Lloydspharmacy.com Health - Seborrhoeic eczema

Reviewed by Dr Victoria Lewis, specialist registrar in dermatology

General

Seborrhoeic eczema has little or nothing to do with sebum (the oily secretion of the sweat glands), so the name is a poor one. The name persists partly because some of the areas affected (eg the groins and armpits) are also where there are greater concentrations of sweat glands within the skin.

It is a well recognised pattern of eczema affecting all age groups from young adults to the elderly. A type of seborrhoeic eczema is also seen in babies during the first year of life.

Appearance and symptoms

Four common patterns are seen.

Scalp and face: skin is greasy, red and scaly. Affects the central face and forehead, the sides of the nose down to the outer ends of the mouth, the edges of the scalp, eyebrows and behind the ears. The scalp is very scaly (dandruff).
Front of chest: a red scaly patch over the breast bone.
Back of trunk: multiple red raised dots across and between the backs of the shoulder blades.
Skin folds: a moist red skin reaction in the groins, under the breasts and in the armpits. In childhood seborrhoeic eczema the skin folds are most affected, but there can be a yellowish scaly crust on the scalp, too (known as cradle cap).

The condition varies in severity. A mild case would be a little bit of dandruff and flaky skin over the face. In severe cases, the skin is widely affected and very itchy; the scalp is itchy, oily and, if very inflamed, there is much scaling of the scalp skin.

Causes

Skin infection by yeast called Pityrosporum is thought to play a part in seborrhoeic eczema. Anti-yeast treatment can therefore be effective, although it usually needs to be repeated periodically.

Treatments

Scalp

Medicated shampoos containing anti-yeast medication may keep mild activity under control. If there is a lot of scaling, additional treatments such as sulphur and salicylic acid cream followed by selenium shampoo or coal tar preparations can be needed.

Face, trunk and skin folds

A mixture of anti-fungal cream and mild steroid (1% hydrocortisone) is the usual regime for flare-ups. This is used for approximately two weeks at a time. Washing your face and body twice a week in the shower with the medicated shampoos listed above helps to prevent relapse.

Children

The main treatments for infants are emollient creams, but mild steroid and/or antifungal creams may be needed.

Cradle cap can be loosened with a mixture of salicylic acid in aqueous cream, which is then washed out with baby shampoo.

Oils such as olive or arachis are also long-standing remedies for de-scaling cradle cap.

Other types of eczema

Based on a text by Dr Dan Rutherford, GP

Last updated 15.09.2005