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Seborrheic Dermatitis Print E-mail
by Ron Kennedy, M.D., Santa Rosa, CA

Dr. Kennedy Seborrheic dermatitis is an inflammation in areas of the body like the scalp, sides of the nose, eyebrows, eyelids, and the skin behind the ears and middle of the chest. What all these areas have in common is a high concentration of sebaceous (oil producing) glands. Other areas, such as the navel and skin folds under the arms, breasts, groin and buttocks, may also be involved. The affected skin is red and is covered by yellowish, greasy-appearing scales. Itching may or may not occur. When it does, it is usually mild.

Dandruff is sometimes considered to be seborrheic dermatitis, but in fact dandruff is characterized by excessive scaling on the scalp. There is no skin inflammation.

The word "seborrhea" (literally "oil flow") describes excessive oiliness of the skin, especially on the scalp and face. There is no redness and scaling. Patients with seborrhea may later develop seborrheic dermatitis.

Seborrheic dermatitis can occur at any age, but is most common in three distinct age groups-- infancy, when it's called "cradle cap," middle age, and old age. Cradle cap in infancy usually clears without treatment by age eight to 12 months. This may be due to the gradual disappearance of hormones passed from the mother to the child before birth. Gentle shampooing is helpful. In some children, this condition may develop only in the diaper area where it can be confused with other forms of diaper rash. When seborrheic dermatitis develops at other ages, it may appear, disappear and then reappear. Whether treated or not, this condition comes and goes.

Because this is such a common disorder, it's not surprising that some patients may have other skin or systemic diseases. There is an increased incidence in adults with conditions of the nervous system such as Parkinson's disease and in some patients recovering from stressful medical conditions such as heart attack. Those who have been confined to hospitals or nursing homes for long periods of time and those with immune system disorders, such as AIDS, appear to be more likely to develop seborrheic dermatitis. Some more intense forms of this condition can be seen in those with psoriasis. People with seborrheic dermatitis have no increased risk of other skin diseases. This condition does not progress to, or cause skin cancer, no matter how long it remains untreated.

While it may subside without treatment, it usually improves temporarily with treatment. In any case, this condition tends to recur. If the rash is a cosmetic problem or if symptoms such as itching are significant, it should be treated. If the scalp is involved, frequent shampooing is usually recommended once the condition clears up.

This skin disorder is treatable but may recur periodically, requiring re-treatment. One of the more effective methods of treatment is low strength hydrocortisone (cortisol) applied to the affected areas of skin. For patients who do not respond to this treatment, there are several other effective medications that a doctor can prescribe. The frequent use of nonprescription shampoos containing tar, zinc pyrithione, selenium sulfide, sulfur and/or salicylic acid may be recommended.

Recent evidence suggests that this skin disorder may be intensified or perpetuated by a yeast-like organism. This organism is normally found on non-diseased skin in low numbers. With the increased scaling and retention of oil in seborrheic dermatitis, this yeast grows to very high numbers and can aggravate the inflammation of the disease. Specific prescription creams and shampoos can be helpful in controlling the condition in some people and elimination of sugar and high glycemic index foods such as breads, pastas, potatoes, and rice should help. Food allergies may also play a significant role in the causation of seborrheic dermatitis. In cases which do not respond to treatment, this should be investigated.

The information in this article is not meant to be medical advice.�Treatment for a medical condition should come at the recommendation of your personal physician.

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