Seborrheic Dermatitis or Seborrheic Eczema is a skin condition, which is quite common and it primarily affects the scalp, producing itchy, scaly, red skin along with stubborn dandruff. The face, back, upper chest, and other regions of the body, which have many sebaceous glands, can also be affected by seborrheic dermatitis. Seborrheic Dermatitis or Seborrheic Eczema is not contagious, and it has nothing to do with personal hygiene. It is not a fatal condition and the patient’s general health is not affected by it. However, seborrheic dermatitis is uncomfortable and can be embarrassing when it affects the exposed parts of the body. Seborrheic dermatitis of the scalp in infants is termed as cradle cap.
Seborrheic Dermatitis or Seborrheic Eczema has a tendency to recur and the flare-ups can be managed by identifying the signs and symptoms and conservative treatment, including over-the-counter medications.
Causes of Seborrheic Dermatitis or Seborrheic Eczema
The exact cause of Seborrheic Dermatitis or Seborrheic Eczema is not known. Potential causes include:
- Malassezia is a fungus which can be found on our body along with some specific bacteria, in the sebum. Using medications, such as lotions, creams, foams which have ketoconazole (antifungal agent), help in reducing the flare-ups.
- Seasonal changes also play a role in the flare ups, which are worse in winter.
- Neurological disorders, such as Parkinson’s disease, make a person more vulnerable for developing seborrheic dermatitis.
- Mental stress and tiredness can help trigger flare ups or aggravate this condition.
- Individuals who are suffering from HIV/AIDS are at a higher risk for developing seborrheic dermatitis.
Signs and Symptoms of Seborrheic Dermatitis or Seborrheic Eczema
- Skin redness or inflammation.
- Scalp has thick crusts or patchy scaling.
- Patient experiences itching or soreness in the region affected by this condition.
- Dandruff is found on the scalp, eyebrows, mustache or beard.
- The skin, on other parts of the body, appears red and oily with flaky white or yellow scales on them.
Serious Symptoms Which Need Medical Attention Are:
- If this condition is affecting your daily life and you are losing sleep.
- If this condition affects you psychologically and you are suffering from anxiety and embarrassment.
- If you suspect an infection of the skin.
- Conservative treatment does not help you.
Seborrheic Dermatitis or Seborrheic Eczema commonly affects the scalp; however, it can also affect other body parts which are rich in oil glands. It can also be found in skin folds, between the eyebrows, sides of the nose, behind the ears, over the sternum, groin region, and armpits.
Investigations for Seborrheic Dermatitis or Seborrheic Eczema
- Medical history and physical examination is done where the doctor will examine the scalp and other areas of the face and body for symptoms of this condition.
- A skin biopsy can be taken for detailed analysis and to confirm the diagnosis and to exclude other similar skin conditions, such as psoriasis, eczema (atopic dermatitis) and ringworm of the scalp (tinea capitis).
Treatment for Seborrheic Dermatitis or Seborrheic Eczema
Seborrheic Dermatitis or Seborrheic Eczema is a chronic condition and it doesn’t have a permanent cure. Treatment consists of managing the signs and symptoms and preventing flare-ups. Treatment depends on the patient’s skin type and the severity of the condition.
Treatment primarily comprises of using medicated shampoos, lotions and creams on the affected body regions. Oral medications are prescribed in severe conditions.
Antifungal agents work by decreasing the number of the Malassezia yeast in the affected portions of the body. Antifungal agents commonly used in treating seborrheic dermatitis are:
- Ketoconazole in OTC shampoos, gels, foams, and creams can be used. Products containing 2% strength of Ketoconazole are found to be more effective. Side effects include: Itching, irritation and burning.
- Ciclopirox is another antifungal agent found in prescription skin products and shampoos.
- Terbinafine is also an antifungal agent and is prescribed in a tablet form for treating severe flare-ups. However, its effectiveness is debatable. Oral antifungal agents can have some serious side effects, such as liver problems and severe allergic reactions and they should be used with caution.
Corticosteroids help with the symptoms, such as decreasing the inflammation, discomfort and itching. They’re prescribed for short-term treatment, as long-term use can cause serious side effects, such as skin damage, surplus hair growth, decreased immunity, and high blood sugar etc.
Some of The Corticosteroids Used Include:
- OTC hydrocortisone is used in 1% strength and can be used on scalp, as well as other affected body areas.
- Desonide and betamethasone are prescription medications and are available in gel, ointment lotion or cream form to be applied on the scalp and other parts of the body.
Calcineurin inhibitors are prescription creams, which help in lowering the immune system activity. According to research they are as effective as topical antifungal and corticosteroids. There is a risk of skin cancer or lymphoma with this medicine due to exposure to the whole-body drugs. This method of treatment should be used only after other treatments have failed. Some of the calcineurin inhibitors are tacrolimus and pimecrolimus.
Shampoos which contain active ingredients, such as selenium sulfide, zinc pyrithione, coal tar and salicylic acid also help with managing the symptoms and flare-ups of seborrheic dermatitis.
Self-Care Remedies for Seborrheic Dermatitis or Seborrheic Eczema
- OTC antifungal cream and medicated anti-dandruff shampoos can be tried at home.
- Applications of an anti-itch lotion/cream to the affected regions can help in relieving the itching.
- Always use mild, unscented soaps and avoid using harsh soaps and detergents. Also, make sure that you rinse the soap completely from your scalp and body.
- Always wear loose and smooth-textured cotton clothes to help with the air circulation around the skin and to avoid irritation.
- Seborrheic Dermatitis or Seborrheic Eczema often tends to be worse under beards and mustaches. Shaving them can alleviate your symptoms.
- Avoid scratching as much as possible, as it increases irritation, and also increases the chances of infection.
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