Seborrheic dermatitis: Severe Cases


Are you suffering from  dandruff and itching on your head, back and face? Chances are high that you have seborrheic dermatitis, a chronic inflammation of the skin. And most probably it is caused by a yeast infection. But how do you diagnose and treat this disease properly?

“Sometimes I think I want to get out of my skin!”. This is how Anthony B. descibes his situation. His head itches and scales, countless times he has to scratch his head – sometimes till it becomes bloody. Anthony is suffering from seborrheic dermatitis – just like Mel F. Last year in November her scalp started to itch in a vey annoying way.

“Sometimes it bites, sometimes it itches, sometimes it tingles, as if thousands of ants  crawl all over your head.” Says Mel F.

Up to five percent of the populationare suffering from harmless and non-contagious, but chronic inflammation of the skin with yellowish oily skin peeling. Seborrhoeic dermatitis is found mainly on the scalp, but also on eyebrows, eyelids, between the mouth and nose, sternum or spine. There are areas of the skin where many oil glands occur.

 A constant up and down.

Anthony (41) has suffered for 20 years from the eczema, he never completely got rid of it. The disease is usually intermittent and only sometimes it disappears after epic treatment. Anthony has eczema on the scalp,  including the face, chest and back.

“It’s a constant up and down. Sometimes it feels better, only to become worse again. It is very annoying , not just the itching,  but also the scales falling onto the clothes.”, he says.

For most sufferers it means a very significant limitation of self-esteem because it occurs in visible locations such as on the head and face. “If the itching occurs again and again, it can affect your skin. Too much scratching can lead to open wounds and if bacteria come in touch with it this can lead to further problems. ” In rare cases it can even lead to hair loss.

 The causes

Seborrhoeic dermatitis is genetic. But that does not mean that everyone diagnosed with it will actually ever experience it. The exact causes are not yet fully understood. The experts suggest that the inflammation is caused by yeast, for example, the Malassezia fungi. Fungi are actually common inhabitants of the skin, but if exposed to an increased amount of tallow, they can multiply excessively and ewoke an inflammation in the area of ​​the hair root. The result is that the skin is falls of in yellowish greasy scales. With some patients, it may ooze and itch.



Many sufferers do not even know that they have seborrhoeic dermatitis. They mistake it for normal dandruff or an allergy. The dermatologist can diagnose seborrheic dermatitis by the characteristics of the skin lesions. Other conditions should be excluded, such as eczema, psoriasis and possible allergies. Often, a microscopic examination of skin scales brings much more clarity.

In severe cases, the affected areas are initially treated with cortisone. Then, usually after 2 weeks, the actual therapy with antifungal drugs will be applied. These are available as an ointment, shampoo or foam. The agents act anti-fungal , anti-inflammatory and contain, for example, the active ingredient ketoconazole.  This cream should be applied once and in severe cases twice a day.

In rare cases, seborrhoeic dermatitis disappears forever, but maintaining a consistent treatment usually keeps it to a minimal.




Seborrheic Dermatitis: Current Medical Approaches


The following shows a typical medical approach on seborrheic dermatitis.



Seborrheic dermatitis has various causes. Normally, the skin of a healthy human which consists of several layers is subject to constant renewal process. On the inside of the skin, new skin cells are constantly renewed while the outside of the skin sheds off the old, dead skin cells. These tiny skin cells can not be identified, even with the naked eye. With seborrheic dermatitis however, the skin sheds off large, greasy dandruff . In this case the natural process of skin renewal is disrupted.

The exact triggers of seborrheic dermatitis are not yet fully understood. Experts suggest that an inflammation of the hair follicles can trigger seborrheic dermatitis. Causes for the inflammation are yeast infections. This seemingly harmless “residents” of the human skin can, under certain conditions reproduce excessively and thus trigger diseases.

In addition aiding factors for seborrhoeic dermatitis are hormonal (eg testosterone) and climatic factors (heat and humidity). Also physical and mental stress or a poor diet can play a vital role in the developmentof the disease. Experts are also discussing whether zinc or vitamin deficiencies, mechanical and chemical stimuli can promote a seborrheic dermatitis.

In addition, about 50 percent of th world’s population has a genetic predisposition for seborrhoeic dermatitis – which does not necessarily mean that they will develop it.



A person with seborrheic dermatitisis typically has scales that  show

symptoms such as:


- semarcated

- symmetrical

- yellowish-red foci

- greasy scales.


Primary infested  areas are places on the skin that have particularly large sebaceous glands. These include, for example, the scalp and the face – especially the eyebrows and eyelids, the hairline at the forehead, the wrinkles between the nose and lips, the area behind the ears and the neck. Also, the chest and the back (front and rear weld groove) and the genital area can be affected. Although seborrheic dermatitis often causes physical symptoms such as itching, many patients still suffer greatly from their disease, since the scales are clearly visible and are often difficult to make invisible.



If a physician makes a diagnosis on seborrheic dermatitis it usually is based on the typical appearance (“visual diagnosis”) of the patient. In some cases, the symptoms are not very clear, as other forms of dermatitis (eg, allergic or atopic eczema) or psoriasis can cause a similar complexion. The doctor can distinguish the seborrheic dermatitis from these other types of eczema by performing allergy tests and by doing microscopic examinations of the skin scales.


Seborrheic dermatitis usually requires a two-phase treatment: The treatment of the acute phase and as a maintenance therapy for the phase between two acute attacks.


Acute Stage Therapy

During an acute stage of seborrheic dermatitis  antifungal drugs will be applied. These are available for application on the skin in the form of ointments, lotions or shampoos. For severe and persistent symptoms, the physician will prescribe antifungals in tablet form.

In some severe cases with bacterlial seborrheic dermatitis before (superinfection), the doctor will prescribe antibiotics. In agressive inflammatory cases the doctor may temporarily prescribe corticosteroids in the form of ointments, which reduce the inflammatory response. However, for long-term therapy (especially in the face) Glucocorticoids are not suitable.

If the production of scales has spread significantly, so-called keratolytic agent will be applied. These include salicylic acid and urea – substances which soften the skin flakes and make them come off.

Seborrheic dermatitis with a particularly persistent symptoms often requires treatment with UVB rays (phototherapy).


Maintenance Therapy

Seborrheic dermatitis, which has not displayed any acute symptoms for a longer period need a different therapy: the so-called maintenance therapy. In this case care of the skin will be the main focus – the goal is to delay the next wave as long as possible. The recommended cleaning and care products often contain keratolytic agensts and have a skin-neutral pH. Since stress and tension negative effect on dermatitis, relaxation techniques (autogenic training, progressive muscle relaxation) may be helpful.



Common Seborrheic Dermatitis Cases

The term seborrheic dermatitis refers to a fatty, flaky skin inflammation that occurs especially on the scalp, the face and the trunk. The affected area of ​​seborrheic dermatitis are covered with red and yellow, greasy scales. Itching only occurs in rare cases.

Seborrheic dermatitis often affects the skin in particular areas where many oil glands occur. Excessive sebaceous secretion leads to the development of the typical strong grease film on the skin.

In some cases, the symptoms of seborrheic dermatitis are not entirely clear, since other forms of dermatitis (eg, allergic or atopic eczema) or psoriasis can cause a similar complexion. However, an allergy test and a microscopic examination of skin scales can easily confirm the diagnosis.

The seborrheic dermatitis often affects infants in the first months of life, as well as young men. Seborrheic dermatitis is probably caused by various reasons. Often the following factors can play a role: weakened immune system, climatic conditions, hormonal changes or a genetic predisposition. In addition, experts suggest that a fungal infection can be responsible for an outbreak of seborrheic dermatitis. Therefore, seborrhoeic dermatitis is often treated with shampoos containing antifungals. In severe cases of seborrheic dermatitis a transient use of cortisone-like drugs might be helpful.

In recent research, some experts have come to the conclusion that seborrheic dermatitis can be linked to a body being too acidic. If the pH levels of your blood and urine are too high the body could mistake the proteins as harmful substances and begins to defend itself by creating antibodies. The antibodies fight off the proteins and trigger production of histamine in the mast cells. This increased level of histamine causes inflammation and irritation in different parts of the body.

While a seborrheic dermatitis in infants usually heal spontaneously after a few weeks, it shows in adulst a pronounced tendency to relapse.

Another peak incidence of seborrheic dermatitis is located between the third and fourth decade of life, while men are more often affected. Women are affected especially after menopause. Very often the disease is observed in patients whose immune system is severely weakened – 80 percent of AIDS patients suffer from seborrheic dermatitis.

Seborrheic dermatitis can not be prevented in general. But if you are prone to oily skin and excessive sweating, you should clean your skin regularly and maintain it. Often one only need to apply most skin neutral detergents or water alone in order to prevent it. Also staying in the sun and exposing yourself to fresh air, especially near the sea and the mountains, can lessen the symptoms dramatically. However, you should not forget about the dangers of UV radiation and therefore always apply adequate sun protection.

What Seborrheic Dermatitis Looks Like

This is a pretty good video about what seborrheic dermatitis looks like.

It is essential to identify wether you actually have seborrheic dermatitis as sometimes other skin problems can be easily mistaken for it.


What is Seborrheic dermatitis about?

Seborrheic dermatitis is a popular, inflammatory skin condition which will cause flaky, white colored to yellowish scales to form on fatty areas for instance the neck or inside the ear. It can occur with or without itchy skin.

Milk crust is the term used when seborrheic dermatitis affects the scalp of toddlers.

Seborrheic dermatitis is believed to be due to a blend of an over production of skin grease and inflammation from a yeast referred to as malessizia.

Seborrheic dermatitis looks to run high in relatives . Anxiety, burnout, weather extremes, fatty skin, sporadic shampoos or bad skin cleaning, application of lotions that include alcohol, skin disorders (such as pimples), or weight excess may maximize the threat.

Neurologic conditions, which includes primary parkinsonism, head injuries, and stroke may be associated with seborrheic dermatitis. AIDS or human immunodeficiency virus  (HIV) has as well been related to higher circumstances of seborrheic dermatitis.


Seborrheic dermatitis may appear on many different body areas. Usuallky it forms where the skin is oily or greasy. Commonly affected areas include the scalp, eyebrows, eyelids, creases of the nose, lips, behind the ears, in the outer ear, and middle of the chest.

Seborrheic dermatitis in infants, also called cradle cap, is a harmless, temporary condition. It appears as thick, crusty, yellow or brown scales over the child’s scalp. Comparable flakes could possibly also be located near the nose ,on the eyelids, ear and even in the groin. Milk crustcould very well be observed on babies and small kids up to the age of three.

Crusta lactea ,as it is also often called, is not transmittable, nor is it triggered by lousy hygienics. It is not regarded as an allergic reaction, and it is not harmful. Honey comb disease might or might not itch. Should it itch, too much scraping of the spot may result in further irritation, and cracks in skin surface might lead to moderate bacterial infections or bleeding.


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