Adult seborrheic dermatitis: a status report on practical topical management

Abstract

Seborrheic dermatitis is a common chronic-recurrent inflammatory disorder that most commonly affects adults; however, a more transient infantile form also occurs. The definitive cause of seborrheic dermatitis is unknown. However, proliferation of Malassezia species has been described as a contributing factor. The adult form of seborrheic dermatitis affects up to approximately five percent of the general population. The disorder commonly affects the scalp, face, and periauricular region, with the central chest, axillae, and genital region also involved in some cases. Pruritus is not always present and is relatively common, especially with scalp disease. A variety of treatments are available including topical corticosteroids, topical antifungal agents, topical calcineurin inhibitors, and more recently, a nonsteroidal "device "cream. This article reviews the practical topical management of seborrheic dermatitis in the United States, focusing on the adult population.

Figure 1

Seborrheic dermatitis of the anterior hairline characterized by pink erythema and fine scaling in a 68-year-old Caucasian man

Figure 2

Seborrheic dermatitis of the melolabial fold characterized by pink erythema and fine scaling in a 68-year-old Caucasian man

Figure 3

Severe scalp scaling (dandruff) associated with continued shedding of scalp flakes, which fall on dark clothing and are readily visible

Figure 4

Discoid, waxy, fine, scaly plaques of “medallion” seborrheic dermatitis on the face of a 50-year-old Filipino woman