Seborrheic Dermatitis
Old dandruff ad!
About The Author: FutureDerm is pleased to welcome dermatologist Dr. Hanan Taha, M.D. to our staff as a Contributing Writer. For a complete bio please visit our About page.
Seborrheic Dermatitis (SD) is one of the most common causes of dandruff. It affects about 5% of the population. While it does not affect your overall health, its symptoms are more bothersome than words can describe! Here are a few things to know, and a few things to do to help make it better if you’ve already been diagnosed with SD.
Charactaristics
The word “seborrheic” comes from the Latin word sebum (meaning fat) and the Greek word rhoia (meaning to flow). Dermatitis is basically skin (derm) inflammation (-itis). So: fat – flow – skin – inflammation. Yup, that pretty much sums it up!
SD is a chronic inflammatory skin disease. It is characterized by large-ish scales (dandruff) and red itchy skin. In more severe cases there is excessive greasiness, yellow crusts and fissuring of the skin with possible secondary bacterial infection.
Areas affected by SD
It affects areas rich in sebaceous glands: scalp, eyebrows, eyelids, nasolabial folds, eyebrows, mustache, beard, ears, behind the ears, neck, sternum, armpits, breast underside, umbilical area, between the shoulder blades, groins, and gluteal crease.
If it affects the scalp, it can be associated with hair loss (reversible if the inflammation is treated).
SD may be mistaken for eczema, psoriasis, rosacea or various skin infections. Sometimes, two skin diseases can occur simultaneously, which makes diagnosis and treatment more complicated (e.g. sebopsoriasis: overlapping SD and psoriasis).
SD is not contagious and not caused by poor hygiene. It does not affect general health, but can cause embarrassment to the person affected when the dandruff is very visible in the hair or on the face.
What Causes it?
SD is associated with an increase in the Malassezia species, a fungus normally present on human skin, but that has been found to be higher in number in people suffering from SD.
Things that aggravate SD
Stress, exhaustion, lowered immunity, cold, dry climates, alcohol based products on the face and hair, and poor nutrition.
SD is found to be associated with:
Parkinson’s, stroke, mycordial ischemia, Diabetes, HIV infection, obesity, epilepsy, alcoholism, Down syndrome.
Treatment
SD cannot be cured, only treated.
This means it can never completely go away, but it can be very well controlled with medication and life style changes. Its course will vary during a lifetime, peaking between the ages of 20-40, with intervals of flares and relief.
The various classes of medications that your physician might prescribe include: oral and topical antifungals, calcineurin inhibitors (tacrolimus, pimecrolimus), topical corticosteroids, UV light, and anthralin.
What can YOU do to make life with SD more tolerable?
No scratching!
THE one most useful thing you can do to improve SD is to NOT SCRATCH. It is very tempting, and scratching that itch can be quite the relief, especially when stressed out, but trust me, the less you scratch, the more improvement you will see. Not scratching also means less chance of breaking the skin and secondary bacterial infection. using ice, cold water, or menthol creams help alleviates the itching.
Also, SUNSCREEN! To prevent excessive irritation and post inflammatory hyperpigmentation. Use something appropriate for sensitive skin, such as zinc oxide.
Moisturize regularly. One study showed that the licorice root extract, licochalcone, can help improve redness in SD. This can be found in Eucerin Redness Relief Soothing Night Crème.
For the purpose of an improved immunity and overall health, which are associated with improved SD symptoms: take your vitamins, exercise right, eat right, and sleep right!
Many times, you may not have to go to the doctor every time SD flares up. OTC medications can be helpful in milder, less frequent cases, and they include:
Antifungal shampoos (e.g. selsun blue and head and shoulders).
This Selsun Blue Shampoo contains selenium sulfide, which helps relieves the symptoms of SD.
Other useful shampoos contain pyrithione tar or salicylic acid, such as the Neutrogena T/Gel line of shampoos.
Antifungal creams (e.g. ketoconazole).
Anti-itch creams and antihistamines.
Gentle, non scented soaps.
Other tips
Avoid alcohol based preparations so as not to irritate the scalp and skin further.
Hair becomes weaker and loses its luster with SD. Be extra gentle with it. Read my previous article on hair care for more tips.
Men: shaving offers some relief, as many men experience a worsening of SD under their beards and mustaches.
Mix 2 parts tea tree oil with 8 parts water in a spraying bottle.
Tea tree oil: try mixing 2 parts tea tree oil with 8 parts water in a spray bottle and spray your face with it after washing it or before applying your facial moisturizer or antifungal cream. It does a pretty decent job of calming down the itchiness.
Aloe vera: recently mentioned by Leah, read more about its benefits in her post.
Omega 3 supplements: among their many benefits, they also help improve SD symptoms.
Makeup: many SD patients feel that mineral makeup is gentler on their skin and looks better.
If you try any of these home remedies, tell us which one works best for you!
Got your own tip on what improves SD? Please share it with us!
Thanks for reading! Remember, stop by my blog or tell your friends if interested in reading about skin care in Arabic!
Sources
WD James et al. Andrew’s Diseases of the Skin: Clinical Dermatology. Tenth Edition. Saunders Elsevier 2006.
T. Burns et al. Rook’s Textbook of Dermatology. Eighth Edition. Wiley-Blackwell 2010.
S. Wananukul et al. Randomized, Double Blind, Split Side Comparison Study of Moisturizer containing Licochalcone vs. 1% Hydrocortisone in the Treatment of Infantile Seborrheic Dermatitis. Journal of the European Academy of Dermatology and Venereology 2012; 26 (7): 894-7.
Mayoclinic.com
About Author
Dr. Hanan Taha, M.D. got her MD from Kuwait University in 2002, and obtained a masters degree in Dermatology in 2010 from the University of Alexandria. She has experience in various cosmetic procedures, such as hair removal, facial rejuvenation, skin tightening, cellulite treatment, and management of stretch marks. Hanan’s passion for dermatology started on her very first day of rounds, and after being undecided for years on which direction to go, she decided to become a dermatologist. A strong believer in patient education as grounds for a healthy living, she strives to thoroughly explain her patients their skin problems or concerns and the proposed treatment plan. She also runs a blog in Arabic dedicated to spreading the knowledge about dermatology and cosmetic dermatology in a simple, concise manner (elbashra.com). Elbashra (البشرة) is the Arabic word for “the skin.”
View all Dr. Hanan Taha, M.D. posts.(10) Readers Comments
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Sarah
Ever since I started using a topical L-ascorbic acid solution several months ago, the seb derm around my nose has been negligible. I made my own at first, then switched to a pre-packaged preparation (CE + Ferulic acid), and both have been effective. I’ve been diagnosed with both seb derm and perioral dermatitis in the past, and nothing has worked this well in keeping the bumps/scaling/itchiness/redness away.
Janessa
I haven’t heard of this before but anything that’s not curable seems scary lol.
Dr. Hanan Taha, M.D.
Hello Janessa! Its not really that scary. SD is basically oily dandruff that can cause inflammation at times and can be really irritating at times. Many illness are not curable, but treatable, one very common one is diabetes. Not curable simply means no treatment exists yet that can make it completely go away. But like diabetes, there are many ways to control it
Nancy
What do you think of coconut oil? I’ve used it with pretty average results, but some people swear by it for SD on their scalp.
Dr. Hanan Taha, M.D.
Hello Nancy!
I do not have personal experience with coconut oil. However, research suggests it does have some anti-inflammatory properties, which means it could help in SD. However it should be used with caution as it does cause irritation in some although that is rare. If it works, that’s great!
Sarah
@Nancy. I had great hope for coconut oil, as I LOVE the idea of a natural treatment that is also paleo-friendly. have seb derm on my face and some minor dandruff on my scalp. I used it 2x/day for a few weeks, and the redness/scaling/itchiness actually spread to places it hadn’t ventured before. My dandruff was made slightly worse, as well.
Marcus
What’s a weak immune system have to do with it?
And why get it @ age 25 when I’ve been fine?
Are there any ideas on a cure or something to take that keeps it as if you didn’t have it? When’s the science kickin in. How bout skin grafts or stem cells. Or something that actually works.
Dr. Hanan Taha, M.D.
@Marcus Hello!
As SD is quite common, its been studied extensively for years, still is being studied. To date, research shows the following:
-A fungus that is normally present in everyone’s skin is present in higher quantities in people with SD.
-The immune system responds abnormally to the presence of this fungus.
-People with a weakened immune system, whether from a simple cold, an organ transplant, cancer, or even HIV, tend to show more severe symptoms of SD compared to those with normal immune systems.
-The reason why SD peaks starting around the 20s is due to its relation to sebum production, which starts to peak at puberty and into adulthood. Sebum production increases, the fungus thrives, and SD develops.
-The main treatment for SD is antifungals (which are mostly prescription only) among other things that were mentioned in the article.
Finally, it would seem that mentioning that SD cannot be cured, but can be treated, caused a lot of alarm. Perhaps I need to make a post about this soon. But there is no reason to be alarmed by this statement at all. Current medications exist that can control SD to make it as if you don’t have it at all. This is comparable to having, for example, acne! The medicine your doctor gives you controls your current outbreak, but you are gonna get another one: no worries, just take your medications again!
Hope this helped. Thank you for stopping by and commenting!
Rahul
I have been under the dight of Vitamin C (Ascorbic acid) 500 mg & Loratadine USP 10 mg – each tablet 1 daily since last 3 days before that I have used Levocitirizine Hydrochloride 5mg (twice daily) for 14 days. I am also using Ketoconazole cream (twice daily) since past 20 days . but I am experiencing a new spot since past 3-4 days & whenever I apply cream on that spot My itchness increases and that spot becomes red as blood , is that the normal function how ketoconazole works but 1 thing 4 sure that my past spots are almost negligible .
and 1 most important thing as this is uncurable , isn’t any possibility in near future that this might get its permanent cure what is the researchers of whole world doing ?? Why are they not working on the diseases like this ..
Please help
Thanks in advance
Dr. Hanan Taha, M.D.
@Rahul
Some people can experience a little itching and redness when they first start using ketoconazole cream. However, this might or might not be the case in your situation, especially since you mention other spots have improved on ketoconazole cream. Another explanation is that this new spot is unrelated to your current SD problem. In any case I advice that you visit your dermatologist so that he can diagnose the problem in person.
As for a cure, research is always in progress. Lets hope for the best.
In the meantime, I wish you the best of luck, and thank you for your comment.