Seborrheic dermatitis (=Seborrhoeic Dermatitis) is a common, chronic, superficial skin disorder causing scaly, itchy, red skin on the scalp, face, upper chest, back and other oily areas in the body. Seborrheic dermatitis is one of the leading causes of stubborn dandruff and occurs in all age groups. This condition primarily affects the sebaceous cysts present in the skin.

The sebaceous glands are present nearly everywhere in our skin except on the palms and soles. These glands secrete an oily substance (sebum) which consists of fat, and dead fat-producing cells.

People with this condition seem to have increased production of sebum.

Symptoms of Seborrhoeic dermatitis:

Common symptoms of this disorder are:

• Patchy scaling and thick crusts on scalp
• Plaques may include the scalp, eyebrows, nose, forehead, or ears.
• Sometimes it may affect your breastbone, your groin area, and your armpits.
• Scales may be white or yellowish and attach themselves to the body of the hair
• Greasy, red skin with white or yellowish, flaky scales
• Skin flakes or dandruff
• Small red-brown bumps on skin
• Itch or soreness
• Hair loss: this occurs in very long-standing cases having repeated inflammations of the sebaceous gland.
• Dandruff is thought to be closely related to seborrheic dermatitis, but is less severe. In infants, the condition commonly affects the scalp and is called ‘cradle cap’.

All the symptoms need not occur in the same person. Also, symptoms vary in their severity. Many a times, the symptoms improve while at other times they seem to remain the same or may increase in severity. Children are less severely affected than adults.

Causes of Seborrhoeic dermatitis:

Seborrheic dermatitis is thought to be due to a combination of an over production of skin oil and irritation from a yeast called malessizia.

Recent studies have attributed seborrheic dermatitis to the presence and perhaps over-abundance of malessizia furfur, a naturally-occurring yeast on the surface of the skin. (4-8) Other researchers consider seborrheic dermatitis to be an inherited primary inflammatory process and malessizia furfur to cause only a secondary aggravation of the condition.

Persons prone to seborrheic dermatitis respond unfavorable to an infection with malessizia furfur resulting in itchy, flaky, red, irritated skin.

Certain factors increase the risk of developing seborrheic dermatitis:

• Affection of a close family member
• Obesity
• Oily skin
• Stress
• Fatigue
• Infrequent shampooing and use of hair-care products containing alcohol
• Skin disorders like acne.
• HIV infections

Diagnosis of Seborrheic Dermatitis

The diagnosis can be established by talking to your physician and letting him examine your skin and scalp. Occasionally the physician may insist on a biopsy. This helps in excluding other medical conditions that resemble seborrheic dermatitis. Common conditions that need exclusion are:

• Atopic dermatitis: This form of dermatitis is a chronic condition that causes itchy, inflamed skin. Most often, it occurs in the folds of the elbows, backs of the knees or the front of the neck. It tends to flare periodically and then subside for a time, even up to several years.
• Psoriasis: A skin disorder characterized by dry, red, skin covered with silvery scales. Like seborrheic dermatitis, psoriasis can affect the scalp and cause flaky dandruff. Psoriasis patches can range from a few spots of dandruff-like scaling to major eruptions that cover large areas of the body.
• Ringworm of the scalp (tinea capitis): Ringworm of the scalp is a type of fungal infection that is most common in toddlers and school-age children. It causes red, itchy, bald-looking patches on the scalp.

Treatment Options Available for Seborrheic Dermatitis

Conventional treatment

There is no complete cure available for seborrheic dermatitis till date. Conventional medicines manage to control the symptoms. But, the condition is ever recurring. The skin-type of the patient, severity of symptoms and general well-being all need to be considered when adjusting the dosing of available drugs.

Scalp dermatitis treatment

Common medicines come in the form of shampoos medicated with one or more of the following:

• Ketoconazoles
• Salicyclic acid
• Tar
• Pyrithrione zinc
• Selenium sulfides

Non-scalp dermatitis treatment

The medications used try control repeated inflammations and build-up of flakes. These drugs used are

• Anti-fungal applications
• Corticosteroid applications
• Ointments of ketoconazole and desonide
• Immune-modulators having anti-inflammatory and anti-fungal properties (ONLY when other treatments fail, as these have many adverse side-effects)

Alternative treatments include

• topical zinc and/or lithium,
• essential fatty acids, and
• various B-vitamins.

Self-care tips:

• Shampoo daily. Use an anti-dandruff shampoo that contains selenium sulfide, tar, pyrithione zinc, salicylic acid or ketoconazole as the active ingredient. Use a different shampoo with varying active ingredients each week for three weeks. Then repeat the rotation.
• Use an over-the-counter antifungal cream. Daily application of nonprescription clotrimazole (Lotrimin) may be helpful.
• Apply an anti-itch cream or lotion to the affected area. A nonprescription hydrocortisone cream, containing at least 1 percent hydrocortisone, can temporarily relieve the itch.
• Avoid harsh soaps and detergents. Be sure to rinse the soap completely off your body.
• Wear smooth-textured cotton clothing. This will help you avoid irritation.
• Avoid scratching whenever possible. Cover the itchy area with a dressing, if you can't keep from scratching it. Trim nails and wear gloves at night.

Homeopathic treatment for Seborrhoeic dermatitis

Homeopathy offers an excellent treatment for Seborrhoeic dermatitis during all stages. Cases treated especially in the early stages show much better results. However, old cases of Seborrhoeic dermatitis also respond very well, but would require time. Most cases approach for homeopathic treatment only after failing with the conventional medicines, unfortunately. Homeopathy is strongly recommended for Seborrhoeic dermatitis.