Seborrheic Dermatitis: Symptoms And Treatment

Seborrheic dermatitis can affect both adults and children. It usually appears at stages of life when there is greater sebaceous activity.
Seborrheic dermatitis: symptoms and treatment

Seborrheic dermatitis is a common skin condition. It is a type of eczema that is not triggered by external factors. It mainly affects the scalp, although it can also affect other areas such as the face, sides of the nose, eyebrows, ears, eyelids and chest.

Seborrheic dermatitis can occur in adults and children. In general, it appears in stages of life when there is greater sebaceous activity linked to greater hormonal stimulation.

Causes of seborrheic dermatitis

The exact cause of seborrheic dermatitis is unknown, although its appearance may be related to the malassezia fungus  ,  found in the sebaceous secretion of the skin. Another cause of seborrheic dermatitis can be an irregular immune system response.

There are several factors that can increase your risk of developing seborrheic dermatitis, such as suffering from neurological and psychiatric disorders. Having a weak immune system also increases the risk, as does organ transplant recipients and people with HIV.

woman with dermatitis
Seborrheic dermatitis usually occurs on the scalp and some parts of the face. Although it can be caused by the malassezia fungus, there are other factors that can trigger it.

What are your symptoms?

Symptoms of seborrheic dermatitis include dandruff, skin lesions, itching and mild erythema. The scalp is usually affected and has small scales.

It is also  common to have scaling of the eyebrows, eyelashes, beard and mustache, in addition to redness and scaling of the nasolabial fold and the back of the ears.

In some patients, the eyelids become inflamed and small scabs form on the edge. On the trunk, seborrheic dermatitis usually presents as rounded erythematomorphic plaques. Sometimes the plaques are covered with very adherent scales, resembling psoriasis lesions.

Diagnosis

Diagnosis is based on clinical examination, the appearance and location of the skin lesions. Spots with oily scales on the scalp are characteristic symptoms.

In addition, there are usually erythematous and scaly lesions in the insertion areas of the scalp, retroauricular folds, nasogenic creases or eyebrows. In babies, the characteristic lesion is the “cradle cap”  .

A differential diagnosis of seborrheic dermatitis should be made with other diseases  that present similar symptoms, such as:

  • Psoriasis: also causes dandruff and skin redness with the presence of flakes and scales. In psoriasis there are more scales, and they are silvery white.
  • Atopic Dermatitis : This skin condition causes itchiness and swelling in the creases of the elbows, the back of the knees and the front of the neck.
  • Pityriasis versicolor : This rash appears on the trunk but is usually not reddened like the patches in seborrheic dermatitis.
  • Rosacea : usually occurs on the face and generates few scales.

Treatment of seborrheic dermatitis

There are several general hygiene measures, such as avoiding hot baths, heated or air-conditioned environments and situations of increased emotional stress. Neutral moisturizing soaps  and non-greasy moisturizing creams or lotions  should be used for daily hygiene.

Dermatitis treatment
Topical products with anti-inflammatory and antifungal properties can help in the treatment of seborrheic dermatitis.

Anti-inflammatory

Corticosteroids, such as hydrocortisone, fluocinolone, and clobetasol, are 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 must be used with caution. If used for a long period without rest, they can cause side effects, such as thinning of the skin or appearance of blemishes.

Creams or lotions containing calcineurin inhibitors, such as tacrolimus and pimecrolimus, may be effective and have fewer side effects than corticosteroids. However, they are not the first treatment option.

Antifungals

They are used in the form of gels, creams or shampoos, alternating with other medications. They can be used at 1 or 2% as ketoconazole, depending on the intensity and the area to be treated.

In more severe cases, oral treatments with tetracyclines can be used,  which reduce sebum secretion. In general, the response to treatment for seborrheic dermatitis is good.

You should keep in mind that maintenance treatment will be necessary as the disease persists for months to years. However, it will show outbreaks that will improve in the warmer seasons, although they can worsen in the cold months and in situations of fatigue and emotional stress.

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