What is seborrheic dermatitis (dandruff)?
You may have noticed to have a lot of dry skin on your scalp or even on your face. The scalp can also be very itchy and red at times. Dandruff or seborrheic dermatitis is a very common skin condition that affects part of body which produces a lot of oil including scalp, forehead, eyebrows, laugh lines and neck area. It is believed to occur due to tendency of some people to produce a lot of oil on their skin as well as overgrowth of Malassezia yeast.
What are the signs of having seborrheic dermatitis (dandruff)?
You may have noticed a very itchy red scaly (flaky) rash on your face which creates a greasy like skin texture. The rash is usually very symmetrical (equally affects the right and left side of face, neck or scalp area). It is usually accompanied by considerable dandruff to the scalp area. The rash doesn’t cause significant discomfort and most people tend to seek help due to the unpleasant look of it. Seborrheic dermatitis can affect young patients, including infants. It starts around one week after birth and can lasts several months. Interesting, it is common for infants to have the rash all over their body, starting from the head (cradle cap) to the diaper area. It tends to be considerably itchy and uncomfortable for the infant.
Can dandruff be associated with any diseases?
- In people who have very severe and wide spread dandruff, it is very important to rule out HIV infection.
- Patients who have limited facial muscle mobilities including suffering from Parkinson disease or stroke, they tend to have very severe, widespread and resistant disease
- Patients who use oral steroid to treat medical conditions or for recreational purpose may also notice flaring up of their condition
- Infantile seborrheic dermatitis usually responds satisfactorily to bathing and application of emollients.
- Ketoconazole cream (2%) is indicated in more extensive or persistent cases.
- Short courses of low-potency topical corticosteroids may be used initially to suppress inflammation.
- Mild shampoos are recommended for the removal of scalp scales and crusts.
- In Adult type, the mainstay of therapy is the use of topical antifungal (e.g. ketoconazole), either as shampoos (scalp) or as creams (body).
- Ciclopirox olamine has antifungal and anti-inflammatory properties and has also been shown to be effective as a shampoo or cream.
- Second-line treatment options include zinc pyrithione (Head & Shoulder shampoo), selenium sulfide (Selenium Blue), and tar shampoos as well as topical calcineurin inhibitors (Protopic or Elidel cream)
Complications of seborrheic dermatitis
- In patients with severe seborrheic dermatitis, the rash may become very bright red and patients develop sores in their skin.
- Malassezia (Pityrosporum) folliculitis is another complication characterized by itchy red bumps around hair follicle, sometimes pus can be seen too, typically in very oily skin area
- In infantile form, the skin folds may be superinfected with Candida or bacteria (Strep or Staph)
Prevention of seborrheic dermatitis
- In infants, irritating agents (soap, high concentration of salicylic agent or other peeling agents) or scrubbing the skin should be completely avoided
- Maintenance regimens to prevent relapse is a key in treatment of seborrheic dermatitis
For more information and to get help for your skin, hair and nail concerns, visit one of our Canadian board certified dermatologists at RemoteDerm.ca 24/7. No matter you live in Vancouver, Edmonton, Calgary, Toronto or any other place across Canada, RemoteDerm allows you to connect with Canadian Board Certified Dermatologist in a very short span of time.