What is the difference between Eczema and Seborrheic Dermatitis?

Often when people get itchy rashes, they wonder if it’s Seborrheic Dermatitis or perhaps eczema. Although, both these are chronic skin conditions that usually relapse even after effective treatment, they differ from each other greatly.

What is the difference between Eczema and Seborrheic Dermatitis?

Associate program director and assistant professor of dermatology at the University of Texas Medical Branch-Austin, Mr. Jason S. Reichenberg says, “They’re both a kind of dermatitis”. And for this reason, it’s natural for people with eczema (also known as atopic dermatitis) to be confused with seborrheic dermatitis.

In several cases, it’s also possible for people to get affected by both eczema and seborrheic dermatitis simultaneously. Jason further says, “Essentially, there’s enough overlap that it’s possible that many people have both”. And even it is possible that there’s one fundamental condition manifesting itself in two different ways, i.e. showing the symptom of both the skin conditions.


According to the American Academy of Dermatology, about 10 to 20 percent of people are affected by atopic dermatitis. It is a medical condition in which skin patches become rough and inflamed with blisters causing itching and bleeding.

Symptoms – This skin condition usually involves a dry, itchy rash on the hands, feet, face, inside of the elbows, and behind the knees.

Treating Eczema – First and good step for treating eczema is to try hydrocortisone cream, an over-the-counter cream. According to a 2005 study published in the N EJM about 80 percent of people reported good, excellent, or clear improvement when taking topical corticosteroids like hydrocortisone for treating eczema. Many a times, skin specialists may also prescribe a non-steroidal ointment such as the immunosuppressive medications Elidel or Protopic (tacrolimus).

Seborrheic Dermatitis

About 5 percent of the U.S. population currently has Seborrheic dermatitis, which is also referred to as “cradle cap” or “dandruff”.

Symptoms – It typically results in flaky, white or yellowish scales that form on oily parts of the body, such as the scalp, the inside of the external ear, or on the eyebrows, eyelids, creases of the nose, the lips, or along skin folds near the middle of the body. Often, infants (3 months old) and youngers get crusty yellow or brown scales on their scalp. It is believed that, “This inflammatory condition results from a “hypersensitivity to a yeast that likes larger oil glands,” explains Joseph Jorizzo, professor of dermatology and founding chair of dermatology at Wake Forest University

Treatment – Cure for seborrheic dermatitis is different than that of eczema. An antifungal solution is probably the best treatment. A shampoo called Nizoral or ketoconazole, as well as creams, gels, foams, or shampoos that contain other antifungal ingredients are also considered as the best bet because they kill fungi, including yeasts. Applying these solutions on the affected scalp area, corner of the nose, ears and the chest can help manage the ailment. If all these fail, doctors recommend using hydrocortisone to treat Seborrheic Dermatitis in these areas.

For patients with seborrheic dermatitis, using antifungal solutions regularly on problem areas is highly recommended because this will prevent you. The extent and duration of using antifungal products can vary from daily to once or twice a week. Eczema generally doesn’t respond to the antifungal solutions that can help combat seborrheic dermatitis. Also, since it can cause thinning of the skin and excessive hair growth, you should use a hydrocortisone ointment or cream cautiously for an extended time, particularly at prescription-strength dosages.

However, at-home treatments aren’t working well, there are many other safe options. While primary-care doctors may handle your case, they may also sometimes refer you to a dermatologist. They may prescribe you stronger hydrocortisone creams or solutions, or may prescribe Protopic or Elidel that can be used to help treat both the skin conditions. Since, these steroid-free medications contain antifungal and anti-inflammatory properties, these can help tame both conditions. However, it is important to consider here that these medicines should be used for short-term treatment only. These have warnings on their labels saying that long-term safety is unknown and that a fewer section of people who took the medicines developed skin cancer.

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