Seborrheic dermatitis (think dandruff), also known as seborrhea, is a common non-contagious condition of skin areas rich in oil glands (the face, scalp, and upper trunk). Seborrheic dermatitis is marked by flaking (overproduction of skin cells) and sometimes redness and itching (inflammation) of the skin, and it varies in severity from mild dandruff of the scalp to scaly, red patches on the skin. Although there is no "cure" for seborrheic dermatitis, control is usually possible with medicated shampoos. Menopausal women often get this nuisance due to hormone fluctuations - low thyroid and a loss of estrogen. Severe dermatitis can lead to hair loss.
The scalp is itchy and sheds white, oily skin flakes. One or more of the following areas has patches of red, scaly skin: the scalp,hairline, forehead, eyebrows, eyelids, creases of the nose and ears, ear canals, beard areas, breastbone, midback, groin, or armpit. In darker skin, some of the affected areas may look lighter in color.
- Mild – only some flaking and redness in a few small areas.
- Moderate – several areas affected with bothersome redness and itch.
- Severe – large areas of redness, severe itch and unresponsive to self-care measures. Hair loss.
The treatment depends on its location on the body. Mild dandruff may respond to more frequent shampooing with a longer lather time. If that doesn't work, then try O.T.C. shampoos that contain ketoconazole, selenium sulfide (Selsun Blue, Exsel), 2% pyrithione zinc (DHS Zinc, Head & Shoulders), salicylic acid (X-Seb, Scalpicin), or tar-based shampoos (DHS Tar, Neutrogena T-Gel, Polytar)). These shampoos can be used 2-3 times a week. When you use a dandruff shampoo, rub the shampoo into your hair thoroughly and let it stay on your hair and scalp for at least 5 minutes before rinsing. This will give it time to work. If you have patches on your face, use the shampoo on those too. If the shampoo alone doesn't help, your doctor might want you to use a prescription steroid lotion once or twice daily, in addition to the shampoo.
- Stress reduction and a healthy diet, especially with adequate B vitamins, zinc, omega-3 fatty acids, and reduction of sugar- and yeast-containing foods such as bread, beer, and wine.
- Get your thyroid checked. Low thyroid can often be the underlying culprit.
- A little (not too much!) sun – this seems to suppress the growth of Pityrosporum.
- Managing any eyelid changes (blepharitis) by gentle cleaning of the skin around the eye lashes (eyelid margins) with a Q-Tip® and baby shampoo.
- If the scalp is covered with widespread, dense scale, the scale may first be removed by applying warm mineral oil or olive oil to the scalp and washing several hours later with a detergent, such as a dishwashing liquid or a tar shampoo.