What is Seborrheic Dermatitis?
Seborrheic dermatitis or seborrhea is a common chronic skin condition characterized by red, flaky scales, itchy rash typically on the scalp, may also appear on the face and torso. It is associated with psoriasis (sebopsoriasis) or eczema or an allergic reaction. It affects both infants and adults. In infants, it is referred as cradle cap and in adults, it is seborrheic dermatitis and commonly related to dandruff which is its uninflated form. Dandruff is the scaly patches spread within hair bearing areas of the scalp. In face, it may appear in nasolabial folds or smile lines.
Symptoms of Seborrheic Dermatitis
Infantile Seborrheic Dermatitis or Cradle Cap – Children of 3 months or less than three months often get cradle cap. The symptoms are crusty yellow or brown scales on their scalp. It looks like dandruff. It usually goes away naturally just by proper care before they are one year old.
Seborrheic Dermatitis in Adults – In adults, it appears on the scalp, behind the ears, nose, eyelids, and skin folds near nose or smile lines. It may appear on your body also in places like:
- Skin folds like armpits and on legs
- Below breast
- Middle part of the chest
- Around the navel
One or more symptoms may appear. They are:
- Red skin
- Scaly white or yellow flakes (dandruff) on your scalp or behind the ears.
- Crusting of the eyelids
- Patches of greasy red skin with or without scales on the face and other body parts.
- Itching or stinging
Causes of Seborrheic Dermatitis
The actual cause of seborrheic dermatitis is not known yet. Some factors that may induce the condition are:Oily skin – Oily skin may be the reason since the condition occurs in areas of heavy sebum production.
1. Yeast growth – It is reported that patients with the condition have excessive growth of yeast that normally live on the skin in the affected areas. It is not confirmed that the overgrowth of the yeast is responsible for seborrheic dermatitis, or it is just the secondary phenomena.
2. Cold and dry weather – Some people get dandruff in the winter season. Cold and dry weather may be responsible for scaly flakes to occur on the scalp or other body parts.
3. Certain medical conditions – Some medical conditions may also raise your risk of getting seborrheic dermatitis:
- Weak immune system
- Heart diseases
- Parkinson’s disease
- Sleep deprivation
4. Genetic Causes – If your one or both the parents have seborrheic dermatitis, then it is likely for you to inherit the condition from them.
Diagnosis of Seborrheic Dermatitis
Your dermatologist will look at your skin and ask you about your medical history. If your condition is related to other medical conditions, then your doctor may suggest you for other tests.
You may need skin biopsy if your condition is severe with exfoliative erythroderma.
If overgrowth of skin yeast is suspected then you may need a fungal culture to rule out tinea capitis.
Treatment of Seborrheic Dermatitis
Topical Medications – Some of the topical medications that can control seborrheic dermatitis are topical antifungal creams such as ketoconazole, naftifine and ciclopirox, topical corticosteroids, and keratolytic creams such as topical urea.
You can use antihistamines to reduce itching.
Coal tar can also be very useful but its use is limited since many cases of cancer is found due to the use of shampoos containing coal tar.
Calcineurin inhibitors such as pimecrolimus, tacrolimus, sulfur or sulfonamide combinations, or propylene glycol may help.
Isotretinoin gel can be useful as it reduces the activity of sebaceous gland and hence reducing sebum production. Thus, it may help in healing severe seborrheic dermatitis. But it is restricted to some patients as it may cause side effects.
Oral antifungal medication – Oral antifungal medications such as azoles (ketoconazole or itraconazole) or terbinafine acn be helpful if topical treatment doesn’t work alone.
Ultraviolet light treatment – Light therapy may also be an option for treating seborrheic dermatitis.
Self-care at home
- You can control seborrheic dermatitis with self-care measures at home. Many of these are available in stores without a prescription.
- Always wash your hair with medicated anti-dandruff shampoo such as pyrithione zinc (Head & Shoulders) or selenium (Selsun Blue).
- Shampoo with the antifungal ketoconazole, twice a week alternating with your daily shampoo.
- You can also use tar shampoo.
- Shampoo containing salicylic acid can be used daily.
- Gently rub these shampoos on the affected areas of the face, ears, and chest and rinse off completely.
- You can apply mineral oil or olive oil to your scalp for an hour or overnight. Oil softens and removes scales from your hair. Gently brush your hair and wash it with anti dandruff shampoo.
- Avoid using skin products that contain alcohol.
- Wear loose cotton clothes as reduce skin irritation.
- For eyes, gently clean eyelids with baby shampoo and wipe away scales with a cotton swab.