Definition

Seborrheic dermatitis is a commonly encountered skin condition, particularly affecting the scalp. In infants, this condition on the scalp is known as cradle cap. This disorder results in elevated skin surfaces with a rough texture (scaly), redness, and dandruff when occurring on hair-bearing skin.

Seborrheic dermatitis can also manifest on oily areas of the body such as the face, the sides of the nose, the skin of the eyebrows, ears, eyelids, and chest. This condition can resolve without specific medication but can easily recur, especially if you do not maintain proper skin hygiene. Cleansing the skin with soap and shampoo can help reduce oil content and remove dead skin cells.

This disease is more common in men than women, particularly in individuals with oily skin.

Causes

The exact cause of seborrheic dermatitis remains unknown. However, it is often associated with a fungal infection by Malassezia sp. Though not directly involved, this fungus can suppress immune cell activity and increase oil (sebum) production, thus triggering seborrheic dermatitis. Additionally, individuals with seborrheic dermatitis are known to have a compromised skin barrier. Certain medications are also known to trigger this condition.

Risk factor

While the precise cause is unknown, risk factors for seborrheic dermatitis can be mitigated to prevent its occurrence. Some of these factors include stress and genetic predisposition.

It is known that certain fungi normally reside on the human skin surface. However, under certain conditions, their growth becomes uncontrolled, leading to skin infections. Medical conditions that weaken immune function and the use of specific medications can also trigger seborrheic dermatitis. Such immune-compromising conditions include HIV/AIDS infection, alcohol abuse, and depression. These conditions can contribute to the risk of developing seborrheic dermatitis.

A weakened immune system can also result from age. Infants with underdeveloped immune systems and elderly individuals over 60 years old are particularly vulnerable to seborrheic dermatitis.

Environmental factors such as low humidity and hot air can cause your skin to become dry and susceptible to infection. Additionally, a compromised immune system can further exacerbate seborrheic dermatitis.

Symptoms

In infants up to three months old, symptoms typically include a yellowish or brownish scalp surface that may disappear before the child turns one year old. However, this skin condition can reappear in adulthood.

In the elderly, it can be challenging to distinguish seborrheic dermatitis from diaper rash.

In adults, seborrheic dermatitis frequently affects the face, especially around the nose, on the eyebrow skin, eyelids, and behind the ears. Furthermore, it can occur on various parts of the body such as the chest, around the navel, buttocks, arm folds, legs, groin, and breast folds. Affected skin feels sore, itchy, or has a burning sensation. The scaly and peeling skin may appear white or yellowish and look moist or oily. Additionally, severe seborrheic dermatitis on the scalp can lead to thickened skin and extensive lesions, covering the entire scalp, thereby causing a loss of confidence in sufferers.

Diagnosis

The diagnosis of seborrheic dermatitis is conducted by your physician through examination of the skin lesions. Additionally, your doctor will inquire about your medical history. A small skin sample will be taken and examined under a microscope. A skin biopsy is a crucial procedure to distinguish seborrheic dermatitis from other conditions, such as fungal infections of the scalp or tinea capitis.

Management

Seborrheic dermatitis typically resolves on its own. However, the condition can sometimes persist and affect the appearance of your skin, causing discomfort. If you have seborrheic dermatitis, your doctor may recommend switching to a shampoo containing specific ingredients such as ketoconazole, salicylic acid, selenium sulfide, and zinc.

For infants with scaly scalps, use baby shampoo and gently rinse their scalp with warm water during baths. Avoid using dandruff shampoos or adult shampoos as they can irritate a baby's scalp. For seborrheic dermatitis on the face and body, ensure the affected areas are kept clean by washing with soap and water daily. Sunlight exposure can help inhibit the growth of fungal organisms on your skin, so it is advisable to sunbathe while using sunscreen to prevent sunburn.

Your doctor may also prescribe corticosteroid creams to reduce skin inflammation. Antifungal medications or creams may be provided if a fungal infection is present. In severe cases, your doctor may prescribe fluconazole therapy to alleviate the symptoms.

Complications

Untreated seborrheic dermatitis can lead to complications, including skin infections and decreased self-esteem. Scratching the lesions can trigger infections.

Prevention

Preventive measures for seborrheic dermatitis primarily involve maintaining skin hygiene. Clean skin helps protect against microorganisms that can cause irritation or infection. It's also important to keep your skin moisturized; using lotions or moisturizers can prevent dryness. If you have allergies, avoid known allergens to prevent skin irritation. Inform your doctor about any ongoing medications for other medical conditions if you experience skin issues suggestive of seborrheic dermatitis.

When to see a doctor?

Consult your doctor if you experience significant skin discomfort that disrupts daily activities or affects your confidence. Inform your doctor of any medical conditions or medications you are taking, as this can aid in diagnosing your skin problem and allow for appropriate treatment.

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