Seborrheic dermatitis

Causes and Risks:
Seborrheic dermatitis may involve the skin of the scalp, face, nose, eyebrows, behind the ears, in the external ear, and the skin of the trunk (particularly over the sternum and along skin folds). The cause is unknown.

Seborrheic dermatitis appears to run in families. Stress , fatigue , weather extremes, oily skin , infrequent shampoos or skin cleaning, skin disorders such as acne , obesity , and use of lotions that contain alcohol may increase the risk of seborrheic dermatitis. Neurologic conditions, including Parkinson's disease , head injury , and stroke can also be associated with seborrheic dermatitis. The AIDS complex or syndrome also seems to be associated with a higher incidence of seborrheic dermatitis.

Cradle cap appears as thick, crusty, yellow scales over the child's scalp. Similar scales may also be found on the eyelids, ear, around the nose, and in the groin. Cradle cap may be seen in newborns and small children up to the age of 3 years. It is a chronic , recurring condition caused by inflammation of skin glands. It is similar to dandruff in adults. (However, dandruff can also be caused by other scalp conditions).

Cradle cap is not contagious, it is not caused by poor hygiene, it is not an allergy , and it is not dangerous. Cradle cap may or may not itch . If itching is present, excessive scratching of the area may cause additional inflammation and breaks in skin may cause mild infections or bleeding .

Prevention:
The tendency to develop seborrheic dermatitis appears inherited. The severity can be lessened by controlling the risk factors and by careful attention to skin care (see treatment).

Symptoms:
  • skin lesion
    • patch or large area
    • greasy, oily areas of skin
  • skin scales , white and flaking or yellowish, oily, and adherent "dandruff"
    • patches may include the scalp, eyebrows, nose, forehead, or ears
    • itching , usually painless unless infected
    • mild redness
Hair loss may also be associated with this disease.

Signs and Tests:
The diagnosis is based on the appearance and location of the skin lesions .

Treatment:
The goal of treatment is to reduce the symptoms.

Adults and older children:
Flaking and dryness may be reduced by use of "dandruff" or medicated shampoos. Shampoo the hair vigorously and frequently (preferably daily). Loosen scales with the fingers, scrub for at least 5 minutes, and rinse thoroughly. Active ingredients in these shampoos include salicylic acid, coal tar, zinc, or selenium.

Shampoos or lotions containing selenium, ketaconazole, or corticosteroids may be prescribed for severe cases. To apply lotions or medications, part the hair into small sections (if on the scalp), apply to a small area at a time and massage into the skin.

Seborrheic dermatitis may improve in the summer, especially after outdoor activities.

Infants (cradle cap):
1. Massage your baby's scalp gently with your fingers or a soft brush to loosen the scales and improve scalp circulation.
2. Give your child daily, gentle shampoos with a mild soap while scales are present. After scales have disappeared, you may reduce shampoos to twice weekly.
3. Be sure to rinse off all soap.
4. Brush your child's hair with a clean, soft brush after each shampoo and several times during the day.
5. If scales do not easily loosen and wash off, apply some mineral oil to the baby's scalp and wrap warm, wet cloths around his head for up to an hour before shampooing. Then shampoo as directed above. Remember that your baby loses a lot of heat through his scalp. If you use warm, wet cloths with the mineral oil, check frequently to be sure that the cloths have not become cold. Cold, wet cloths could drastically reduce your baby's temperature.
6. If the scales continue to be a problem or concern, or if you child seems uncomfortable or scratches his scalp, contact your physician. He may prescribe a cream or lotion to apply to your baby's scalp several times a day.

Prognosis:
Seborrheic dermatitis is a chronic condition, controllable with treatment. It often has extended inactive periods followed by flare-ups.

Complications:
  • psychological distress, low self esteem, embarrassment
  • secondary bacterial or fungal and/or yeast infections


Call Your Healthcare Provider:
Call for an appointment with your health care provider if seborrheic dermatitis symptoms do not respond to self care or over-the-counter treatments.

Also call if patches of seborrheic dermatitis drain fluid or pus, form crusts, or become very red or painful.