Seborrheic dermatitis affects millions of people and is a skin condition that causes patches of skin itchiness and dryness, most often on the face and scalp. It is difficult to diagnose, because it resembles other inflammatory skin conditions such as psoriasis and eczema and even skin allergies. This is a chronic skin condition that can be treated successfully, but symptoms can return or flare up at any time.
Seborrheic dermatitis is frequently found on areas of the skin that have a high concentration of sebaceous glands. The condition is a form of eczema, but can cause both dry or oily skin patches.
The condition can be found on the face (near the eye brows, top of the nose or on the chin), behind the ears, on the scalp or neck, on the upper chest or on the back and in any body fold such as the groin area. The majority of patients however, have facial symptoms.
The main symptom of seborrheic dermatitis is flaking (dry or oily) skin patches covered with white or yellow scales. Unlike dandruff, which doesn’t involve inflammation, seborrheic dermatitis often involves red, burning and itchy skin patches.
Many patients confuse the white flaky skin as very dry skin, reducing the frequency of shampooing their hair or washing their face, which could worsen the symptoms.
The difference between Seborrheic dermatitis and Scalp Psoriasis
Seborrheic dermatitis differs from scalp psoriasis in that it forms large pores that look like a sponge (“spongiform”). Another difference is that psoriasis usually causes more dry and red scaling. Psoriasis symptoms often include patches on the elbows and knees.
Common Causes and Risk Factors of Seborrheic Dermatitis
There are several factors that can trigger Seborrheic Dermatitis (SD), including stress, a weakened immune system, hormonal Imbalance and nutritional deficiencies.
- Increased stress is a major risk factor
- Oily skin or not washing the face or scalp often enough can cause the condition
- Extreme weather conditions can trigger a flare-up in susceptible patients
- A weakened immune system caused by chemotherapy, immunosuppressant drugs or diabetes can cause SD
- In some cases, a particular yeast called Malassezia has been found to trigger symptoms. This yeast is normally found on the skin in sebum-rich areas, but in people with SD are found in much higher numbers, which causes skin inflammation
Seborrheic dermatitis is often successfully treated with over-the-counter (OTC) shampoos and creams containing salicylic acid and/or ketoconazole, which can be helpful for clearing up fungal induced patches and infections.
Dietary changes can also have an impact on symptoms. Reducing sugar intake, increasing the use of natural oils such as olive oil and coconut oil, eliminating processed foods as much as possible and eating foods high in antioxidants will all help to alleviate symptoms.
Some patients have found relief by limited sun exposure. During the winter months, vitamin D supplements can be taken to prevent any vitamin D deficiency.
Tea tree oil with its anti-fungal and anti-microbial properties, has been shown to reduce the symptoms of dandruff (and can possibly help with Seborrheic dermatitis symptoms due to its activity against Malassezia fungi).
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Nenoff, P., Haustein, U.F. and Brandt, W. (1996) Antifungal activity of the essential oil of Melaleuca alternifolia (tea tree oil) against pathogenic fungi in vitro. Skin Pharmacol9 (6):388-94.
Pirkhammer, D., Seeber, A., Hönigsmann, H. and Tanew, A. (2000) Narrow‐band ultraviolet B (TL‐01) phototherapy is an effective and safe treatment option for patients with severe seborrhoeic dermatitis. Brit J Dermatol143 (5) : 964-968.