Common dermatologic disorders Seborrhoeic dermatitis

Dr. Faramarz DidarCosmetic Facial UKwww.cosmeticfacial.co.uk

definitionan inflammatory[skin disorder affecting the scalp, face, and torso. Typically, seborrheic dermatitis presents with scaly, flaky, itchy, and red skin. It particularly affects the sebaceous-gland-rich areas of skin.Seborrhoeic dermatitis is caused by seborrhea, a pathologic overproduction of sebum, and subsequent infection and inflammation.Seborrhoeic dermatitis may involve an inflammatory reaction to a proliferation of a form of the yeast Malassezia,though this has not been proven. The main species found in the scalp is Malassezia globosa, others being Malassezia furfur (formerly known as Pityrosporum ovale) and Malassezia restricta. Genetic, environmental, hormonal, and immune-system factors have been shown to be involved in the manifestation of seborrhoeic dermatitis.Seborrhoeic dermatitis may be aggravated by illness, psychological stress, fatigue, sleep deprivation, change of season and reduced general health.In children, excessive vitamin A intake can cause seborrhoeic dermatitis.symptoms appear gradually and usually the first signs are flaky skin and scalp. Flakes may be yellow, white or grayish.A clean scalp is essential to preventing a flare-up of seborrhoeic dermatitisThere is evidence of a relationship between seborrheic dermatitis and intestinal yeast, such as candida.

TreatmentsProper scalp hygiene is primary in treating seborrheic dermatitis.Dermatologists recommend topical treatments such as shampoos, cleansers or creams/lotions that contain antifungal, anti-inflammatory, sebo-suppressive or keratolytic ingredients:

1. One combination approach combines a dandruff shampoo, antifungal agent and topical steroid.

2. If a class III steroid is unsuccessful, short-term "pulse fashion" use of a more potent topical steroid in combination with a dandruff shampoo and antifungal agent may put some resistant patients into remission and actually decrease total steroid exposure.

3. Therapeutic choices include a nonfluorinated class III steroid such as mometasone furoate (Elocon) or an extra-potent class I or class II topical steroid such as clobetasol propionate (Temovate) or fluocinonide (Lidex). The more potent agents may be applied once or twice per day, even on the face. must be stopped after two weeks because of the increased frequency of side

effects. If the patient responds before the two-week limit, the agent should be stopped

immediately. Some prescription creams such as topical cortisone may be effective in

minimizing inflammation and itchinessAntihistamines are used primarily to reduce itching, if present. However, research studies suggest that some antihistamines have anti-inflammatory properties.PhototherapySome dermatologists recommend photodynamic therapy using UV-A and UV-B laser or red and blue LED light to inhibit the growth of Malassezia fungus and reduce seborrhoeic inflammation.

Natural treatmentsAloe Vera applied topicallyCoconut oil applied topically[

Tea tree oil: diluted to 5% applied topicallyOregano Oil: diluted and applied topicallyViola tricolor or Heartsease: applied topically. Is recognised by Germany's Commission E as Monograph 195 for the treatment of Cradle Cap a form of seborrheic dermatitis.Honey apply diluted crude (raw) honey (90% honey diluted in warm water) every other day on the lesions with gentle rubbing for 2-3 mins. Honey is left on for 3 hr before gentle rinsing with warm water. Treatment is continued for 4 weeks.Avocado Extracts: AV119 & 5-alpha Avocuta, also known as butyl avocadate applied topically.SupplementsProbiotics Lactobacillus casei and Lactobacillus paracaseiLactoferrinVitamin B7 Biotin Vitamin B6 Vitamin B2Vitamin B3: Nicotinamide, also known as NiacinamideBlackcurrant seed oil ,Milk of magnesia applied to the face while showering and rinsed off may help clear up seborrheic dermatitis.[

Boswellia serrata extracts: Boswellic acid has anti-inflammatory properties.DietThere is evidence of a relationship between seborrheic dermatitis and intestinal yeast, such as candida.[ An antifungal diet consisting of the elimination of sugar and increasing vegetable intake should reduce seborrheic dermatitis.

References James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin:

Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0. ^ "seborrheic dermatitis" at Dorland's Medical Dictionary ^ Hay, R.J.; Graham-Brown, R.A.C. (1997). "Dandruff and seborrhoeic dermatitis:

causes and management". Clinical and Experimental Dermatology 22 (1): 3–6. DOI:10.1046/j.1365-2230.1997.d01-231.x. PMID 9330043. 

^ Nowicki R (January 2006). "[Modern management of dandruff]" (in Polish). Polski Merkuriusz Lekarski 20 (115): 121–4. PMID 16617752. 

^ Parry, ME; Sharpe, GR (1998). "Seborrhoeic dermatitis is not caused by an altered immune response to Malassezia yeast". British Journal of Dermatology 139 (2): 254–63. DOI:10.1046/j.1365-2133.1998.02362.x. PMID 9767239.

Buslau, M; Hänel, H; Holzmann, H (1989). "The significance of yeasts in seborrheic eczema". Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete 40 (10): 611–3. PMID 2533189.

"What is Seborrheic Dermatitis?". http://www.mamashealth.com/skin/seb.asp. Retrieved June 11, 2010. 

^ "Symptoms". http://www.mayoclinic.com/health/seborrheic-dermatitis/ds00984/dsection=symptoms. Retrieved June 11, 2010. 

^ "Seborrheic Dermatitis and Dandruff". http://www.reddingdermatology.com/seborrheic-dermatitis.html. Retrieved June 11, 2010. 

Wikler JR, Janssen N, Bruynzeel DP, Nieboer C (1990). "The effect of UV-light on pityrosporum yeasts: ultrastructural changes and inhibition of growth". Acta Dermato-venereologica 70 (1): 69–71. PMID 1967880. 

^ Calzavara-Pinton PG, Venturini M, Sala R (2005). "A comprehensive overview of photodynamic therapy in the treatment of superficial fungal infections of the skin". Photochem Photobiol 78 (1): 1–6. DOI:10.1016/j.jphotobiol.2004.06.006. PMID 15629243.