Seborrheic Dermatitis: Diagnosis and Treatment

LeFevre, Nicholas M. MD, MSAM
Braudis, Kara MD
Feigenbaum, Lawrence S. MD

Author Information

NICHOLAS M. LEFEVRE, MD, MSAM, FAAFP, is an associate professor in the Department of Family Medicine at the University of Missouri Columbia School of Medicine, Columbia.

KARA BRAUDIS, MD, FAAD, is an associate professor in the Department of Dermatology at the University of Missouri Columbia School of Medicine, Columbia.

LAWRENCE S. FEIGENBAUM, MD, FAAD is a dermatologist at Mid-County Dermatology in St. Louis, Missouri, and the president of the Missouri Dermatological Society.

Author disclosure: No relevant financial relationships.

This article updates previous articles on this topic by Clark, et al.; Schwartz, et al.; and Johnson and Nunley.

Data Sources: PubMed was searched for systematic reviews, meta-analyses, and randomized controlled trials on the topic of seborrheic dermatitis since 2009. The search was restricted to infants (younger than 1 year of age), adolescents (13-18 years of age), adults (18-65 years of age), and older adults (65 years and older). The reference list of key articles was also reviewed for additional key citations. Two major dermatologic textbooks were reviewed, and additional citations were obtained from their reference list. The Cochrane database of systematic reviews was searched. Our search and review did not assess literature that evaluated diagnosis or treatment by specific race, gender, or ethnicity. We specifically sought literature evaluating diagnosis and treatment on skin of color, which is described in the cited literature as a visual (Fitzpatrick skin type) assessment rather than a social construct. Search dates: June 2024 and June 2025.

American Family Physician 112(2):p 166-173, August 2025.

Seborrheic dermatitis is a common, chronic relapsing skin condition that predominantly affects areas of the body that are rich in sebaceous glands. Clinically, seborrheic dermatitis presents as symmetric, poorly defined erythematous patches with yellow, oily scales and fine, superficial desquamation (flaking). In people who have darker skin, erythema may be less apparent, and postinflammatory pigmentary changes might be a presenting sign with hypopigmented, slightly scaly areas. Seborrheic dermatitis of the scalp can be effectively treated with topical over-the-counter antifungal shampoos and prescription-strength antifungal or corticosteroid solutions, foams, or oils. Thick, scaly areas can be treated with keratolytic shampoos and lotions. Seborrheic dermatitis of the face and body can be treated with over-the-counter and prescription-strength antifungal creams, over-the-counter and prescription-strength corticosteroid creams and ointments, and calcineurin inhibitor cream or ointment. Neonatal seborrheic dermatitis is common and typically self-resolves by 6 months of age. Mild cases of the scalp (cradle cap) may be treated conservatively with mineral oil to loosen scale and gentle combing. More severe cases may overlap with atopic dermatitis and can be treated with topical antifungals or topical corticosteroids.