Seborrhoeic dermatitis

Seborrhoeic dermatitis
Seborrhoeic dermatitis
Classification and external resources
ICD-10 L21
ICD-9 690
DiseasesDB 11911
MedlinePlus 000963
eMedicine derm/396
MeSH D012628

Seborrhoeic dermatitis (also seborrheic dermatitis AmE, seborrhea, informally seb derm) (also known as "seborrheic eczema"[1]) is an inflammatory[2] 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. In adolescents and adults, seborrhoeic dermatitis usually presents as scalp scaling (dandruff) or as mild to marked erythema of the nasolabial fold.



Acute form of seborrhoeic dermatitis on scalp

The cause of seborrhoeic dermatitis remains unknown, although a yeast that is part of the normal skin flora, Malassezia furfur, likely plays a key role.[3]


Most cases of seborrhoeic dermatitis likely involve an inflammatory reaction to the proliferation of the yeast Malassezia,[4][5] though this hasn't been proven.[6]

The main species found in the scalp is Malassezia globosa, others being Malassezia furfur (formerly known as Pityrosporum ovale) and Malassezia restricta. The yeast produces toxic substances that irritate and inflame the skin. Defeat of yeast that naturally occurs in human skin. Usually this causes no problems, but may start to grow uncontrollably. Excessive development of the yeast can cause scalp irritation and overproduction of skin tissue, which in conjunction with the sebum causes dandruff.[7] Patients with seborrhoeic dermatitis appear to have a reduced resistance to the yeast.[citation needed] However, the colonization rate of affected skin may be lower than that of unaffected skin.[8]

Only saturated fatty acids (FAs) have been shown to support Malassezia growth. It has also been shown that while number density of M. globosa and M. restricta do not directly correlate to dandruff presence or severity, removal correlates directly with amelioration of flaking. Furthermore, in dandruff-susceptible individuals pure oleic acid, an unsaturated FA and Malassezia metabolite, induces flaking in the absence of Malassezia by direct effects on the host skin barrier. These findings support the following hypothesis:

Malassezia hydrolyze human sebum, releasing a mixture of saturated and unsaturated fatty acids. They take up the required saturated FAs, leaving behind unsaturated FAs. The unsaturated FAs penetrate the stratum corneum and because of their non-uniform structure breach the skin's barrier function. This barrier breach induces an irritation response, leading to dandruff and seborrheic dermatitis.[9]

Other causes

Genetic, environmental, hormonal, and immune-system factors have been shown to be involved in the manifestation of seborrhoeic dermatitis.[10][11]

Seborrhoeic dermatitis may be aggravated by illness, psychological stress, fatigue, change of season and reduced general health. It may also occur during times of stress or sleep deprivation.[12]

In children, excessive vitamin A intake can cause seborrhoeic dermatitis.[13] Lack of biotin,[12] pyridoxine (vitamin B6)[12][14] and riboflavin (vitamin B2)[12] may also be a cause.

Those with immunodeficiency (especially infection with HIV) and with neurological disorders such as Parkinson's disease (for which the condition is an autonomic sign) and stroke are particularly prone to it.[15]


Another example of seborrhoeic dermatitis on scalp

The condition's symptoms appear gradually and usually the first signs of seborrheic dermatitis are the flakes of skin called dandruff.[16] The symptoms may occur anywhere on the skin of the face, behind the ears and in areas where the skin folds. These are common sites that become red and flaky. The flakes can be yellow, white or grayish.[17] In more rare cases, redness and flaking may occur on the skin near the eyelashes, on the forehead or around the sides of the nose. Other body areas where these symptoms occur are the chest and upper back. The symptoms of seborrheic dermatitis can appear basically on any part of the body where there is certain amount of hair and therefore follicles which might become inflamed. A sign that the condition has become more severe is the formation of thick, oily and yellow scales which might appear on the forehead, around the sides of the nose or on the skin near the eyelashes.

In more severe cases, yellowish to reddish scaly pimples appear along the hairline, behind the ears, in the ear canal, on the eyebrows, on the bridge of the nose, around the nose, on the chest, and on the upper back.[18]

Commonly, patients experience mild redness, scaly skin lesions and in some cases hair loss.[19] Other symptoms include patchy scaling or thick crusts on the scalp, red, greasy skin covered with flaky white or yellow scales, itching, soreness and yellow or white scales that may attach to the hair shaft.[20]

Seborrheic dermatitis can occur in infants younger than three months and it causes a thick, oily, yellowish crust around the hairline and on the scalp. Itching is not common among infants. Frequently, a stubborn diaper rash accompanies the scalp rash.[18] Usually, when it occurs in infants the condition resolves itself within days and with no treatment.

Many patients experience alternating periods of the symptoms, when they either improve or suddenly worsen. In adults, symptoms of seborrheic dermatitis may last from few weeks to even years.

The condition is referred to a specialist when it becomes painful, the individual suspects that the skin might have become infected or they have tried self-care therapy without success. Also, seborrheic dermatitis can cause discomfort and interfere in one's daily activities. Addressing the condition to a doctor is important in order to prevent potentially long-lasting damage to the hair follicles which may lead to hair loss.

Hair loss

Side effects to inflammation may include temporary hair loss. If severe outbreaks are untreated for extended intervals, permanent hair loss may result because of damage to hair follicles.[citation needed]

It is still unclear if seborrheic dermatitis causes permanent hair loss, although the inflammation involves the hair follicles.[21] Some researchers claim that the yeast causing seborrheic dermatitis is the main cause of hair loss because of this condition. For others, hair loss can be a result of the many other factors combined: excess oil production by the oil glands for reasons such as hormonal imbalance, stress, extreme hot or cold weather conditions, weakened immune system, Parkinson's disease, certain neurological conditions and keeping the scalp unclean.


Dermatologists recommend topical treatments such as shampoos, cleansers or creams/lotions that contain antifungal, anti-inflammatory, sebo-suppressive or keratolytic ingredients:

One approach is to try different combinations of the usual agents: a dandruff shampoo, an antifungal agent and a topical steroid. If this fails, short-term use of a more potent topical steroid in a "pulse fashion" may put some refractory patients into remission and actually decrease the total steroid exposure. Therapeutic choices for pulse therapy may 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 class III topical steroid should be tried first, but if the condition remains unresponsive, the clinician may then choose to use a class I agent. These more potent agents may be applied once or twice per day, even on the face, but 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. Adjuvant therapy including use of a dandruff shampoo, an antifungal agent, or both, is essential during the "pulse" period and should be continued as maintenance therapy after each pulse.

Treating seborrheic dermatitis is quite difficult to achieve given that there seem to be more than just one factor contributing to its development, but the condition can be held under control with few measures. Controlling the disorder can be done by using various medicated shampoos or creams. Maintaining the scalp clean is mandatory for sufferers of seborrheic dermatitis and therefore using anti-dandruff shampoos which are effective may be one way of preventing getting this condition. Also, there are several special shampoos that contain sulfur, zinc or salicylic acid. A thorough cleaning of the scalp is the first step to be made in preventing and curing this condition because by having a proper scalp hygiene, the bacteria and fungus are removed and the likelihood of developing a follicular inflammation is reduced.

Some creams may also be used to treat hair loss caused by seborrheic dermatitis. Topical cortisone creams are highly effective in minimizing the symptoms of this condition, especially inflammation and itchiness. These creams are only available on prescription.



Medications other than antifungals

  • Isotretinoin (Accutane) at low dose 5 mg to 10 mg: As a last resort in refractory disease, sebosuppressive agent isotretinoin (Accutane) may be used to reduce sebaceous gland activity. However, isotretinoin has potentially serious side effects and few patients with seborrhea are appropriate candidates for therapy.


Dermatologists recommend the use of photodynamic therapy also known as phototherapy which uses UV-A and UV-B laser or red and blue LED light to inhibit the growth of Malassezia and reduce the inflammation.[30][31][32]

Natural treatments

  • Aloe Vera applied topically[33][34]
  • Coconut oil applied topically[35]
  • Tea tree oil: diluted to 5% applied topically[36][37]
  • Viola 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.[38][39][40]
  • 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.[41]
  • Avocado Extracts: AV119[42] & 5-alpha Avocuta, also known as butyl avocadate[43] applied topically.
  • Monarda fistulosa[44]



There is evidence that there is relationship between seborrheic dermatitis and intestinal yeast, such as candida.[54] An antifungal diet consisting of the elimination of sugar and increasing vegetable intake should reduce seborrheic dermatitis.[55][56] Moreover, a change in the diet should be considered given that foods rich in antioxidants and beta-carotene are efficient in reducing the inflammation[citation needed].

Alternative treatments

Applying milk of magnesia may help clear up seborrheic dermatitis; one may apply on the face while showering and rinse off at the end of the shower.[57]


A healthy scalp is the first step to preventing a flare-up. This can be accomplished with good hygiene and daily use of over-the-counter or prescription anti-fungal shampoo. Some effective over-the-counter shampoos include: Nizoral, Medicated Selsun Blue, and Head & Shoulders.

Regular stays in the sun are beneficial to healing of the symptoms. Also UV-radiation (especially in the winter) is recommended by doctors. The reason for this is that the UV-radiation curbs the growth of the Malassezia yeast that is suspected to be the cause of the rash.[58]

By means of a very short hair cut (more air and sun comes to the concerned areas) and through frequent hair washing - at least every two days - the symptoms can be alleviated.

See also


  1. ^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
  2. ^ "seborrheic dermatitis" at Dorland's Medical Dictionary
  3. ^
  4. ^ 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. 
  5. ^ Nowicki R (January 2006). "[Modern management of dandruff]" (in Polish). Polski Merkuriusz Lekarski 20 (115): 121–4. PMID 16617752. 
  6. ^ 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. 
  7. ^ "Excessive yeast conjunction with the sebum causes dandruff & dermatitis". Healthy Hair Highlights News. 16 August 2011. Retrieved 2011-23-09. 
  8. ^ "Treatment of Seborrheic Dermatitis". Retrieved September 10, 2010. 
  9. ^
  10. ^ Johnson, Betty Anne; Nunley, Julia R. (May 2000). "Treatment of seborrheic dermatitis". American Family Physician 61 (9): 2703–10, 2713–4. PMID 10821151. 
  11. ^ Janniger CK, Schwartz RA (July 1995). "Seborrheic dermatitis". American Family Physician 52 (1): 149–55, 159–60. PMID 7604759. 
  12. ^ a b c d Schwartz, Robert A.; Janusz, Christopher A.; Janniger, Camila K. (July 2006). "Seborrheic dermatitis: an overview". American Family Physician 74 (1): 125–30. PMID 16848386. 
  13. ^ MedlinePlus Encyclopedia Hypervitaminosis A
  14. ^ Nutritional Neuropathy at eMedicine
  15. ^
  16. ^ "Dermatitis Seborrheic Treatment". Retrieved June 11, 2010. 
  17. ^ "Seborrheic Dermatitis". Retrieved June 11, 2010. 
  18. ^ a b "Dermatitis". Retrieved June 11, 2010. 
  19. ^ "What is Seborrheic Dermatitis?". Retrieved June 11, 2010. 
  20. ^ "Symptoms". Retrieved June 11, 2010. 
  21. ^ "Seborrheic Dermatitis and Dandruff". Retrieved June 11, 2010. [dead link]
  22. ^ Faergemann, J.; Jones, T.C.; Hettler, O.; Loria, Y. (1996). "Pityrosporum ovale(Malassezia furfur)as the causative agent of seborrhoeic dermatitis: new treatment options". British Journal of Dermatology 134: 12–5: discussion 38. doi:10.1111/j.1365-2133.1996.tb15652.x. PMID 8763461. 
  23. ^ Shemer, A; Kaplan, B; Nathansohn, N; Grunwald, MH; Amichai, B; Trau, H (2008). "Treatment of moderate to severe facial seborrheic dermatitis with itraconazole: an open non-comparative study". The Israel Medical Association journal 10 (6): 417–8. PMID 18669136. 
  24. ^
  25. ^ Leeming JP (1993). "Use of topical lithium succinate in the treatment of seborrhoeic dermatitis". Dermatolog 187 (2): 149–50. doi:10.1159/000247228. PMID 8358107. 
  26. ^ Murray, Michael; Pizzorno, Joseph (1997). "Encyclopedia of Natural Medicine" (Revised 2nd Edition) Three Rivers Press. ISBN 0-7615-1157-1[page needed]
  27. ^ Smith, J. G.; Wehr, RF; Chalker, DK (1976). "Corticosteroid-induced cutaneous atrophy and telangiectasia. Experimental production associated with weight loss in rats". Archives of Dermatology 112 (8): 1115–7. doi:10.1001/archderm.112.8.1115. PMID 952530. 
  28. ^ Scheinfeld, Noah S. (2005). "Seborrheic Dermatitis". SKINmed 4 (1): 49–50. doi:10.1111/j.1540-9740.2005.03961.x. PMID 15654167. 
  29. ^ Firooz, A.; Solhpour, A; Gorouhi, F; Daneshpazhooh, M; Balighi, K; Farsinejad, K; Rashighi-Firoozabadi, M; Dowlati, Y (2006). "Pimecrolimus Cream, 1%, vs Hydrocortisone Acetate Cream, 1%, in the Treatment of Facial Seborrheic Dermatitis: A Randomized, Investigator-Blind, Clinical Trial". Archives of Dermatology 142 (8): 1066–1067. doi:10.1001/archderm.142.8.1066. PMID 16924062. 
  30. ^ 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. 
  31. ^ 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. 
  32. ^ Tim Maisch,a Rolf-Markus Szeimies,a Giulio Jori*b and Christoph Abels (2004 [1]). Antibacterial photodynamic therapy in dermatology. 
  33. ^ "WHO Monographs on Selected Medicinal Plants - Volume 1: Aloe Vera Gel". World Health Organization. Retrieved 2011-05-28. 
  34. ^ Feily A, Namazi MR (February 2009). "Aloe vera in dermatology: a brief review". Giornale Italiano Di Dermatologia E Venereologia 144 (1): 85–91. PMID 19218914. 
  35. ^ "Coconut oil & seborrheic dermatitis". Retrieved 2011-04-15. 
  36. ^ Gupta AK, Nicol K, Batra R (2004). "Role of antifungal agents in the treatment of seborrheic dermatitis". American Journal of Clinical Dermatology 5 (6): 417–22. doi:10.2165/00128071-200405060-00006. PMID 15663338. 
  37. ^ Satchell AC, Saurajen A, Bell C, Barnetson RS (December 2002). "Treatment of dandruff with 5% tea tree oil shampoo". Journal of the American Academy of Dermatology 47 (6): 852–5. doi:10.1067/mjd.2002.122734. PMID 12451368. 
  38. ^
  39. ^ Matthias Augustin: 6.46 Stiefmütterchen In: Phytotherapie bei Hauterkrankungen, S.226-227; Elsevier, Urban & Fischer 2004. ISBN 978-3-437-56120-7 Volltext
  40. ^ Meyer, S.; Vogt, T.; Landthaler, M.; Karrer, S. (2005). "Einsatz von Phytopharmaka in der Dermatologie". Der Hautarzt 56 (5): 483–99; quiz 500–1. doi:10.1007/s00105-005-0949-y. PMID 15830171. 
  41. ^ Al-Waili NS (July 2001). "Therapeutic and prophylactic effects of crude honey on chronic seborrheic dermatitis and dandruff". European Journal of Medical Research 6 (7): 306–8. PMID 11485891. 
  42. ^ Donnarumma, G; Buommino, E; Baroni, A; Auricchio, L; De Filippis, A; Cozza, V; Msika, P; Piccardi, N et al. (2007). "Effects of AV119, a natural sugar from avocado, on Malassezia furfur invasiveness and on the expression of HBD-2 and cytokines in human keratinocytes". Experimental dermatology 16 (11): 912–9. doi:10.1111/j.1600-0625.2007.00613.x. PMID 17927574. 
  43. ^ Piccardi N, Piccirilli A, Choulot JC, Chadoutaud B, Msika P; Pharmacological and Clinical Activities of 5-Alpha Avocuta : Application for the Management of Androgenic Disorders [2]
  44. ^ Zhilyakova, ET; Novikov, OO; Naumenko, EN; Krichkovskaya, LV; Kiseleva, TS; Timoshenko, EY; Novikova, MY; Litvinov, SA (2009). "Study of Monarda fistulosa essential oil as a prospective antiseborrheic agent". Bulletin of experimental biology and medicine 148 (4): 612–4. doi:10.1007/s10517-010-0777-7. PMID 20396753. 
  45. ^ Ji, GE (2009). "Probiotics in primary prevention of atopic dermatitis". Forum of nutrition. Forum of Nutrition 61: 117–28. doi:10.1159/000212744. ISBN 978-3-8055-9097-6. PMID 19367116. 
  46. ^ A.G. Gueniche , D. Philippe , P. Bastien , E. Buyukpamukcu , P. Reygagne , I. Castiel(Clichy; France)Oral supplementation with probiotic Lactobacillus paracasei ST improves dandruff condition [3] [4][verification needed]
  47. ^ Kiratli H, Irkeç M, Orhan M (2000). "Tear lactoferrin levels in chronic meibomitis associated with acne rosacea". European Journal of Ophthalmology 10 (1): 11–4. PMID 10744199. 
  48. ^ Dreno, B; Moyse, D; Alirezai, M; Amblard, P; Auffret, N; Beylot, C; Bodokh, I; Chivot, M et al. (2001). "Multicenter randomized comparative double-blind controlled clinical trial of the safety and efficacy of zinc gluconate versus minocycline hydrochloride in the treatment of inflammatory acne vulgaris". Dermatology (Basel, Switzerland) 203 (2): 135–40. doi:10.1159/000051728. PMID 11586012. 
  49. ^ Basset-Séguin, N; Sotto, A; Guillot, B; Jourdan, J; Guilhou, JJ (1998). "Zinc status in HIV-infected patients: relation to the presence or absence of seborrheic dermatitis". Journal of the American Academy of Dermatology 38 (2 Pt 1): 276–8. doi:10.1016/S0190-9622(98)70250-6. PMID 9486690. 
  50. ^ Guillard, O; Fauconneau, B; Piriou, A; Pineau, A (1997). "In vitro study of the antiseborrheic activity of zinc L-cysteate, a novel zinc compound, on rat preputial gland". Pharmacology 55 (1): 54–8. doi:10.1159/000139512. PMID 9309801. 
  51. ^ Olivi, O; Balli, F; Olivi, F (1986). "A new and original therapy for seborrheic dermatitis". La Pediatria medica e chirurgica 8 (3): 407–9. PMID 2947051. 
  52. ^ Klevay, LM (1979). "Diets deficient in copper and zinc?". Medical hypotheses 5 (12): 1323–6. doi:10.1016/0306-9877(79)90101-4. PMID 161345. 
  53. ^ Abou-Mourad, NN; Farah, FS; Steel, D (1979). "Dermopathic changes in hypozincemia". Archives of dermatology 115 (8): 956–8. doi:10.1001/archderm.115.8.956. PMID 111624. 
  54. ^ 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. 
  55. ^ Putzier, E (1989). "Dermatomycoses and an antifungal diet". Wiener medizinische Wochenschrift (1946) 139 (15–16): 379–80. PMID 2556862. 
  56. ^ Menzel, I; Holzmann, H (1986). "Reflections on seborrheic scalp eczema and psoriasis capillitii in relation to intestinal mycoses". Zeitschrift fur Hautkrankheiten 61 (7): 451–4. PMID 2939630. 
  57. ^ Graedon, Joe; Graedon, Teresa (2008-04-17). "The People's Pharmacy". Atlanta Journal Constitution Evening Edge (Atlanta Journal Constitution): pp. 15. 
  58. ^ 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 (Stockholm) 70(1) (1): 69–71. PMID 1967880. 

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