A Very Common Scalp Complaint

Seborrheic dermatitis


What is seborrhoeic dermatitis?

Dermatitis’ is a red, itchy, flaky (inflamed) skin complaint; ‘seborrhoeic’ means that the rash affects greasy (sebaceous) skin zones such as the face, scalp, and center of the chest.

Seborrhoeic dermatitis is very common, and many people don’t even know they have it. Overall, it has been reported to affect about 4% of the population, and dandruff (which is mild seborrhoeic dermatitis of the scalp) can affect almost half of all adults. It can start at any time after puberty and is slightly commoner in men. Babies can also get a short-lived type of seborrhoeic dermatitis in the scalp (cradle cap) and nappy area, which usually clears after a few months.

What causes it?

It is thought that seborrhoeic dermatitis is triggered by an overgrowth of a harmless yeast called Malassezia that lives on the skin, or an overreaction by the skin’s immune system to this yeast. These are not the same as the yeasts that cause thrush or those that are present in foods.

 Tiredness and stress can sometimes trigger a flare of seborrhoeic dermatitis. It is more common in cold than in warm weather, and it is not related to diet.

How is it treated?

Seborrhoeic dermatitis is managed with treatment that reduces the level of skin yeast – these include creams and shampoo, which can be used safely on a long-term basis.

What are the symptoms of seborrhoeic dermatitis?

The symptoms of seborrhoeic dermatitis seem to vary from person to person. Affected areas can be itchy, sore, and sensitive and flaking skin can be bothersome and embarrassing, especially with dark clothing. Some people have the rash without being troubled.

What does it look like?

Affected areas are red with greasy looking skin flakes. It usually affects one or two body areas but can sometimes be widespread. The commonest sites are:

  • On the scalp: seborrhoeic dermatitis here ranges from mild flaky skin (dandruff) to a redder, scalier and sometimes weeping rash.
  • On the face: it often affects the inner eyebrows and creases around the nose and cheeks. The eyelids may also become red, swollen and flaky (seborrhoeic blepharitis).
  • In and around the ears: some people have inflammation inside the ear canals, in the cup of the ear and behind the ears. The skin can get infected with bacteria which result in oozing and crusting. Inflammation in the ear canal (otitis externa) can cause it to become blocked
  • On the front of the chest and between the shoulder blades: it shows up as well-defined, round pink-red patches with mild scaling
  • In the skin folds: it often affects moist areas such as the skin under the breasts, in the groin, under the arms, or in folds of skin on the abdomen. The skin is pink and shiny with surface cracks.
  • In darker skin: affected areas may look lighter (hypopigmented) or (hyperpigmented) than the surrounding skin.

Can it be cured?

Treatment can improve and sometimes clear seborrhoeic dermatitis, but there is no permanent cure, and the complaint tends to come back when treatment is stopped.

The Spencer Clinic clinical treatment.

Treatment for the above condition at the clinic involves the use of a scalp ointment called a Keratolytic. This ointment comes in two strengths. Which one is used depends on the thickness of the scale. The scalp ointment works by removing the skin cells that build up on the scalp and in the case of Seborrhoeic dermatitis reduces the level of skin yeast. We have shampoos and scalp lotions that can be used at home to help reduce itching.
Treatments take 1 hour.

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