Seborrheic dermatitis is an inflammation of the skin caused by increased allocation of qualitatively altered fat and active exposure to microbial agents – Pitirosporum orbiculare and Pityrosporum ovale – opportunistic fungi of the genus Malassezia. This defeat exposed skin, densely populated sebaceous glands, namely, the face (forehead, chin, nose, esomeone folds), scalp, chest (middle line), back (interscapular region), the region of the auricles.
It is noticed that the activity of these opportunistic fungi growing under adverse conditions, such as immune and endocrine disorders, stress, and various lesions of the nervous system. It is known that opportunistic pathogenic fungi of the genus Malassezia are concentrated around the mouths of the sebaceous glands to produce fatty acids, abundant sebaceous saturating the secret. Thus seborrhea – change the quality and quantity of sebum promotes hyperactivation of the fungal microflora: Pityrosporum ovale, a parasite mainly on the scalp and Pityrosporum orbiculare, isotropic to the sebaceous glands chest and back. Adverse factors to enhance the pathological process are considered irritating alkaline detergents, excessive sweating and a winter season.
Symptoms of seborrheic dermatitis
When seborrheic dermatitis skin lesion is gradual, slowly progressive in nature and is accompanied by itching, often intense. On the seborrheic areas on the background stains of red plaques appear with fairly clear boundaries, formed by the merger of small nodules of yellowish-pink in color, covered with greasy scales. The process of skin lesions is often symmetrical in nature and at the expense of peripheral growth and resolution in the center of the plaque can be purchased and getlangoptions annular shape.
Pathological process located in the folds (behind-the-ear, under the Breasts, in the groin) is often accompanied by oozing, sticky appearance of crusts and cracks.
With the defeat of the scalp uneven peeling or the formation of dense crusts. Often during the inspection, you can see yellow or white scales attached to the hair shaft and dandruff. The hair is usually thinned and thinning, which ultimately leads to a diffuse alopecia (baldness).
In the long process, in severe cases, seborrheic dermatitis can progress. Peeling becomes significant, the scales thicken. Often joins a secondary infection in the form of honey-yellow crusts. Redness and peeling of the skin can increase in size up to erythroderma – redness large areas of skin. This state requires mandatory medical supervision and additional tests.
In newborns with a combination of seborrheic erythroderma with diarrhea and failure to gain body mass is diagnosed quite a serious skin lesions – desquamative erythroderma of Leiner. Such a condition belongs to the category heavy and requires urgent medical intervention.
Diagnosis of seborrheic dermatitis
If the diagnosis of seborrheic dermatitis you need to eliminate such skin diseases as atopic dermatitis, eczematid, psoriasis, fungal infections (ringworm) and microbial infections of the skin. This requires microscopic and mycological study of skin flakes pathogenic fungi. Sometimes resorted to diagnostic biopsy, which together multiple signs will be recorded cells-neutrophils in the composition of crusts and scales, and in the mouths of the hair follicles. When seborrheic dermatitis occurring torpedo further research of hormonal status of the patient.
Treatment of seborrheic dermatitis
It is known that at present there are no drugs that normalize the sebaceous glands, therefore the problem of the treatment of seborrheic dermatitis should be aimed at correction of the manifestations of certain symptoms. For example, in the localization process on the scalp first preferred specific antifungal treatment. Apply shampoos that contain anti-fungal components such as ketoconazole or ciclopirox, as well as zinc pyrithione and tar.
In the treatment of seborrheic dermatitis also use other shampoos with pyrithione zinc.
Trichologists and dermatologists prescribe a comprehensive antifungal drugs topical use. The most effective shampoos are considered with the contents of the two mandatory ingredients – zinc pyrithione and ketoconazole, for example, such as “Keto Plus” which comes first among medical prescriptions. It is effective against all types of dandruff, keeps the hair from falling out, gives quick and lasting visible results and favorable from the point of view of price and volume of the vial.
Shampoo containing both ketoconazole and zinc pyrithione, often helps solve the problem of seborrheic dermatitis of the scalp and induce a longer remission.
In the acute phase may everyday use of these shampoos as long until symptoms decrease. By reducing the effectiveness of one of the shampoos, it can be interleaved with others. In the absence of full stabilization of the process, the dermatologist additionally designates products that contain selenium sulfide, tar, and salicylic acid. The combination of antifungal shampoos and components that have a drying effect, reduce infiltration, swelling, redness and help to achieve a more rapid recovery of the skin of the scalp. Well established 1-2% pasta “SULSENA”, as a therapeutic and prophylactic agent for seborrheic dermatitis of the scalp. After using medicated shampoo, a small amount of 2% paste (about 5 ml) in a circular motion rubbed into the hair roots, and the resulting emulsion is kept on the scalp for 30 minutes and then washed off with warm water.
This treatment is usually given once a week for 3 months. Supportive therapy in a similar mode is 1% of the paste. Good effect in the treatment of seborrheic dermatitis of the scalp have shampoo “Head and shoulders”, “freederm zinc” and “freederm-tar”.
In cases resistant to the above treatment, the dermatologist may purpose of combination products containing antifungals and hormonal components. Independent use these tools are not allowed because they have numerous contraindications and side effects.
With the defeat of the facial skin seborrheic inflammatory process assigns the appropriate care of the skin. It is necessary to use means that do not cause irritating effect to the skin. In this area, well established cosmetics firm, “Bioderma”, line “Sensibio”. The most preferred skin care face without contact with water – cleansing lotion.
Treatment of affected skin in the first place should be aimed at reduction of inflammation. For this purpose, various mash containing zinc. Use mash “Zindal” 2 times a day stabilizes the skin inflammation in the short term. The use of anti-fungal cream “lamisil” 2 times daily on affected skin reduces aggression opportunistic fungi of the genus Malassezia in the mouth of the hair follicles and thus causes a exfoliating and anti-inflammatory effect. Cream that contains zinc pyrithione, well proven in the treatment of seborrheic dermatitis of the face.
Recently increasingly used in dermatology outdoor immunomodulators, having also anti-inflammatory, and antifungal activity. This cream “Elidel and Protopic” that can be used at a certain stage in the treatment of seborrheic dermatitis, under the supervision of a physician.
In lesions seborrheic dermatitis skin chest and back used all of the above means. It and shampoos, foam wash which, when applied to the torso, and an anti-fungal cream, and mash and immunomodulators for topical use.
With the defeat of the seborrheic process folds effective remedy is to use liquid Castellani.
Self-treatment of seborrheic dermatitis
Of the numerous folk remedies in the treatment of seborrheic dermatitis more often lately we hear about the use of tea tree oil. This authority tea tree oil has gained due to its antifungal effect. Unfortunately, anti-inflammatory qualities of this tools are not numerous, so tea tree oil may not be the drug of choice in the treatment of seborrheic dermatitis. Good drying is the effect of decoctions of herbs used in the form of lotions and wet-drying dressings with active inflammatory process. To prevent injury to the skin for itching you can use diluted lemon juice in the form of a drench itchy areas of the skin.
To achieve longer remission period required daily hygienic care of the skin, while avoiding the use of Soaps and cleansers that irritate the skin. Since the exacerbation of the process is called irregular hygienic care for skin, growing facial hair is an aggravating factor in the development of the pathological process. When choosing underwear, you must consider that soft cotton clothing reduces skin irritation. Ultraviolet irradiation in suberythermal doses in the treatment of seborrheic dermatitis helps to achieve a longer effect remission.
When making recommendations on diet for patients with seborrheic dermatitis you should give preference to low-calorie products, and eliminate drinks that increase the secretion of sebum.
The consultation on “Seborrheic dermatitis”:
1. Why in times of stress, my husband is constantly escalating seborrheic dermatitis?
It is known that when the functional and organic disorders of the nervous system the body is unable to keep opportunistic fungi of the genus Malassezia in the saprophytic state. The active form of these fungi is significantly increased and they begin to show their pathogenic quality. This occurs due to the action of free fatty acids, actively growing under the action of lipolytic enzymes on fungi sebum that triggers skin inflammation.
2. Is it True that seborrheic dermatitis is more common in men than in women?
Indeed it explains this phenomenon by the effect of androgens on the sebaceous glands. Most likely this is due to the presence of a special receptor on the surface of cells of the sebaceous glands – sebocyti to sex hormones, which causes changes in the secretion of sebum and breaches of the barrier properties of the skin.
3. Does seborrheic dermatitis in children?
In children seborrheic dermatitis manifests itself in the form of thick yellow plaques, often oily and flaky. This so-called cradle cap. They usually appear at the age of 3 months. These rashes do not itch and do not cause anxiety to toddlers and painlessly removed with the help of vegetable oils.
4. Dandruff and seborrheic dermatitis are the same?
No. Seborrheic dermatitis unlike dandruff characterized by an inflammatory reaction of the skin and the presence of lesions.
5. A Year ago I had eczema. Recently on the breast appeared plaque. The dermatologist diagnosed seborrheic dermatitis. I asked him not could it be eczema again. He said no. As it can be confirmed?
The dermatologists have their diagnostic techniques. For example, when scraping plaque caused eczematic process will be determined by the point of erosion.
6. Can one person be both, and seborrheic dermatitis, and psoriasis? And how to distinguish them from one another?
Yes, this combination is often found. The difference of these plaques of skin pathologies detected diagnostic scraping of scales with a scalpel. Psoriasis clearly identifies the symptoms of psoriatic triad: increased silvery flaking (a symptom of the “stearin spot”), under the scales, exposing the shiny surface (a symptom of the “terminal film”), droplets of blood appearing at the end of the scraping of plaque (a symptom of “Blood dew”).