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Seborrheic dermatitis

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Seborrheic dermatitis is a skin disorder affecting the scalp. It is also known as cradle cap when it occurs in infants. While it can affect the scalp and cause stubborn dandruff, it also affects the face, chest, back, and other areas that are especially oily, appearing wither with or without red skin. Seborrheic dermatitis is not contagious, but many people find it to look unattractive and to feel uncomfortable. In addition to secondary infections that can result, people who differ from this disorder often have low self-esteem. Seborrheic dermatitis is often confused with other skin disorders, such as atopic dermatitis, psoriasis, and ringworm of the scalp. It often takes a dermatologist to discern the difference and to prescribe an appropriate course of treatment.

SEBORRHEIC DERMATITIS SIGNS AND SYMPTOMS

Seborrheic dermatitis can appear as thick or scaly patches on the scalp, smaller skin flakes or dandruff, yellow or white scales of skin that attach themselves to the hair follicles, small bumps that appear either reddish-brown in color, itching or soreness of the skin. It can also result in hair loss. It is most commonly found on the scalp, but it can also occur anywhere that oil collects, such as on the face or in the folds of the skin. Other areas you might experience it are in your eyebrows or in the patch between your eyebrows, on your eyelids, on the sides of your nose, in the center of your chest, behind your ears, in the folds of your groin area, and your armpits. In infants, the condition does not cause as much itching as it does for adults. Infant experience patches of thick, yellow, crusty or greasy skin, mostly on their scalp.

SEBORRHEIC DERMATITIS CAUSES

Doctors have not been able to determine an exact cause for seborrheic dermatitis, but there may be several factors that contribute to its formation. One of these factors may be that your oil glands and hair follicles have an abnormality that causes them to produce too much oil. Some people may also be susceptible to a fungus known as malassezia, which grows in the skin’s oils along with the skin’s normal bacteria. This idea is supported by the fact that antifungal medications are often effective against seborrheic dermatitis. You may find that your condition gets worse, resulting in outbreaks when you are under stress, under certain hormones or at certain times in your cycle, when you are tired, when you travel, if you are very overweight, or in the winter. It also seems to be worse in people who suffer from neurological disorders, such as Parkinson’s disease, head injuries, or strokes. It is also common in patients with HIV/AIDS. In some cases, it has also been known to accompany another skin disorder, acne rosecea.
seborrheic dermatitis
Image: Seborrheic Dermatitis

SEBORRHEIC DERMATITIS TREATMENT

There is no cure for seborrheaic dermatitis, but in most cases, it can be treated with over-the-counter medications. The first step in treating this disorder is medicated shampoos; you want to choose an over-the-counter shampoo that contains ketoconazole, tar, zinc, resorcin, pyrithione, selenium sulfate, or salicylic acid. Doctors recommend that you use the shampoo every day, leaving it on for five minutes at a time, until your symptoms are controlled, and after that you can cut back to two or three times a week. You may need to switch back and forth between two brands to maintain their effectiveness.

If over-the-counter medicated shampoo does not relieve your symptoms, you may require either a prescription strength medicated shampoo, or treatment with a steroid lotion. There are some cases when you should consult with your doctor or with a dermatologist. If your condition is making you very uncomfortable, to the point of losing sleep or being distracted from your usual activities, if your skin feels painful or overly sensitive, if your skin seems to be infected, or if you have tried self-care methods but not received any improvement from them, you should seek medical attention.

If the seborrheic dermatitis does not appear on your scalp, or appears in other locations in addition to your scalp, the goal of treatment is to reduce inflammation and the build-up of scaling on the skin. You should first try to use over-the-counter antifungal creams or anti-itch creams. If these methods are ineffective and your condition continues to cause you embarrassment or discomfort, your doctor may prescribe corticosteroids in cream or lotion form. Another option is a topical antifungal medication, or some combination of both corticosteroids and antifungals. If the condition covers a large area of your body, your doctor may also prescribe an oral medication as well. There are effective oral medications, called Elidel and Protopic, that work well, but they work by reducing the effectiveness of the immune system, and can have other serious effects on your body. For this reason, it is recommended that these two medications be used only after all other treatments have been tried.


A regimen of self-care is important in order to keep seborrheic dermatitis under control. These steps include shampooing daily, especially with one of the medicated shampoos listed above. You should also apply an over-the-counter antifungal cream, containing at least 1% hydrocortisone, on affected areas of skin every day. Harsh soaps and detergents can irritate your skin and cause it to increase oil production; you should also be careful to rinse all the soap off you body to minimize irritation. Smooth and non-constricting clothing, especially that made of cotton, also minimizes irritation. And even when your condition causes itching, you should try to avoid itching as much as possible. This may mean clipping your nails short and wearing gloves over them at night.

Cradle cap in infants usually clears up on its own in a few months. While it is still present, however, wash your baby’s hair once a day. Use a mild baby shampoo, loosen the scales with a small, soft-bristled brush, and then rinse the skin off along with the shampoo. Your doctor may recommend a medicated shampoo, but only if the cradle cap perseveres or is very severe.
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