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Sebborheic dermatitis is more commonly known as dandruff in adults or cradle cap in infants. Although it affects the scalp most often, it can also affect the skin on other parts of the body, such as the face and chest, and the creases of the arms, legs and groin. Seborrheic dermatitis usually causes the skin to look a little greasy and scaly or flaky.
The exact cause isn't known, but has been attributed to hormonal changes, a fungus, sensitivity to yeast, and even neurologic disorders like Parkinson's and Epilepsy.
Seborrheic dermatitis is a chronic inflammatory disorder affecting areas of the head and trunk where sebaceous glands are most prominent. Lipophilic yeasts of the Malassezia genus, as well as genetic, environmental and general health factors, contribute to this disorder. Scalp seborrhea varies from mild dandruff to dense, diffuse, adherent scale. Facial and trunk seborrhea is characterized by powdery or greasy scale in skin folds and along hair margins. Treatment options include application of selenium sulfide, pyrithione zinc or ketoconazole-containing shampoos, topical ketoconazole cream or terbinafine solution, topical sodium sulfacetamide and topical corticosteroids.
Many cases of seborrheic dermatitis are effectively treated by shampooing daily or every other day with antidandruff shampoos containing 2.5 percent selenium sulfide or 1 to 2 percent pyrithione zinc. Alternatively, ketoconazole shampoo may be used.10 The shampoo should be applied to the scalp and beard areas and left in place for five to 10 minutes before rinsing. A moisturizing shampoo may be used afterward to prevent dessication of the hair. After the disease is under control, the frequency of shampooing with medicated shampoos may be decreased to twice weekly or as needed. Topical terbinafine solution, 1 percent, has also been shown to be effective in the treatment of scalp seborrhea.
If the scalp is covered with diffuse, dense scale, the scale may first be removed by applying warm mineral oil or olive oil to the scalp and washing several hours later with a detergent such as a dishwashing liquid or a tar shampoo. An alternative is an overnight application of a coal tar-keratolytic combination or phenol-saline solution with or without occlusion with a plastic shower cap followed by shampooing in the morning.
Involved areas of the face may be washed frequently with shampoos that are effective against seborrhea as detailed above. Alternatively, ketoconazole cream, 2 percent, may be applied once or twice daily to affected areas. Often, 1 percent hydrocortisone cream will be added once or twice daily to affected areas and will aid with resolution of erythema and itching. Sodium sulfacetamide, 10 percent lotion, is also an effective topical agent for seborrheic dermatitis.
Are dandruff, seborrhea and seborrheic dermatitis the same?
Dandruff appears as scaling on the scalp without redness. Seborrhea is excessive oiliness of the skin, especially of the scalp and face, without redness or scaling. Patients with seborrhea may later develop seborrheic dermatitis. Seborrheic dermatitis has both redness and scaling.
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