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Seborrheic Dermatitis Specialist

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Our skin experts at Dermatology & Skin Health are guaranteed to help bring improvements to your quality of life by helping you solve your seborrheic dermatitis problems. No matter how severe your skin condition is, we're here to provide a personalized seborrheic dermatitis treatment plan that will work for you and even give you more confidence.

What is Seborrheic Dermatitis?

Seborrheic dermatitis is an inflammatory skin disease that affects the scalp, face, and skin folds. It’s non-contagious and non-fatal, but it can greatly impact a patient’s self-esteem due to physical discomfort and social embarrassment.

Infantile Seborrheic Dermatitis vs. Adult Seborrheic Dermatitis

Seborrheic dermatitis occurs in a bimodal fashion, in that it may occur in infants (infantile seborrheic dermatitis, ISD) and adults (adult seborrheic dermatitis, ASD). These two may be differentiated based on the following:

Infantile Seborrheic DermatitisAdult Seborrheic Dermatitis
First 3 months of lifeBetween ages 30 and 60
Mild and self-limiting; resolves spontaneouslyRelapsing and remitting
Ranks 3rd after atopic dermatitis and contact dermatitis in the potential to impair the quality of life
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Seborrheic Dermatitis vs. Dandruff

Seborrheic dermatitis is a disease that affects the seborrheic areas of the body, belonging to the same spectrum of dermatological diseases as dandruff. They both manifest as itchy, flaky skin but they may be differentiated based on the following:

Seborrheic DermatitisDandruff
Affects the scalp as well as other seborrheic areas like the face, retro-auricular area, and the upper chestRestricted to the scalp
With visible signs of inflammation such as red skinNo visible signs of inflammation

What are the Symptoms of Seborrheic Dermatitis?

Seborrheic dermatitis is characterized by red plaques and greasy, yellowish scales in parts of the body that are rich in sebaceous glands. It’s distributed symmetrically in the affected area, has a seasonal pattern (more prevalent in the winter), and may aggravate upon sleep deprivation and stress.

Patients with immunosuppression such as those with AIDS usually present with more severe disease that doesn’t respond to treatment. They also present with the disease in unusual sites such as the extremities. They may also present with other skin conditions such as rosacea, psoriasis, and acne.

The clinical manifestations of seborrheic dermatitis also differ in infants and adults. These are summarized as follows:

ISDASD
“Cradle cap”Red, flaky plaques (face/retro-auricular area)Moist, shiny, non-scaly skin (body folds)Most extensive form in the trunkLeiner’s Disease: a rare form usually associated with immunodeficiency“Corona seborrheica”Butterfly distribution in malar regions and cheeksBlepharitis in the eyelidsCrusting, oozing fissures in the retro-auricular areaPetaloid Type, Pityriasiform Type (upper chest)May progress to fissures and infection (body folds)

What Causes Seborrheic Dermatitis?

The exact mechanism of how seborrheic dermatitis occurs isn’t yet well-understood, but studies have implicated several factors that may be associated with this skin disorder. These factors include fungal colonization, sebaceous gland activity, individual susceptibility, and nutrition.

Fungal Colonization

The etiologic agent most commonly implicated in the causation of seborrheic dermatitis is Malassezia, which are yeasts who thrive on oils and lipids and thus are commonly found in the sebaceous areas of the body. 

These yeasts have lipase activity, or the ability to break down lipids for use in their own metabolism, releasing unsaturated fatty acids which cause impairments in the processing of the skin such as in keratinocyte differentiation. 

These metabolites also play a role in prolonging the immune response by producing proinflammatory cytokines and encouraging the recruitment of pro-inflammatory mediators like neutrophils.

Sebaceous Gland Activity

Sebaceous glands or oil glands occur on all body parts except the palms and soles. Sebum or oil is produced at a highest rate on the scalp, face, and scalp, with the amount produced mediated by hormones like androgens. 

A high activity of sebaceous gland is implicated in the development of seborrheic dermatitis, along with abnormal lipid composition that encourage the growth of Malassezia.

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Individual Susceptibility

Some individuals are also more prone to developing seborrheic dermatitis than others. There are numerous factors behind this, which include the following:

  • Epidermal Barrier Integrity - Impairments in epidermal barrier integrity contributes to the aggravation of seborrheic dermatitis, as evidenced by the structural findings in patients with this skin disorder. These structural findings include changes in corneocyte shape and corneodesmosomes and disrupted lipid lamellar structure, which further encourage the growth of Malassezia.
  • Immune Response - Seborrheic dermatitis is more prevalent and more severe in cases of immune suppression, especially in patients living with HIV/AIDS. No difference may be found in immunosuppressed patients and normal patients when it comes to Malassezia growth, so it’s likely that an immune or inflammatory reaction is the reason for this pattern of prevalence and severity.
  • Other Factors - Genetic factors, neurogenic factors and emotional stress, and nutrition are also thought to be associated with seborrheic dermatitis.

How is Seborrheic Dermatitis Treated?

The therapeutic objectives of the treatment options for this skin disorder include relief of its symptom, especially itching, and the prevention of remission by promoting long-term therapy. 

A dermatologist typically prescribes topical antifungal (including a medicated shampoo) and anti-inflammatory agents. These are chosen on the basis of efficacy, side effects, compliance, and the age of the patient.

Alternative therapies like tea tree oil may also be used. On the other hand, those whose disease is widespread and non-responding to typical drugs prescribed may be given systemic therapy like oral itraconazole and oral terbinafine.

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At Dermatology & Skin Health, we're composed of knowledgeable and skilled healthcare professionals that are award-winning and well-trained in our respective fields. We're committed to helping you solve your skin conditions and scalp concerns like seborrheic dermatitis. Visit our clinics or contact us on our website to book your appointment and start your journey towards healthier skin.

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