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Seborrheic Dermatitis
What is
seborrheic dermatitis?
Seborrheic
dermatitis is a scaling disorder of the face, ears
and scalp which is characterized by waxing and
waning of symptoms. Scale is noted by its yellow and
greasy character. Inflammation is thought to be due
to an allergic reaction to a yeast (Pityrosporum
orbiculare) which colonizes affected
individuals. Areas such as the abdomen, under arms,
breasts, groin and buttocks can also be affected.
Those patients with oily skin or hair are more
likely to contract seborrheic dermatitis.
At what age
does seborrheic dermatitis begin?
Seborrheic
dermatitis may develop as early as infancy. Rarely,
it is seen in children older than six months of age.
Seborrheic dermatitis presents later in life by
approximately the third decade, when it flares,
during times of stress or illness. Between three and
five percent of the United States population are
thought to be affected by this condition.
Who is
prone to seborrheic dermatitis?
There are a
variety of individuals who are more susceptible.
Infants are at risk early in life, when they develop
"cradle cap". This disorder is characterized by a
symptomatic crusting of the scalp. Most of the time,
it is the worried patient who brings the condition
to the attention of the dermatologist. Other
individuals who are more susceptible to seborrheic
dermatitis include those with immune deficiency
disorders, diabetes, malignancy or AIDS. Finally,
those who inherit the tendency for psoriasis, acne
or Parkinsons disease are prone to develop
seborrheic dermatitis.
How is
seborrheic dermatitis treated, and is this disorder
preventable?
Seborrheic
dermatitis may be treated topically with either
corticosteroid creams or antifungal medications,
such as Nizoral or Spectazole.
At present, there is no cure for seborrheic
dermatitis. Symptoms can be controlled with either
shampoos or topical creams. In several instances tar
shampoos or zinc shampoos are helpful. In instances
where the scalp is involved, and patients complain
of a secondary bacterial infection, we recommend
antibacterial shampoos, or even oral antibiotics.
The treatments work to remove any persistent scale,
inhibiting yeast from colonizing the scalp and skin.
Improvement is gradual, with treatments directed at
controlling symptoms rather than achieving a cure.
Are there
any special tests needed to diagnose the condition
of seborrheic dermatitis?
Usually not.
This diagnosis is typically made on clinical
grounds. In most instances, blood, urine or biopsy
samples are not performed. In cases unresponsive to
treatment, skin biopsies or immune testing may be
indicated. Dr. Harvey and Dr. Hardy and his staff can advise you
on how to proceed if your condition is resistant to
treatment.
Dr. Harvey and Dr. Hardy
may recommend:
Daily
shampooing with the following prescription
shampoos. It is important to leave the prescribed
shampoo on the scalp
for at least five to ten
minutes. You are
to alternate these with some of the other shampoos
listed below.
-
Nizoral
shampoo
-
Zincon
shampoo
-
Capex shampoo
-
Head &
Shoulders shampoo
-
Selsun
Blue shampoo
-
Ionil T
shampoo
-
Capitrol
shampoo
-
Salicylic
acid 6% gel under occlusion with coal tar, as
directed
-
Derma
Smoothe FS oil, leave on the scalp
overnight with shower cap occlusion, then wash out
in the morning with Dove dishwashing
detergent.
-
Luxiq
Mousse, applied after shampooing.
-
Olux
Mousse, applied after shampooing
For the
face, neck or chest, one of the following creams
or tablets may be recommended:
-
Hytone,
2.5% mixed 1:1 with Nizoral cream
b.i.d. to affected areas
-
Plexion
Facial Cleanser- Wash face twice a day as
directed
-
Westcort,
0.1% cream b.i.d. to the affected areas
-
Texacort
solution, twice daily to the ears, to treat
ear scale.
-
Nizoral
tablets, 200 mg, as directed. Take with Coca
Cola and exercise to induce sweating
on the skin, one hour after taking the medication.
If you
have any questions, or wish to schedule a
consultation, please
call Ponte
Vedra Dermatology
& Aesthetic Surgery at (904) 285-7546 or email
consultation@pvderm.com.
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