Medical & Surgical Dermatology

Seborrheic Dermatitis

Seborrheic dermatitis is a common skin disorder that can be easily treated. Causing a red, scaly, itchy rash, this condition most commonly develops on the scalp, sides of the nose, eyebrows, ears, eyelids, and middle of the chest. Other areas, such as the navel (belly button), buttocks, underarms, breasts, and groin, may be involved.

THE DIFFERENCES BETWEEN DANDRUFF, SEBORRHEA, & SEBORRHEIC DERMATITIS

While these terms are sometimes used inter–changeably, there are differences. Dandruff causes scaling on the scalp but not redness. With seborrhea, there is excessive oiliness of the skin, especially of the scalp and face, without redness or scaling. Patients with seborrhea may later develop seborrheic dermatitis, which causes both redness and scaling.



THOSE AFFECTED BY SEBORRHEIC DERMATITIS

This condition is most common in three age groups — infancy, middle age, and in seniors.
In infants, the condition most often develops on the scalp and is called “cradle cap.” This usually clears without treatment between 8 and 12 months of age. In some infants, seborrheic dermatitis develops only in the diaper area and can be confused with other forms of diaper rash. When seborrheic dermatitis develops after infancy, it tends to come and go. It is common in people with oily skin or hair, and may be seen with acne or psoriasis. A yeast–like organism may be involved in causing seborrheic dermatitis. For people living in northern climates, winter can worsen seborrheic dermatitis.

ASSOCIATION WITH OTHER DISEASES

Seborrheic dermatitis may occur in patients with diseases of the nervous system, such as Parkinson's disease. Patients recovering from stressful medical conditions, such as a heart attack, also may develop this condition. People in hospitals or nursing homes and those with immune-system disorders appear to be more prone to seborrheic dermatitis as well.

DIAGNOSIS

For most patients, there is no need to perform blood, urine, or allergy tests. In rare cases of chronic seborrheic dermatitis that do not respond to treatment, a skin biopsy or other laboratory test may be necessary to eliminate the possibility of another disease.

TREATMENT

There is no way to prevent or cure seborrheic dermatitis, but treatment can control it. Seborrheic dermatitis may get better on its own. With regular treatment, the condition improves quickly.

Gentle shampooing with a mild shampoo is helpful for infants with cradle cap. A cream or lotion containing a low–dose corticosteroid or an anti–fungal topical such as ciclopirox or ketoconazole may be applied to the child's affected skin. Adults often need to use a medicated shampoo and a stronger corticosteroid preparation. A dermatologist may recommend non-prescription medicated shampoos containing tar, zinc pyrithione, selenium sulfide, ketoconazole, and/or salicylic acid. In some cases, the dermatologist will write a prescription for a shampoo, cream, gel, or foam. As excessive use of stronger preparations can cause side effects, patients should follow their Water’s Edge Dermatology practitioner's advice.

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