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Seborrheic dermatitis: what is it? Causes, Symptoms and Treatment

The seborrheic dermatitis refers to a skin disease benign characterized by the formation of red spotsaccompanied by dander, kinds of films on the surface of the skin. This disease evolves by outbreaksand can last several years.

It is called “seborrheic” because it mainly affects the fatty parts of the skin, such as the face, trunk and hair. It has no character of gravity and entails no complication but is inconvenient aesthetically. The proliferation of a yeast would be responsible for red plaques. The treatments are based on the use of antimycotics ( shampoos, creams, lotions ).
It affects between 3% and 5% of the population and is manifested by the creation of red patches and scales of white or yellowish coloring.

Causes of seborrheic dermatitis

At present, it is not known with certainty the origin of seborrheic dermatitis.
Two elements are involved: the area of ​​oily skin and a fungus (yeast) type Malassezia furfur (formerly pitysporum). But it does not seem that sufferers suffer from an excess of sebum production.  Malassezia yeasts are present on all skins, but some people seem to react inappropriately, which could lead to seborrheic dermatitis. Another hypothesis is that yeasts transform sebum into free fatty acids, which themselves would be a source of inflammation.

Diagnostic of seborrheic dermatitis

Visible manifestations are sufficient for the physician to make a diagnosis, although the lesions presented are sometimes similar to those of psoriasis . It is not always easy to differentiate between these two diseases. Sebopsoriasis is also described as profuse forms of seborrheic dermatitis associated with psoriasis plaques on the body.

What are the symptoms of seborrheic dermatitis?

Symptoms vary slightly depending on the area affected:

  • On the scalp (the most common): white scales, kinds of dandruff visible on clothes or shoulders when the person is combing, red scalp, itching .
  • On the skin, it is red patches that peel. They are preferentially:
    • On the face  : in the nasolabial folds (furrows between the nose and both ends of the mouth), the wings of the nose, the eyebrows, the eyelids, behind the ears, and in the external auditory canal. Plates are generally symmetrical.
    • On the trunk, the back  : on a median vertical line between the breasts (intermuscular zone), or on the back a median zone between the shoulders (interscapular zone).
    • On the genital areas, hairy areas and folds, for example, folds of the groin.
  • Itching: they are relatively frequent, but not systematic and may be accompanied by burning sensations.
  • Lesions are very inconsistent: they come and go, often triggered by stress, fatigue or overwork. And they are improved by the sun.

What are the risk factors for seborrheic dermatitis?

It can also affect infants (so-called ”  milk crusts  “), and about 70% of them are concerned before the age of 3 months. There is an extended form of Leiner-Moussous erythroderma, which usually cures itself. It is common in children (10% of them up to 5 years). About 4% of adults have seborrheic dermatitis. In the over 65 years, a quarter of the population is affected.
This disease is therefore more common at both ends of life, just after birth or after 65 years.

People over 65 years old, those with oily water, Parkinson’s disease, who are HIV positive or with a declared AIDS stage, people with trisomy 21, cancers of the upper aerodigestive tract, have alcoholism, or neuroleptic drugs . Also, stress and fatigue are factors of seizures (not of the disease).

Prevention of seborrheic dermatitis

Prevention of seborrheic dermatitis is difficult. It passes by the reduction of the favorable factors in the hygiene of life such as fatigue, overwork, alcohol …

Therapeutically, prevention consists of

  • the reduction of residual sebum by a daily toilet of the affected areas with mild products
  • the reduction of fungal colonization by the use at the first signs of antifungal products
  • the fight against inflammation by not scratching its lesions and using moisturizing cosmetics and gentle care.

What are the treatments for seborrheic dermatitis?

There is no treatment that can permanently eliminate seborrheic dermatitis which is a field disease. There will always be relapses or outbreaks. The treatments are administered locally, in the form of creams or shampoos. In some serious cases, the doctor may use oral forms, but this is a rare situation.

The treatment consists in using an antimycotic agent acting on the yeasts, making it possible to block seborrheic dermatitis attacks. The doctor takes into account the affected areas and the evolution of the disease in order to propose the most appropriate treatment.

For example, Ketoconazole, or Ciclopirox olamine, or zinc pyrithione are used.
The treatment consists of a daily or bi-daily application of cream or shampoo twice a week. Then, once the crisis has passed, shampoo a week, then every two weeks for 3 months, allowing maintenance therapy ..

The lithium salts can also be used in local applications in the form of gels.

The corticosteroids (cortisone), although they are very effective at the time should be used as little as possible because they cause significant side effects, although more troublesome than the disease: depigmentation, acne, persistent skin atrophy and even relapse faster and more severe than the initial thrust … So they should be used for a very short period and only in case of seborrheic dermatitis very handicapping in combination with antimycotic treatments.

In infants, almond oil can be used to treat scabs of milk.

Several complementary approaches are proposed to fight naturally against seborrheic dermatitis.

The salts of the Dead Sea  : used daily in dermatological bread or cream, they are known to have a positive effect against seborrheic dermatitis, but are for some aggressive.
For the scalp, rinsing hair with salt water (tap water + coarse salt) can sometimes prevent seizures.

Food

At the base of the natural treatment of seborrheic dermatitis, the establishment of a good food hygiene is essential. This amounts to limiting saturated fats and sugars, and in parallel consuming more fiber, green vegetables (especially cabbages), essential fatty acids (omega-3 and 6) and vitamin E.

Homeopathy

– Application on lesions an ointment based on Graphites or Mezereum. To combine these soothing and moisturizing remedies with an antiseptic, add a Calendula ointment (two to three times a day).

To fight more specifically against cutaneous inflammation, especially when it is very important, are recommended 5 granules in 9 CH, twice a day, of:

  • for the scalp and face: Graphites, Natrum muriaticum, Oleander.
  • for members: Anagallis, Antimonium and Petroleum.
  • for the genitals: Croton tiglium.

Phototherapy

Oils: such as borage oil or safflower oil to moisturize and heal your skin. Aloe vera and grapefruit are also used in the treatment of seborrheic dermatitis.

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