Seborrheic Dermatitis is a chronic scaly inflammatory eruption usually affecting but not limited to scalp and face. It may include scalp, face, eyebrows, naso-labial folds, external ear canal and less frequently on axillae, groin and umbilicus area.
Seborrheic Dermatitis is usually severe during the winter and affects both races and sexes, though male ratio is higher then female. The cause of Seborrheic Dermatitis is unknown. Some study suggest yeast Pityrosporum Ovale probably be the causative factor, But both environmental and genetic factors influence the onset and course of disease.
Treatment of Seborrheic Dermatitis:
For mild cases of Seborrheic Dermatitis, shampooing is the best option. It can be controlled and treated completely even with non- medicated shampoos in sufficient quantity. For more severe cases, application of anti-dandruff shampoos daily or 3-4 times a week has a good outcome. Shampoos containing Zinc Pyrithione ( Head and shoulders ), 1% Selenium Sulphide ( selsun Blue ), Ketoconazole ( Nizoral ), Salicyclic acid and Shulphur ( Sebulex ) and Tar derivatives ( ) are good and well tolerated. These products can be bought without doctor prescription.
People often complains of treatment failure of shampoo as they don’t use it in the right way. It is very important to remember that we are treating the scalp not the hair. So, for better result, shampoo should be left for better penetration on the scalp for atleast 5 minutes.
For more severe cases or for those people whom daily shampoo is not possible or is inadequate for treating, Corticosteriods lotion like 1% hydrocortisone can be used. Twice daily regimen is usually safe and effective for short term course. Long term use of corticosteroids is not suggested. If this preparation is not working you may go on strong steroids under dermatologist prescription. These strong preparation includes 0.025% Triamcinolone , 0.01% Flucinolone or 0.05% betamethasone. Study suggest this will improve your dermatitis within 1-4 weeks but relapse is more common then with the use of antifungal application.
When every treatment fails to give the good outcome, more intensive treatment might be required. These preparation includes 5%, 10%, 20% Liquor carbonin detergens in Nivea oil applied at bedtime with occlusion and shampooing the next morning, then followed by steroids during the day. Another option may be applying a tar shampoo at bedtime with occlusion overnight and rinsing the next morning. Tar preparation are slightly malodorous and messy but are safe and effective and has more lasting relief then steroids.
For those with more diffuse type of Seborrheic dermatitis involving face,ears and chest, ketoconazole cream ( Nizoral ) can be applied to clear the scales and erythema. Frequent washing with zinc soap and selenium lotion will suppress the activity and avoid recurrence.