Seborrheic dermatitis is a common skin disease. It is a type of eczema that does not arise from external influences. It mainly affects the scalp, although it can affect other areas as well. Symptoms of seborrheic dermatitis can also appear in places such as the face, sides of the nose, eyebrows, ears, eyelids, and chest.
It should be noted that the symptoms of seborrheic dermatitis can occur in both adults and infants. It generally occurs at stages of life where there is greater sebaceous activity associated with greater hormonal stimulation.
The causes of seborrheic dermatitis
The exact cause of seborrheic dermatitis is currently unknown. The appearance of the disease, however, may be related to the Malassezia fungus, which is found in the sebaceous secretion of the skin. Another cause of seborrheic dermatitis may be an impaired immune system response.
There are many factors that can increase the risk of seborrheic dermatitis, such as neurological and psychiatric disorders. A weak immune system, as is the case in organ transplant recipients and people infected with HIV, also increases the risk.
What are the symptoms of seborrheic dermatitis?
Symptoms of seborrheic dermatitis include: dandruff, skin lesions, itching, and mild erythema. In general, the skin that is covered with hair is always changing, so small scales tend to appear.
There is also frequent flaking of the eyebrows, eyelashes, beard and mustache, as well as redness and flaking of the nasolabial fold and the back of the ears.
In some patients, the eyelids also become inflamed and small crusts form at the edges of the eyelids. At the trunk level, seborrheic dermatitis usually manifests as rounded erythematous brownish plaques.
Sometimes these plaques are covered with very adherent scales that resemble psoriasis lesions.
Diagnosis is based on clinical tests, observation of changes and their location on the skin. Spots covered with greasy scales on the scalp are characteristic.
In addition, erythematous-scaly lesions usually occur where the scalp begins, as well as in the behind-the-ear folds, nasolabial furrows or eyebrows. In infants, the so-called “cradle cap” is a characteristic change.
A differential diagnosis should be made to diagnose the disease as the symptoms of seborrheic dermatitis may be confused with other diseases such as:
- Psoriasis: It also causes dandruff and reddening of the skin with flakes and scales. Psoriasis has more scales and they are silvery white.
- Atopic Dermatitis: This skin condition causes itchy and inflamed skin in the folds of your elbows, back of your knees, and the front of your neck.
- Tinea versicolor: This rash appears on the torso but is usually not red like seborrheic dermatitis symptoms.
- Rosacea: Usually occurs on the face and produces very few scales.
Treatment of seborrheic dermatitis
There are many general hygiene measures that should be followed if you have symptoms of seborrheic dermatitis. Very hot showers, rooms with hot air or air conditioning, and situations with greater emotional stress should be avoided.
For daily hygiene, use neutral moisturizing soaps and non-greasy moisturizing creams or lotions.
Corticosteroids such as hydrocortisone, fluocinolone, and clobetasol are recommended to be applied to the scalp or other affected area. They are used in the form of creams, shampoos or ointments.
They are effective and easy to use, but you should use them wisely. If used continuously for a long time, they can cause side effects such as thinning of the skin or the appearance of stains.
Creams or lotions containing calcineurin inhibitors, such as tacrolimus and pimecrolimus, may also be effective and cause fewer side effects than corticosteroids. However, they are not first-line drugs.
They are used in the form of gels, creams or shampoos, alternating with other medications. They can be used at a concentration of 1 or 2%, similar to ketoconazole, depending on the intensity and the area to be treated.
In more severe cases, oral treatment with tetracyclines can be used, which reduce sebaceous secretion. Patients generally respond well to treatment of seborrheic dermatitis.
But you should know that maintenance treatment will be necessary as the disease lasts from several months to even many years. However, subsequent relapses will improve in the warmer seasons. However, they can worsen in the cold months and in times of fatigue and emotional stress.