Seborrhea - Seborrheic Dermatitis

Have you noticed red or flaking skin around your nose or in your eyebrows? How about in your scalp - especially over your forehead or ears? If you answer yes, you may have something called seborrheic sermatitis or seborrhea.

Cause of Seborrhea
Seborrhea is a chronic inflammatory skin disorder that affects the areas of the head and trunk that have sebaceous glands. A type of yeast that has an affinity for these glands called Pityrosporum ovale may be the cause, but this has not been proven yet. It is believed that the build-up of yeast in these glands irritates the skin causing redness and flaking.

Who Gets Seborrhea?
Seborrhea is more common in men than women and affects 3 percent of the general population. It occurs more commonly in older people who are bedridden or have neurologic conditions such as Parkinson's disease. Seborrhea also affects almost 85 percent of people with AIDS.

Treatment of Seborrhea
Adults who have seborrhea usually experience a waxing and waning course. In other words it can't be "cured". The good news is with proper maintenance, seborrhea can be controlled. Furthermore, most of the treatments can be found over-the-counter.

Proper hygiene plays an important role in treatment. Frequent washing with soap gets rid of the oils in the affected areas and improves symptoms. Sunlight inhibits the growth of the yeast; therefore exposure of affected areas to sun is helpful, although caution should be exercised to avoid sun damage. The main medical treatments are antifungal shampoos and topical steroids.

Seborrhea Shampoos
There are several good antifungal shampoos on the market that can be purchased without a prescription. The main shampoos are selenium sulfide found in Selsun, Pyrithione zinc found in Head & Shoulders and Sebulon, Coal tar found in Sebutone and Tegrin, and finally ketoconazole found in Nizoral.

All of these shampoos have a medicated smell. The way to use them is to shampoo and leave on for at least 10 minutes then rinse off. The shampoos can be used on the face and other parts of the body as a lotion with the same instructions as long as precaution is used around the eyes. Do this daily until the redness and flaking is controlled then use 2-3 times a week as needed to keep symptoms from returning.

Topical Steroids For Seborrhea
Topical steroids reduce the inflammatory response and help control itching. Hydrocortisone cream 1% can be bought over-the-counter and is safe to use on the face. Apply twice a day to the affected area until the redness resolves. Save the hydrocortisone for flare-ups and use the antifungal shampoo for maintenance because long-term steroid use can cause side effects like acne and thinning of the skin.

When to See a Doctor For Seborrhea
You should see your doctor if you're not sure you have seborrhea. Other conditions that can be similar are psoriasis, rosacea, atopic dermatitis, or superficial fungal infections.

You should also consult your doctor if you have tried this over-the-counter treatment and you still have symptoms, especially if you have very thick flakes. Your doctor may recommend a stronger steroid or a combination medicine to help dissolve the dead skin. Finally, it may not be feasible for black persons to shampoo every day. Ask your doctor about a special steroid preparation in oil that can be used on the scalp like a pomade.