What is Seborrhoeic Dermatitis

Seborrhoeic Dermatitis is a common, chronic or relapsing form of eczema / dermatitis that mainly affects the scalp and the face. There are infantile and adult forms of seborrhoeic dermatitis.

Sometimes it is associated with psoriasis. Seborrhoeic dermatitis is also known as seborrhoeic eczema. Dandruff, or pityriasis capitis, is an uninflamed form of seborrhoeic dermatitis. Dandruff presents as bran-like scaly patches scattered within hair-bearing areas of the scalp.

What causes Seborrhoeic Dermatitis?

The exact cause of seborrhoeic dermatitis is not known. A combination of factors seems to contribute, including:

  • Stress
  • Genetic factors
  • Yeast that normally lives on the skin
  • Certain medical conditions and medications
  • Cold, dry weather

Seborrhoeic Dermatitis is not caused by an allergy or bad hygiene.

Who gets Seborrhoeic Dermatitis?

Infantile seborrhoeic dermatitis affects babies under the age of 3 months and usually resolves by 6–12 months of age.

Adult seborrhoeic dermatitis tends to begin in late adolescence. Therefore, it is more frequent in young adults, but it can also occur in older persons (above the age of 40 years) and in the elderly. As far as the gender is concerned, it seems to be more common in males than in females.

The following factors are sometimes associated with severe adult seborrhoeic dermatitis:

  • Oily skin (seborrhoea)
  • Familial tendency or a family history of psoriasis
  • Immunosuppression because of organ transplantation, human immunodeficiency virus (HIV) infection and other reasons
  • Neurological and psychiatric diseases: Parkinson disease, tardive dyskinesia, depression,etc.

How does Seborrhoeic Dermatitis manifest?

Seborrhoeic Dermatitis affects the scalp, face (around the nose, behind ears, eyebrows) and upper trunk.

Typical features of the condition include:

  • Winter flares, improving in summer following sun exposure
  • Minimal itch most of the time
  • Combination of oily and dry facial skin
  • Localised or diffuse scaly patches in the scalp
  • Salmon-pink, thin,scaly, and ill-defined plaques in skin folds on both sides of the face
  • Mildly red, thin, ill-defined plaques showing mild scaling of the folds of the face, and the eyelids
  • Petal or ring-shaped flaky patches on hair-line and on the chest
  • Rashin armpits, under the breasts, in the groin folds and genital creases
  • Superficial folliculitis (inflamed hair follicles) on cheeks and upper trunk
  • Extended rash of the scalp, neck and trunk.

What is the treatment for Seborrhoeic Dermatitis?

Treatment of seborrhoeic dermatitis often involves several of the following options:

  • Keratolytics can be used to removescalewhen necessary
  • Antifungal agents that reduce the yeast
  • Mild topical corticosteroids for 1–3 weeks to reduce the inflammation during an acute flare
  • Calcineurin inhibitors

In resistant cases in adults, oral itraconazole, tetracycline antibiotics or phototherapy may be recommended. In such cases, the factors that contribute in a flare, such as stress, play a crucial role.

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