Why Your Dermatologist Might Miss Your Seb Derm (Especially If You Have Dark Skin)

Picture this: you’ve showered, toweled off, and started applying your go-to body lotion when you notice a particularly dry area of skin. Now imagine finding a thick, flaky patch at your hairline. The two may seem completely different. After all, the skin on your body differs from the skin on your scalp. But with seborrheic dermatitis and melanated skin, things aren’t so simple.

Deeper skin tones vary in shade and complexity, which can make skin issues especially challenging. Seborrheic dermatitis is one of the most common types of eczema and is more prevalent in Black and brown skin. Still, it can feel like a mystery, and not just because of the various symptoms or where it occurs on the body. The biggest issue is how it shows up on the skin. From tiny bumps to widespread rashes, flaky patches to redness, seborrheic dermatitis looks drastically different depending on your skin tone.

The disconnect runs deep. When a flare-up occurs, people are often left guessing or turning to the internet or social media. While we’re not disputing that the web is a gold mine for nail looks and eyeshadow trends, it’s not the ideal source for dermatological advice. To help you understand seborrheic dermatitis more deeply, we tapped two experts who specialize in the issue. Keep reading to learn why seborrheic dermatitis appears differently and what to look for at home.

What Causes Seborrheic Dermatitis

Seborrheic dermatitis is a type of eczema that causes various skin reactions. It’s non-contagious, but it’s also a chronic, relapsing inflammatory skin condition that can be caused by many factors. One of the most common causes is an overgrowth of a naturally occurring yeast called Malassezia. It’s essentially your skin’s inflammatory reaction and can occur in many places, such as the scalp, chest, face, arms, and legs. As Dr. Kseniya Kobets, director of cosmetic dermatology at Montefiore Einstein Advanced Care, notes, not everyone’s immune system reacts the same way.

​The condition affects all types of people, but Kobets tells Nylon, "It's clear that skin tone influences how it looks and how easily we recognize it." She also explains that this is why some people have barely noticeable reactions, while others develop more intense symptoms.

Seborrheic Dermatitis & Dark Skin

Seborrheic dermatitis shows up differently on deeper complexions due to pigmentation. While redness is common in fair complexions, Kobets says darker skin tones are more likely to notice lighter patches or unevenness first. “More melanin can make the underlying redness harder to appreciate, while inflammation can temporarily interfere with normal pigmentation, leaving lighter patches or, in some people, darker marks,” she says.

If you’ve ever experienced seborrheic dermatitis, whether as a teenager or as an adult, you know where the confusion settles in. Sometimes, an area can appear dry and ashy, prompting you to slather on another layer of moisturizer. But that may not be the best solution. According to Kobets, oily skin can look dry and ashy when affected by seborrheic dermatitis. “Inflammation from the condition can change pigment production, and that uneven color can outlast the rash, causing the area underneath to look lighter than the surrounding skin,” she says.

Location also plays a big role in how seborrheic dermatitis looks. Chicago-based dermatologist Morayo Adisa, M.D., FAAD, explains that the condition is most common in areas with oil glands, such as the scalp, eyebrows, and underarms. It can also show up on drier areas like the chest and forearms.

Key Symptoms To Look For

“The classic features include discoloration, either red or variably dark-colored, an itchy, scaly rash, or flaky, greasy patches of skin,” says Adisa. But those aren’t the only culprits. Kobets adds that the condition can also appear in distinct patterns. “Curved or ringlike patches often come together to form a petal shape on the skin,” she says.

Beyond flower-like patterns, you should also track where the changes occur. Flaking that keeps returning or an irritated scalp can signal that something might be off. Document the occurrences on your phone to monitor the situation. Ask questions like: Does the area become itchy or flaky first? Is there a color change? Or, if you have new patches, are they irritated?

This kind of detail will help your dermatologist make a diagnosis. Because seborrheic dermatitis can look like other skin conditions, experts agree that seeing a board-certified professional is crucial to determining next steps.

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