What is seborrheic dermatitis?

Seborrheic dermatitis is a chronic skin disorder that is most commonly expressed on the hairy parts of the head and face, but sometimes outbreaks can occur on the back, chest, armpits, and groin. Usually, the skin suffers in places where there are many sebaceous glands.

The disease is most often first appeared in children in the first three months of life and in adults from 30 to 70 years old.

Is seborrheic dermatitis contagious? No, it is not possible to contract it from another person – it is a non-infectious disease and the exact causes of it are unknown.

Where can seborrheic dermatitis be found?

On the head. The hair-bearing part of the head may only slightly flake or be covered with thick noticeable crusts. Sometimes the outbreaks spread to the forehead, skin behind the ears, the back of the neck. Seborrheic dermatitis on the head may be referred to as dandruff due to its often dry, flaky appearance.

Mistakenly classifying seborrheic dermatitis as dry, oily, and mixed is a mistake – this classification pertains to dandruff.

On the face. On the face, areas of flaking and inflammation typically appear, it may be red, swollen, and itchy. Some people experience inflammation in the eyelids. In dark-skinned people, areas without pigment may appear – light spots.

On the body. Outbreaks can occur anywhere on the body, usually on the chest and back. They look like flaky patches or scales. Sometimes the patches merge with each other and cover a significant area of the body.

Seborrheic dermatitis and dandruff are not exactly the same thing

Dandruff is usually referred to as flaky skin on the hair-covered part of the head that is visible to the naked eye. Indeed, this is often a manifestation of seborrheic dermatitis. However, dandruff can have other causes. For example, ordinary dryness or scaling due to contact dermatitis – irritation caused by various external impacts: inappropriate shampoos or other care products, styling products, headwear, and jewelry. Similar symptoms may also occur in other chronic skin diseases, such as scalp psoriasis.”

The symptoms of seborrheic dermatitis in me are affecting the areas of my face where there are sebaceous glands: in the nose area, on the adjacent cheek areas, eyebrows, and on the forehead near the hair roots. The skin is strongly reddened and itches there. On the hairy part of my head, there is just a slight itching.

Outbreaks of seborrheic dermatitis can appear and disappear. Mine appear after washing with regular water, due to medical masks and sun glasses, especially in heat: the skin sweats more, so the dermatitis appears faster. Also, when I frequently visited the dentist, outbreaks began after appointments due to the dentist’s medical gloves.

In the early stages of the disease, outbreaks occurred approximately once a week. For example, on Monday, redness begins, on Tuesday, the skin swells and scaly patches appear, everything itches, on Wednesday-Thursday the skin burns, swells, and the outbreaks spread. On Friday-Saturday, everything subsides and after three-four days it starts again. This has been happening for several years.

Treatment helps to reduce itching, burning and redness, or even make it disappear completely. Currently, the situation is better: the last flare-up was two weeks ago, I caught it “on the fly” – the skin only slightly reddened and returned to normal without itching, peeling and inflammation.

How to differentiate seborrheic dermatitis from psoriasis

Seborrheic dermatitis and psoriasis are two different diseases. They have common symptoms, such as red and scaly skin, so often only a doctor can distinguish one disease from the other.

Psoriasis scales are usually thicker and drier to the touch. In addition, it often affects different parts of the body, not just the head or face, compared to seborrheic dermatitis.

Seborrheic dermatitis can precede the appearance of psoriasis or coexist with it.

Causes of seborrheic dermatitis

The exact causes of the disease are unknown. It is believed that the disease may be related to the increased reproduction of one of the types of yeast fungi normally found on the skin, or to disruptions in the functioning of the immune system.

Seborrheic dermatitis can start in anyone, but is more common in people with neurological and psychological illnesses, some endocrine diseases, and immune system disorders. For example, with HIV or some types of cancer.

It can also develop due to inappropriate skin care, cold dry weather, and hormonal changes. Apparently, the latter triggered my first episode of the disease after childbirth.

Diagnosis of Seborrheic Dermatitis

The diagnosis is made by the doctor based on examination and questioning of the patient. Sometimes, dermoscopy of the skin helps in the diagnosis, which is an examination under magnification with a special tool. Dermoscopy can be useful in some cases to distinguish seborrheic dermatitis from other skin conditions that may look similar. For example, psoriasis or systemic lupus erythematosus.

Treatment of Seborrheic Dermatitis

The treatment of seborrheic dermatitis does not eliminate the cause, but relieves symptoms: it removes scales, reduces itching, swelling and redness, soothes inflammation. Doctors usually prescribe topical agents: antifungal agents and corticosteroids – hormonal drugs that relieve inflammation. For treating dermatitis on the scalp, they are used in the form of shampoo, and on the face and body – in the form of creams and ointments.

For seborrheic dermatitis on the head, antifungal shampoos with ketoconazole or climbazole may be prescribed, for example, “Nizoral” – it contains ketoconazole. They should be washed twice a week, but not constantly, not more than a month. Then, once every two to four weeks, they are used for prevention, constantly using familiar shampoos.

During flare-ups of dermatitis, corticosteroid ointments, like hydrocortisone, may be prescribed. Typically, they are given for a short time, usually no more than two weeks, just to relieve inflammation.

A doctor can also prescribe shampoos and creams with zinc pyrithione, an antifungal agent. 

Is it necessary to take vitamin or mineral supplements when suffering from seborrheic dermatitis?

Seborrheic dermatitis is a chronic skin inflammation disease that is not related to a deficiency of vitamins and minerals, so they are not used in its treatment. The practice of prescribing supplements probably existed when there was less known about the causes and how this disease occurs.

Diet for seborrheic dermatitis

Evidence-based doctors believe that healthy skin requires simply a balanced and healthy diet. There are no convincing data on the benefits of any particular diet for seborrheic dermatitis to date.

But different dermatologists can advise not to eat fried, fatty, spicy, sweet and avoid drinking alcohol. So the rule is simple: no more than three candies a day, or one piece of cake, or three pieces of yeast bread.

Remember

• Seborrheic dermatitis is a chronic condition characterized by redness, irritation, inflammation, itching, and plaques appearing on the skin. This can occur on the face, back, chest, or on the forehead near the hairline.
• Dermatitis can be confusing with other conditions like rosacea, eczema, or psoriasis, so you will need a dermatologist to diagnose it.
• Among the drugs, topical corticosteroids, which reduce inflammation, and antifungals are effective. However, they cannot be used for a long period.
• It is important to choose skin care that won’t aggravate skin irritations.
• There is no evidence that diet directly affects the skin condition in seborrheic dermatitis, but a healthy and nutritious diet is definitely beneficial.

Sources:

• Mayo Clinic – Seborrheic Dermatitis
• Medscape – Seborrheic Dermatitis
• Psoriasis of the scalp and seborrheic dermatitis: what’s the difference? The Mayo Clinic
• The MSD Physician’s Guide to Seborrheic Dermatitis