Ask your doctor or pharmacist how often you should be using your treatment.

Some people find dermatitis gets worse when they're feeling stressed or not sleeping properly. Dermatitis can get worse in winter and start to clear up in the summer, possibly because getting more sunlight helps.