How Is Seborrheic Dermatitis Diagnosed and Treated in Black People? - Healthline

According to the National Eczema Association, eczema affects roughly 31.6 million people in the United States. Eczema is an umbrella term for multiple skin conditions, such as atopic dermatitis or contact dermatitis, that are characterized by itchy, inflamed skin. Seborrheic dermatitis is a type of chronic eczema that has a very distinct presentation — especially in the way that it can appear on the skin in Black people.

In this article, we'll explore what seborrheic dermatitis is, how it may present in Brown and Black skin, and how to treat and manage this chronic skin condition.

Seborrheic dermatitis is a type of eczema that causes skin redness, scaly patches of skin, and dandruff. In infants, seborrheic dermatitis is known as cradle or crib cap and causes oily or crusty patches of skin on the infant's scalp.

Seborrheic dermatitis is believed to be caused by a variety of factors, such as:

• excessive oil production
• hormonal changes
• yeast overgrowth
• allergic reactions

It often appears in areas where the skin is oilier, such as the:

• Scalp and hairline: in the form of dandruff or thick, crusty patches of skin
• Face: on the eyelashes, eyebrows, facial hair, forehead, ears, and facial and neck folds
• Torso: on the abdomen, back, armpits, breasts, groin, and genitals

Generally, in all skin types, seborrheic dermatitis causes red and inflamed skin, which is often covered with greasy, scaly "patches" or flakes of "dandruff". However, Black people with seborrheic dermatitis may also notice additional symptoms of this condition that typically only present in people of color.

According to 2019 research, seborrheic dermatitis was found to be among the top diagnosed skin conditions in Black people, especially Black women. However, differences in the appearance of seborrheic dermatitis on black and brown skin can lead to inequalities in the diagnosis and treatment of this condition.

Although seborrheic dermatitis is commonly described as red, scaly, patchy skin, this condition can often appear differently on Black skin. In addition to the symptoms of seborrheic dermatitis mentioned above, in Black people or other people of color, this condition may also appear as:

• hypopigmentation, or lightening of the skin
• curved or petal-like lesions along the hairline
• flaking or hypopigmentation on the scalp in infants

Due to the differences in how seborrheic dermatitis can present itself, it can sometimes be more difficult for Black people and other people of color to receive an accurate diagnosis for this condition.

If you have noticed patches of red, inflamed, or scaly skin, areas of hypopigmentation, or excess flaking, talk with a healthcare professional to see if you may have seborrheic dermatitis.

If you have been diagnosed with seborrheic dermatitis, it can be treated with both at-home remedies and medical treatments, depending on the severity of your condition.

At-home remedies

Although medical treatments are available for seborrheic dermatitis, at-home remedies are usually the first line of treatment to manage this chronic condition. At-home treatments can help reduce inflammation and other symptoms, and may include:

• Antifungal and anti-itch creams. Antifungal creams can help prevent the spread of micro-organisms that contribute to seborrheic dermatitis. Anti-itch creams can help reduce itching caused by dermatitis lesions.
• Hypoallergenic skincare products. Hypoallergenic skincare products, such as soaps and lotions, can help reduce irritation from harsh chemicals that are often found in traditional skincare products.
• Dandruff shampoos. Certain shampoo formulations may help reduce mild cases of seborrheic dermatitis on the scalp and can be used on a weekly basis for lesions on the scalp and hairline.
• Modified hygiene techniques. Making certain changes such as shaving the facial hair, wearing loose clothes, and rinsing off the skin thoroughly can help reduce skin irritation and symptoms.

In infants with cradle cap, daily, gentle washing of the scalp can help soften the scaly patches so that they can be brushed or combed away.

Medical treatments

When at-home remedies aren't enough, prescription-strength topical and oral medications can be used to reduce inflammation and other resistant symptoms. Available medications for seborrheic dermatitis include:

• Topical keratolytics and corticosteroids. Keratolytics, such as salicylic acid or lactic acid, can help reduce scaling on the skin. Corticosteroids can help reduce inflammation during seborrheic dermatitis flare-ups.
• Oral antibiotics or acne medications. Antibiotics and acne medications are generally only prescribed when at-home remedies don't work. Both types of medications can help treat seborrheic dermatitis at the source, rather than just addressing the symptoms.
• Experimental procedures. Phototherapy, which includes procedures such as blue light or UV light therapy, may be a beneficial treatment option for skin conditions like seborrheic dermatitis.

Although medical treatment options for seborrheic dermatitis can help keep symptoms under control, lifestyle changes are important to help limit your exposure to potential triggers and reduce flare-ups. Below, we've outlined some tips for keeping your skin happy and healthy while reducing the recurrence of flare-ups:

• Reduce your stress levels. Stress can be a trigger for people with skin conditions like seborrheic dermatitis, so managing your stress levels may help lower your risk of a flare-up.
• Protect your skin in harsh weather. Cold, dry, or otherwise harsh weather can irritate your skin and lead to a flare-up. It's important to keep your skin protected in this type of weather, such as with a high-SPF sunscreen and appropriate clothing for the season.
• Pay attention to changes in your body. Changes that occur in the body due to hormones or infections may be a potential trigger for a seborrheic dermatitis flare-up.
• Keep track of your triggers. Triggers can vary from person to person with seborrheic dermatitis, so it's important to know your own triggers and avoid them to reduce future flare-ups.
• Follow your treatment plan. Creating a treatment plan with your dermatologist can help you understand what steps to take to not only avoid a flare-up but also treat one when it happens.

While seborrheic dermatitis can affect all skin types, the lesions associated with this condition can sometimes have unique symptoms in Black people and people of color. Not all dermatologists have experience in treating skin conditions in people of color, so it is important to utilize resources to find the right care for you.

If you have been diagnosed with seborrheic dermatitis, reach out to a qualified dermatologist in your area to create a personalized treatment plan. This can help you manage your symptoms and reduce flare-ups.

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