Seborrheic Dermatitis

Patients may report chronic, flaky, and itchy patches on the scalp, face, or chest, often worse in cold weather or stressful periods. They might have a history of oily skin and frequent dandruff. The distribution of lesions is the most important clinical feature of SD, with lesions occurring in areas where the skin is rich in sebaceous glands, especially on the scalp and face. It may present in one or more locations, with less scaling on flexural surfaces, and with lesions whose margins tend to be poorly defined.

Examine for erythematous, greasy, scaly patches on areas with high sebaceous glands—commonly the scalp, forehead, eyebrows, and chest. In Black patients, scaling may appear white or yellowish. 

Topical Antifungals (e.g., Ketoconazole 2% cream): Apply once or twice daily for 2-4 weeks.

Anti-inflammatory Shampoos (e.g., Selenium sulfide 2.5%): Use twice weekly on the scalp.

Topical Steroids (e.g., Hydrocortisone 1%): Short-term use on affected areas twice daily if inflammation is severe.