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Seborrheic Dermatitis

What is Seborrheic Dermatitis?

Seborrheic dermatitis is a chronic (lasting a long time) condition of the scalp or body characterized by irritation, itching, redness, and excess shedding of dead epidermal (outer layer of the skin) cells. It is a common condition that affects about 3 percent of the general population. Seborrheic dermatitis is frequently mistaken for dandruff, which is considered a mild form of seborrheic dermatitis.

Although seborrheic dermatitis mimics dandruff with its flaky scales, the inflammation (swollen, red, hot, pain) and itching that accompanies it sets it apart from simple dandruff. OTC preparations are available to help mild cases, but seborrheic dermatitis often is best treated by prescription medications.

Cradle cap is the term used when seborrheic dermatitis affects the scalp of infants. Seborrheic dermatitis in infants is a harmless, temporary condition, which is not contagious, not an allergy, nor is it caused by poor hygiene. Cradle cap is usually seen in newborns and small children up to age 3.


Causes of Seborrheic Dermatitis

Seborrheic dermatitis is thought to be due to a combination of an over production of skin oil and irritation from a yeast called malessizia. Seborrheic dermatitis appears to run in families. Conditions that may increase the risk of seborrheic dermatitis include:

  • Stress
  • Fatigue
  • Weather extremes
  • Oily skin
  • Infrequent shampoos or skin cleaning
  • Use of lotions that contain alcohol
  • Skin disorders (such as acne)
  • Obesity

Neurologic conditions, including Parkinson's disease, head injury, and stroke may be associated with seborrheic dermatitis. Human immunodeficiency virus (HIV) has also been linked to increased cases of seborrheic dermatitis.

Symptoms of Seborrheic Dermatitis

Seborrheic dermatitis often has extended inactive periods followed by flare-ups. Seborrheic dermatitis can occur on many different body areas. Typically it forms where the skin is oily or greasy. Commonly affected areas include:

  • The scalp
  • Eyebrows
  • Eyelids
  • Creases of the nose
  • Lips
  • Behind the ears
  • In the external ear
  • Along skin folds on the middle of the body

In general, symptoms of seborrheic dermatitis include:

  • Skin lesions
  • Plaques over large area
  • Greasy, oily areas of skin
  • Skin scales - white and flaking, or yellowish, oily, and adherent (clinging or sticking) - "dandruff"
  • Itching - may become more itchy if infected
  • Redness
  • Hair loss

How is Seborrheic Dermatitis Diagnosed?

The diagnosis is based on the appearance and location of the skin lesions.

Treatment of Seborrheic Dermatitis

You can treat flaking and dryness with over-the-counter dandruff or medicated shampoos. Shampoo the hair vigorously and frequently - preferably daily. Loosen scales with the fingers, scrub for at least 5 minutes, and rinse thoroughly. Active ingredients in these shampoos include salicylic acid, coal tar, zinc, resorcin, ketoconazole, or selenium.

Shampoos or lotions containing selenium, ketoconazole, or corticosteroids may be prescribed for severe cases. To apply shampoos, part the hair into small sections, apply to a small area at a time, and massage into the skin. If on face or chest, apply medicated lotion twice per day.

Seborrheic dermatitis may improve in the summer, especially after outdoor activities.

Possible Complications of Seborrheic Dermatitis

  • Psychological distress, low self esteem, embarrassment
  • Secondary bacterial or fungal infections

When to Contact a Medical Professional

Call for an appointment with your health care provider if seborrheic dermatitis symptoms do not respond to self-care or over-the-counter treatments. Also call if patches of seborrheic dermatitis drain fluid or pus, form crusts, or become very red or painful.

Prevention of Seborrheic Dermatitis

The severity of seborrheic dermatitis can be lessened by controlling the risk factors and by paying careful attention to skin care.


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References:
Medline Plus - U.S. National Library of Medicine - National Institutes of Health - July 2007 - www.nlm.nih.gov/medlineplus

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