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| Seborrhoeic dermatitis Classification and external resources |
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| ICD-10 | L21. |
| ICD-9 | 690 |
| DiseasesDB | 11911 |
| MedlinePlus | 000963 |
| eMedicine | derm/396 |
| MeSH | D012628 |
Seborrhoeic dermatitis (also Seborrheic dermatitis AmE, seborrhea) is a skin disorder affecting the scalp, face, and trunk causing scaly, flaky, itchy, red skin. It particularly affects the sebum-gland rich areas of skin.
Seborrhoeic dermatitis may be visually unpleasant and moderately itchy but is a harmless condition. The condition is often persistent but is easily controlled using readily available medication. After treatment, the condition may recur after a time lapse of months or years.
As with other dermatitis conditions, seborrhoeic dermatitis is often loosely defined as a form of eczema although it differs from other more serious conditions more properly defined as eczema.
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Causes
The cause of seborrhoeic dermatitis remains unknown, although many factors have been implicated. The widely present yeast, Malassezia furfur (formerly known as Pityrosporum ovale), is involved,12 as well as genetic, environmental, hormonal, and immune-system factors.34 A theory that seborrhoeic dermatitis is an inflammatory response to the yeast has not been proven.5 Those afflicted with seborrhoeic dermatitis have an unfavourable epidermic response to the infection, with the skin becoming inflamed and flaking.
In children, excessive vitamin A intake can cause seborrhoeic dermatitis.6 Lack of biotin,7 pyridoxine (vitamin B6)78 and riboflavin (vitamin B2)7 may also be a cause.
Hair loss
Side effects to inflammation may include temporary hair loss. If severe outbreaks are untreated for extended intervals, permanent hair loss may result, because of damage to hair follicles.
Treatments
Soaps and detergents such as sodium laureth sulfatecitation needed may precipitate a flare-up, as they strip moisture from the top layers of the skin, and the drying property of these can cause flare-ups and may worsen the condition.citation needed Accordingly a suitable alternative should be used instead.
Among dermatologist recommended treatments are shampoos containing coal tar, ciclopiroxolamine, ketoconazole, selenium sulfide, or zinc pyrithione.9 For severe disease, keratolytics such as salicylic acid or coal tar preparations may be used to remove dense scale. Topical terbinafine solution (1%) has also been shown to be effective in the treatment of scalp seborrhoea,10 as may lotions containing alpha hydroxy acids or corticosteroids (such as fluocinolone acetonide). Pimecrolimus topical lotion is also sometimes prescribed.
Chronic treatment with topical corticosteroids may lead to permanent skin changes, such as atrophy and telangiectasia.1112
UV-A and UV-B light inhibit the growth of M. furfur,13 although caution should be taken to avoid sun damage.
According to the American Academy of Family Physicians (AAFP), one treatment that has proven successful, especially when steroid topicals and shampoos aren't working, and the patient continues to suffer from rapid hair loss and rashes, has been low doses (10mg-30mg daily) of the prescription drug Accutane (Isotretinoin). The exact mechanism isn't known, but it is thought to work by reducing sebum, which plays an important role in seborrhoeic dermatitis. Patients should be evaluated monthly, while examing the proper liver functions when putting a patient on accutane therapy. Special screening should be in place for women patients, because of the risk of birth defects. This therapy can last, when the condition is chronic and the isotretinoin dose is low, for years. But, patients should be given a one to two month break off this particular therapy every 6 months to see if the condition still is affecting the patient.14
Other suggested treatments include using an air humidifier, as well as a gentle moisturizer with or without oatmeal.citation needed Applying milk of magnesia may help clear up seborrheic dermatitis; one may apply on the face while showering and rinse off at the end of the shower.15
Plant-based treatments
The World Health Organization mentions Aloe vera gel as a yet to be scientifically proven traditional medicine treatment for Seborrhoeic dermatitis.16
- Arctium lappa (Burdock) oil17
- Chelidonium majus (Celandine)17
- Glycyrrhiza glabra (Licorice)17
- Melaleuca (Tea tree) species17
- Plantago (Plantain) species17
- Symphytum officinale (Comfrey)17
- Zingiber officinale (Ginger) root juice17
- Ledebouriella Seseloides (Fang Feng) 17
- Smilax China (Smilax china) 17
- Trichosanthes Kirilowii (Snakegourd) 17
- Glycyrrhiza Uralensis (gān cǎo) 17
- Coptis Chinensis (Chinese goldthread) 17
- Phellodendron Amurense (Huang Bai) 17
- Sophora Flavescens 17
- Centella Asiatica (Gotu Kola) 17
See also
References
- ^ Hay R, Graham-Brown R (1997). "Dandruff and seborrheic dermatitis: causes and management". Clin Exp Dermatol 22 (1): 3–6. doi:. PMID 9330043.
- ^ Nowicki R (2006). "[Modern management of dandruff]". Pol Merkur Lekarski 20 (115): 121–4. PMID 16617752.
- ^ Johnson BA, Nunley JR (2000). "Treatment of seborrheic dermatitis". Am Fam Physician 61 (9): 2703–10, 2713–4. PMID 10821151.
- ^ Janniger C, Schwartz R (1995). "Seborrheic dermatitis". Am Fam Physician 52 (1): 149–55, 159–60. PMID 7604759.
- ^ Parry M, Sharpe G (1998). "Seborrheic dermatitis is not caused by an altered immune response to Malassezia yeast". Br J Dermatol 139 (2): 254–63. doi:. PMID 9767239.
- ^ MedlinePlus Encyclopedia Hypervitaminosis A
- ^ a b c Schwartz RA, Janusz CA, Janniger CK (2006). "Seborrheic dermatitis: an overview". Am Fam Physician 74 (1): 125–30. PMID 16848386, http://www.aafp.org/afp/20060701/125.html.
- ^ Nutritional Neuropathy at eMedicine
- ^ Schwartz R, Janusz C, Janniger C (2006). "Seborrheic dermatitis: an overview". Am Fam Physician 74 (1): 125–30. PMID 16848386, http://www.aafp.org/afp/20060701/125.html.
- ^ Faergemann J, Jones J, Hettler O, Loria Y (1996). "Pityrosporum ovale (Malassezia furfur) as the causative agent of seborrheic dermatitis: new treatment options". Br J Dermatol 134 Suppl 46: 12–5: discussion 38. doi:. PMID 8763461.
- ^ Smith J, Wehr R, Chalker D (1976). "Corticosteroid-induced cutaneous atrophy and telangiectasia. Experimental production associated with weight loss in rats". Arch Dermatol 112 (8): 1115–7. doi:. PMID 952530.
- ^ Scheinfeld N (2005). "Seborrheic dermatitis". Skinmed 4 (1): 49–50. doi:. PMID 15654167, http://www.medscape.com/viewarticle/499706.
- ^ Wikler J, Janssen N, Bruynzeel D, Nieboer C (1990). "The effect of UV-light on pityrosporum yeasts: ultrastructural changes and inhibition of growth". Acta Derm Venereol 70 (1): 69–71. PMID 1967880.
- ^ http://www.aafp.org/afp/20000501/2703.html
- ^ Graedon, Joe; Graedon, Teresa (2008-04-17), "The People's Pharmacy", Atlanta Journal Constitution Evening Edge (Atlanta Journal Constitution): 15
- ^ "WHO Monographs on Selected Medicinal Plants - Volume 1: Aloe Vera Gel". www.who.int. Retrieved on 2008-03-18.
- ^ a b c d e f g h i j k l m n o "The Green Pharmacy: New Discoveries ... - Google Book Search". books.google.com. Retrieved on 2008-03-19.
External links
- Seborrhoeic Dermatitis at DermNet
- Seborrheic Dermatitis: An Overview - July 1, 2006 -- American Family Physician
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