What do I need to know about Seborrheic Dermatitis?
Seborrheic Dermatitis is considered a chronic form of eczema that follows a pattern of flaring and clearing that can last for years. It is commonly found in oil-producing areas like the upper back, nose, and scalp. Seborrheic dermatitis is a chronic inflammatory condition that can affect people at any age. In infants, known as cradle cap, it usually clears on its own but will go into exacerbations and remissions for adults. There is an inflammatory reaction to excess Malassezia yeast, which lives on the skin’s surface and is likely the cause of seborrheic dermatitis. Overgrowth of the yeast causes the immune system to overreact to it, leading to an inflammatory response that results in skin changes of redness, flaking, and dryness.
There are different inflammatory triggers such as:
- Hormonal changes or illness
- Harsh detergents, solvents, chemicals, and soaps
- Cold, dry weather or humid, summer months
- Certain medications including psoralen, interferon, and lithium
Signs and symptoms typically include:
- Skin flakes (dandruff) on scalp, hair, eyebrows, nasolabial folds, beard, and mustache
- Patches of greasy scaling skin covered with flaky white or yellow scales or crust on the scalp, face, sides of the nose, eyebrows, ears, eyelids, chest, armpits, groin area, or under the breasts
- Red skin
Treatment options typically include topical shampoo or cream or a combination of both. Prescription-strength steroid-like fluocinolone (Synalar, Capex) clobetasol (Clobex), and desonide (Desowen, Desonate) can be applied to the scalp easily to reduce inflammation. Steroids should be used sparingly to avoid thinning skin or striae (stretch marks/lines). Antifungal creams, gels, or shampoos are also effective and can be used in combination with a topical steroid. Usually, a 2% Ketoconazole (Nizoral) shampoo or 1% Ciclopirox are helpful. Oral antifungals aren’t the first choice for treatment because of possible side effects and drug interactions.
If the regular shampoo doesn't help with dandruff, try over-the-counter dandruff shampoos. They are classified according to the active ingredient they contain:
- Pyrithione zinc (Dermazinc, Head & Shoulders)
- Selenium sulfide (Selsun Blue)
- Ketoconazole (Nizoral A-D)
- Tar (Neutrogena T/Gel, DHS Tar)
- Salicylic acid (Neutrogena T/Sal)
These shampoos can be used daily until symptoms have improved then used just 1-3x a week as needed for maintenance. Avoid using excess styling products that can clog the scalp while treating the condition. Also, avoid skin and hair products that contain alcohol as that can be very drying and cause flares.
For further information or to address any other Dermatologic issues, schedule your appointment with our Dermatology PA Megan today. We look forward to seeing you!