What is seborrheic eczema?
Seborrheic eczema, otherwise called seborrheic dermatitis, is an extremely regular skin condition that causes redness, layered patches, and dandruff. It most often affects the scalp, but it may also develop in oily areas of the body, such as the face, upper chest, and back. When children develop this condition, it is known as a crib cover. It usually develops during the first few weeks of life and gradually clears up over several weeks or months.
The exact cause of seborrheic eczema is unknown. However, doctors believe that there are two main factors that can contribute to the condition’s development. The first factor is the overproduction of oil. The excess amount of oil in the skin may act as an irritant, causing the skin to become red and oily. The second contributing factor is Malassezia, a type of fungus found naturally in skin oils. It can sometimes grow abnormally, causing the skin to produce more sebum than usual. Excessive oil production can lead to seborrheic eczema.
The condition may also develop in infants due to the hormonal changes that occur in the mother during pregnancy. The fluctuating hormone levels are thought to stimulate the infant’s sebaceous glands, which leads to an increase in oil production that may irritate the skin.
Seborrheic eczema is a long-term skin condition that requires ongoing treatment. However, developing a good skincare routine, and learning to recognize and eliminate triggers can help you effectively manage the condition.
Seborrheic eczema symptoms
Signs and symptoms of seborrheic eczema may include:
- Scales of skin (dandruff) on the scalp, hair, eyebrows, beard, or mustache
- Patches of oily skin covered with white or yellow flaky scales or crusts on the scalp, face, sides of the nose, eyebrows, ears, eyelids, chest, armpits, groin area, or under the breast
- Red skin
Signs and symptoms may be more severe if you are stressed, and they tend to flare up in cold, dry seasons.
Seborrheic eczema causes
Experts don’t know exactly what causes seborrheic eczema. It appears to be a mixture of things, include:
- Your genes
- Yeast usually lives on your skin without causing problems
- Certain medical conditions and medications
- Cold, dry weather
- An immune system response
It does not come from an allergy or from being unclean.
What is the treatment for seborrheic eczema?
Treatment for seborrheic eczema often includes several of the following options.
- Keratolytics can be used to remove scales when necessary, such as salicylic acid, lactic acid, urea, and propylene glycol.
- Topical antifungal agents are applied to reduce Malassezia such as ketoconazole or ciclopirox shampoo and/or cream. Note that some strains of Malassezia are resistant to azole antifungals. Try zinc pyrithione or selenium sulfide
- Mild topical corticosteroids are prescribed for 1-3 weeks to reduce acute flare inflammation
- Topical calcineurin inhibitors (pimecrolimus cream, tacrolimus ointment) are indicated if topical corticosteroids are often needed, as they have less harmful effects on facial skin.
In resistant cases in adults, oral itraconazole, tetracycline antibiotics, or light therapy may be recommended. Low-dose oral isotretinoin has also been shown to be effective in severe or moderate seborrheic eczema.
- Medicinal shampoos containing ketoconazole, ciclopirox, selenium sulfide, zinc pyrithione, coal tar, and salicylic acid, are to be used twice a week for at least a month, and if necessary, indefinitely.
- Steroid scalp applications reduce itching, and they should be used daily for a few days every now and then.
- Calcineurin inhibitors such as tacrolimus can be used as steroid alternatives.
- Coal tar cream can be applied to the peeling areas and removed after a few hours by shampooing.
- Combination therapy is often recommended.
Face, ears, chest, and back
- Clean the affected skin well once or twice daily with a non-soapy cleanser.
- Apply ketoconazole or ciclopirox cream once daily for 2 to 4 weeks, repeating as necessary.
- Hydrocortisone cream can also be used, by applying it twice daily for one or two weeks. Sometimes the most effective topical steroid may be prescribed.
- Topical calcineurin inhibitors such as pimecrolimus cream or tacrolimus ointment may be used in place of the topical steroids.
- A variety of herbal remedies are commonly used, but their effectiveness is uncertain.
Management in infants
Regular washing of the scalp with baby shampoo or water cream is followed by gentle brushing to clean the scales.
- White petroleum jelly may be helpful.
- Topical antifungals are often prescribed, depending on how far the rash has spread.
Seborrheic eczema is a condition that comes and goes for life. It is best controlled and managed with treatment. There are many natural remedies that can be added to medical treatments. For young children, anyone should always speak to a doctor before using any of these products. This is due to the paucity of research on its effect and safety in children.
A person should always keep in mind that the US Food and Drug Administration (FDA) does not regulate herbs, essential oils, or dietary supplements in terms of their strength, quality, purity, or safety. Therefore, it is important to read labels and research brands before purchasing. Controlling risk factors and practising good skin care can reduce the severity of seborrheic eczema.
How do health care professionals diagnose seborrheic dermatitis?
Seborrheic eczema is usually diagnosed clinically, which means the doctor will identify it based on its appearance. Occasionally, scales of skin treated with potassium hydroxide are examined using a microscope to rule out fungal infection. Rarely, a skin biopsy is needed to be diagnosed.
There are a number of factors that increase the risk of developing seborrheic eczema, including:
- Neuropsychiatric conditions, such as Parkinson’s disease and depression
- The weak immune system, as seen in transplant recipients and people with HIV / AIDS, alcoholic pancreatitis, and some cancers
- Recovery from stressful medical conditions, such as a heart attack
- Some medicine
What are the complications of seborrheic eczema?
There are a few complications that can be attributed to this condition. Most of the problems seem to be related to wrong diagnosis or abuse. In rare cases, some superficial skin fungal infections (dermatophytes) of the face and scalp can resemble seborrheic eczema. If a dermatophyte infection is mistakenly treated with anti-inflammatory drugs (topical steroids), more extensive participation can be encouraged. Overuse of strong topical steroids in the wrong attempt to treat this condition, especially on the face and armpits, can lead to many unwanted changes to the skin including skin thinning. Severe seborrheic eczema can sometimes lead to hair thinning or loss, due in large part to excessive itching. With disease under control, regrowth is expected.
Can seborrheic eczema be prevented or avoided?
If the condition is hereditary, then it cannot be prevented. Most of the other causes cannot be prevented. However, you can reduce the severity of symptoms. Carefully controlling risk factors and caring for your skin can help. This includes avoiding lotions that contain alcohol, using special skin products recommended by your doctor, protecting yourself from HIV / AIDS, losing weight, and getting plenty of rest.