This type of eczema can look different on dark skin, which may lead to inequalities in diagnosis and treatment.

The National Eczema Association reports that 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 it can appear on the skin in Black people.

In this article, we explore what seborrheic dermatitis is, how it may present in dark 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.

Experts have different opinions on the causes of seborrheic dermatitis. Some believe that microorganisms on the skin, along with fats and oils, and an individual’s risk of developing the condition are the main causes, not yeast overgrowth and increased oil production.

Others believe the factors that have been linked to seborrheic dermatitis include:

  • excessive oil production
  • hormonal changes
  • yeast overgrowth

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 dandruff flakes. However, Black people with seborrheic dermatitis may also notice additional symptoms of this condition that typically only present in people of color.

A 2019 scientific paper highlighted research indicating that 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 medium and dark 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 dark 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
  • hypopigmentation on the scalp in infants

Due to the differences in how seborrheic dermatitis can present on skin, 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 received a seborrheic dermatitis diagnosis, a healthcare professional will typically recommend a treatment plan that may include 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 often the first-line treatment to manage this chronic condition. At-home remedies can help reduce inflammation and other symptoms and may include:

  • Antifungal and anti-itch creams: Antifungal creams can help prevent the spread of microorganisms that contribute to seborrheic dermatitis. Anti-itch creams can help reduce itching caused by dermatitis lesions.
  • Hypoallergenic skincare products: Hypoallergenic skin care 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: Keratolytics, such as salicylic acid or lactic acid, can help reduce scaling on the skin.
  • Topical corticosteroids: Corticosteroids can help reduce inflammation during seborrheic dermatitis flare-ups.
  • Alternative therapy: Phototherapy, which includes procedures such as blue light or UV light therapy, may be a beneficial treatment option for skin conditions like seborrheic dermatitis.
  • Oral antifungal medications: Antifungal medications, including itraconazole, fluconazole, and terbinafine, can also help reduce inflammation.

Finding the right care for your condition and skin type

Seborrheic dermatitis is best treated by a healthcare professional who specializes in treating skin conditions, such as a dermatologist. However, not all dermatologists have experience treating seborrheic dermatitis in medium and dark skin.

Here are a few resources for finding healthcare professionals who specialize in treating people of color:

  • Hued and Vaseline’s “Find a Dermatologist” tool: Hued and Vaseline created a search tool to help connect people with dermatologists who are culturally educated.
  • Skin of Color Society’s “Find a Doctor” tool: The Skin of Color Society’s search database is aimed at connecting people with skin care specialists who are trained in treating skin conditions in people of color.
  • American Academy of Dermatology Association’s “Find a Dermatologist” Tool: The American Academy of Dermatology Association’s search tool contains a huge database of information on dermatologists all around the country and their specialized services.

Although medical treatment options for seborrheic dermatitis can help keep symptoms well managed, lifestyle changes are important to help limit your exposure to potential triggers and reduce flare-ups. Below are 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 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 use available resources to find the right care for you.

If you have received a seborrheic dermatitis diagnosis, reach out to a qualified dermatologist in your area to create a personalized treatment plan. Doing so can help you manage your symptoms and reduce flare-ups.