How to treat seborrhoeic dermatitis

General Hair Loss

Seborrhoeic dermatitis is a type of skin inflammation, sometimes called seborrhoeic eczema. It mainly occurs in young adults with a peak around the age of 40. About 1 in 25 adults develops this condition. It is more common in men than women, and can cause significant hair loss in severe cases.

The exact cause of seborrhoeic dermatitis is not known. It is thought that a type of fungal germ called Malassezia furfur (previously called Pityrosporum ovale) may be involved. However, it is not just a simple skin infection and it is not contagious (you cannot catch this condition from others). The germ lives in the sebum (oil) of human skin in most adults. In most people it does no harm. But some people may react to this yeast germ in some way which causes skin inflammation.

Combating Seborrhoeic Dermatitis can be as simple as making a few lifestyle and dietary changes in some cases. See the following video for more information:

People who have immune system problems, such as HIV/AIDS and people with Parkinson’s disease, are more likely to develop seborrhoeic dermatitis. Also, emotional stress is thought to aggravate the condition. Note: a lack of cleanliness does not cause seborrhoeic dermatitis.

What are the symptoms of Seborrhoeic Dermatitis?

The areas of the body that tend to be affected are those where there are the most skin glands which make sebum. Therefore, the condition mainly affects the more greasy areas of the skin such as the scalp, the forehead and the face around the eyebrow area and on either side of the nose. Other areas which are sometimes affected are the chest, the armpits, under the breasts, the groins and inside and behind the ears. In mild cases bad dandruff may be all that occurs. Dandruff is scaling of the scalp because of seborrhoeic dermatitis. The scalp may also become itchy. Mild patches of flaky skin may also develop on the face.

If the condition becomes worse a rash also develops. The rash looks like round or oval patches of red, scaly, greasy skin. Each patch is commonly a few centimetres across, but patches usually vary in size. Yellow-brown crusts may form on the top of each patch. Several patches may develop in a few different areas of skin. The rash may be itchy and feel slightly raised as if it is on top of the skin. The scalp may also become itchy and/or sore. Some people also develop inflammation of the outer ear canal and/or of the eyelids.

Severe cases are unusual. If the condition becomes severe then a red rash can affect much of the face, scalp, neck, armpits, chest and groins. People who have immune system problems such as HIV/AIDS are more prone to develop severe seborrhoeic dermatitis.

The condition tends to flare up and down from time to time. However, treatment can usually keep symptoms to a minimum.

How is Seborrhoeic Dermatitis treated?

An antifungal (anti-yeast) shampoo such as ketoconazole is used to treat the scalp, eyebrows and other hairy areas. This kills the fungal germ and the skin then usually returns to normal. Use the shampoo 2-3 times a week (and use normal shampoo the rest of the time). Leave the shampoo on for about five minutes before rinsing off. Follow the instructions that come with the shampoo. An antifungal cream can be used to treat other areas. Apply the cream to affected areas once or twice daily, depending on the type of cream prescribed.

It often takes 2-4 weeks to clear the dandruff or rash completely. Keep using the treatment for a few days after the dandruff or rash has cleared. You should avoid using soap or shaving creams on your face as they can add to the skin irritation. A non-greasy emollient soap substitute can be used. Cosmetic products that contain alcohol should also be avoided.

Other treatments which may be used include the following:

  • A normal anti-dandruff shampoo that contains zinc pyrithione
  • A scale softener.
  • A mild steroid cream and/or steroid scalp lotion
  • Pimecrolimus cream or tacrolimus ointment
  • A course of antifungal tablets
  • Phototherapy (light treatment) with ultraviolet B

The condition usually goes if the fungal germ is cleared from the skin by the above treatments. However, sebum is a natural place for the germ to live. In many cases, the number of germs gradually rise again on the skin after finishing a course of treatment. So, often, seborrhoeic dermatitis recurs some weeks or months after finishing a course of treatment. Each episode can be treated as it occurs. However, if you have frequent episodes, you may wish to consider using treatment to prevent the condition from recurring.

Where can I get more information?

Further information regarding this condition can be found on the following sites:

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