If you have seborrheic dermatitis and human immunodeficiency virus (HIV), you may wonder if there’s a link between the two conditions. Exploring this connection is crucial, as research indicates that seborrheic dermatitis affects about 35 percent of people with early HIV and 85 percent of people with acquired immunodeficiency syndrome (AIDS).

To get a clearer picture of this possible relationship, let’s start by defining each of these conditions. Seborrheic dermatitis is a common skin condition that can cause discoloration, flakiness, dandruff, and itchy skin, especially on the sebaceous glands — areas that produce oil, like your scalp and face. It’s a chronic, relapsing condition, meaning a person can live with the condition their entire life and their symptoms can come and go.

HIV is a lifelong condition that weakens the immune system, making it harder for the body to fight infections and cancers.

Both HIV and seborrheic dermatitis can affect the skin but through different mechanisms. Importantly, HIV can spread from person to person, while seborrheic dermatitis can’t.

In this article, we’ll learn more about HIV – what it is, how it spreads, and its symptoms. We’ll also explore the link between seborrheic dermatitis and HIV.

What Is HIV?

To understand how seborrheic dermatitis and HIV might be related, let’s start with the basics. The human immunodeficiency virus leads to HIV infection. The virus attacks the immune system (the part of your body that fights infections) by destroying CD4 cells. Also known as helper T cells, CD4 cells are a type of white blood cell that can recognize invaders in your body and guide other immune cells on how to fight them and keep the body healthy.

When your CD4 counts are low because of HIV, your body can’t defend against infections and illnesses well. In the final stage of HIV infection — called AIDS or HIV/AIDS — a person can develop life-threatening infections and cancers due to very low CD4 counts.

How HIV Spreads

HIV only spreads through certain body fluids, according to the Centers for Disease Control and Prevention (CDC). These include:

• Blood
• Semen
• Pre-seminal fluids
• Vaginal fluids
• Rectal fluids
• Breast milk

HIV can get into someone’s body when these fluids contact a mucous membrane (such as a person’s vagina, anus, or rectum), an open skin wound, or the bloodstream. The most common ways HIV spreads is through unprotected vaginal or anal sex and use of shared needles for drugs.

Less commonly, people can get HIV from their mother during pregnancy, birth, or breastfeeding, through oral sex, or from blood transfusions.

HIV does not spread through everyday interactions like hugging, kissing, sharing utensils, or shaking hands. The virus also cannot spread through the air, water, insect bites, or contact with objects like doorknobs or toilet seats.

HIV Symptoms

Some people with HIV infection might feel like they have the flu a few weeks after getting infected, while others won’t have any symptoms. Initial symptoms could include:

• Fever
• Fatigue
• Rash
• Chills
• Sore throat
• Muscle aches
• Night sweats
• Mouth sores
• Swollen lymph nodes

Having these symptoms doesn’t automatically mean you have HIV, as other illnesses can cause similar symptoms. The only way to know for sure is to get an HIV test, which may involve taking a blood sample from your vein, a finger prick, or a swab inside your mouth. You can get an HIV test at your primary care provider’s office, the health department, or a community clinic that offers walk-in testing for sexually transmitted infections (STIs).

Prevention and Treatment

Fortunately, HIV is preventable and treatable. Some of the ways to prevent it include:

• Using a new synthetic (latex or polyurethane) condom every time you have vaginal, anal, or oral sex
• Avoiding sharing used needles and injection equipment
• Taking HIV prevention medications, such as preexposure prophylaxis (PrEP), which are geared toward people who are at an ongoing high risk for HIV infection
• Practicing abstinence (not having sex)

Treatment for HIV is called antiretroviral therapy (ART). It involves taking medications that help a person stay healthy by reducing the amount of HIV in their body. There are many different types (classes) of ART medications, comprising more than 30 drugs.

When beginning HIV treatment, people usually take three medicines that come from at least two drug classes. Newer HIV drugs combine two, three, or four antiretroviral medications from different classes into one pill. Your doctor will work with you to determine the best course of treatment if you have HIV.

Is There a Connection Between HIV and Seborrheic Dermatitis?

Anyone can develop seborrheic dermatitis, but it’s more common in people with weakened immune systems, such as individuals with HIV. Studies have found that the prevalence of seborrheic dermatitis in people with early HIV is 35 percent and increases to 85 percent among individuals with AIDS. By comparison, it affects only about 5 percent of the general population. Because seborrheic dermatitis happens more often in people with HIV than in those without the condition, the two conditions are considered comorbidities.

In people with HIV, seborrheic dermatitis might show up suddenly, be more severe, and sometimes not respond well to treatment.

Researchers aren’t sure why, exactly, seborrheic dermatitis is more common among people with HIV — in part because the exact cause of seborrheic dermatitis itself isn’t very clear. Scientists believe the condition may be caused by an immune system response to a type of yeast living on the skin called Malassezia yeast. This immune response causes yeast overgrowth, severe inflammation, immune system dysregulation, and symptoms of seborrheic dermatitis. Because people with HIV have weaker immune systems, they may be more susceptible to the immune system response that leads to seborrheic dermatitis.

It’s important to know that seborrheic dermatitis is not the same as HIV rash or other skin lesions caused by or linked to HIV. HIV rash is a common symptom of early HIV infection and often appears on the trunk, face, and neck. On the other hand, seborrheic dermatitis is a common type of eczema that may happen alongside other skin conditions like psoriasis. It can lead to different symptoms, such as dandruff or a rash on the affected area.

Additionally, some medications used to treat HIV can cause skin-related side effects, but there’s no evidence that they directly cause seborrheic dermatitis. The good news is that, in general, HIV treatment helps to prevent and manage skin problems caused by HIV. However, researchers are still studying these links to understand them better.

What Causes HIV in Seborrheic Dermatitis?

There’s no direct link between having seborrheic dermatitis and getting HIV infection. Remember, HIV only spreads through certain body fluids during specific activities discussed above, including engaging in unprotected sex and sharing needles. This means that anyone can get HIV, no matter their age, sex, sexual orientation, or background.

Preventing HIV in Seborrheic Dermatitis

Since having seborrheic dermatitis doesn’t make you more likely to get HIV infection, the steps for preventing HIV are the same for everyone, including those with seborrheic dermatitis. This means using a new condom every time you have sex, avoiding sharing used needles, and talking to your doctor about HIV prevention medications like PrEP if you might be at higher risk.

Managing HIV in Seborrheic Dermatitis

Managing and treating HIV is the same for people with and without seborrheic dermatitis. Seborrheic dermatitis treatment usually involves using topical antifungals such as ketoconazole or dandruff shampoos. As seborrheic dermatitis is a chronic condition, the main goal of the treatment is to clear the visible signs of the disease and reduce associated symptoms.

However, because some HIV medications can cause skin problems, it’s important to tell your health care provider if you have seborrheic dermatitis or other skin conditions and if you experience any skin-related side effects from the treatments.

If you’re worried about HIV or seborrheic dermatitis, talk to your primary care provider or dermatologist. They can give you more information on how to prevent and manage HIV and skin conditions. If you’re living with HIV, your health care provider will keep an eye on your CD4 counts to work out a treatment plan that’s right for you.

Talk With Others Who Understand

MySebDermTeam is the social network for people with seborrheic dermatitis and their loved ones. On MySebDermTeam, more than 10,000 members come together to ask questions, give advice, and share their stories with others who understand life with seborrheic dermatitis.

Are you living with seborrheic dermatitis and HIV? Do you want to know how to best support a loved one who has seborrheic dermatitis and may have concerns about HIV? Share your experience in the comments below, or start a conversation by posting on your Activities page.