Seborrheic dermatitis is a common, chronic skin condition that can cause discomfort and distress for those affected. Known for its red, scaly patches, greasy skin and persistent itching, this condition typically affects oily areas of the skin. That’s why seborrheic dermatitis is most common on the scalp (where it commonly presents as dandruff) and face. If that wasn’t bad enough, seborrheic dermatitis can also lead to temporary hair loss. In this article, we’ll explore the causes of seborrheic dermatitis, how it leads to hair loss and the best treatment options for both the scalp and face.
What is it?
In simple terms, seborrheic dermatitis is a common type of eczema that primarily affects the scalp, face and other oily areas of the body like the upper chest and back. It is a long-term condition that flares up periodically, especially in response to triggers like stress, hormonal changes or cold weather. Whilst it can appear at any age, seborrheic dermatitis is particularly common in infants (where it’s known as cradle cap) and adults between the ages of 30 and 60. The main symptoms of seborrheic dermatitis are:
- Red and inflamed skin
- Greasy or oily patches on the scalp, face or body
- Scaly patches that may peel or flake
- Persistent itching and irritation
Although the symptoms can be uncomfortable, seborrheic dermatitis is not contagious and does not pose any serious health risks. However, its appearance, particularly on the face and scalp can be distressing for a lot of people and may lead to self-esteem issues. Whilst this is not a dangerous condition, it can be physically uncomfortable especially with symptoms like itchiness. Additionally, without treatment, seborrheic dermatitis can even cause hair loss.
What’s the difference between Seborrheic Dermatitis vs Dandruff?
Seborrheic dermatitis and dandruff are related but differ in severity and symptoms. Dandruff is a milder form of seborrheic dermatitis. It typically appears as white or yellow flakes on the scalp but there isn’t usually much in the way of inflammation or redness. Seborrheic dermatitis generally causes more severe symptoms like redness, itching, pain, inflammation and patches on the skin. So in short, dandruff is a mild form of seborrheic dermatitis that is generally limited to the scalp.
How Does it Occur?
This condition occurs due to a combination of factors. The main mechanisms that seborrheic dermatitis is thought to occur due to a trio of overproduction of sebum, the presence of the Malassezia yeast on the skin and an inflammatory response. Malassezia is a naturally occurring fungus that thrives in oily areas, such as the scalp and face. In some people, this yeast overgrows, triggering an immune response that leads to inflammation, redness and flaking of the skin.
Causes of Seborrheic Dermatitis
The exact cause of seborrheic dermatitis is not fully understood. However, several factors are believed to contribute to the condition. These include:
- Genetics: Seborrheic dermatitis tends to run in families which suggests a genetic component.
- Overactive Sebaceous Glands: Excess oil production creates an environment conducive to fungal growth. This triggers inflammation.
- Malassezia Yeast: This naturally occurring fungus thrives in oily areas of the skin and plays a key role in triggering teh inflammation that leads to seborrheic dermatitis.
- Immune System Response: Some people may have an exaggerated immune response to the presence of Malassezia yeast which then leads to inflammation.
- Environmental Factors: Cold, dry weather, stress and hormonal fluctuations can all trigger or exacerbate seborrheic dermatitis.
How Seborrheic Dermatitis Affects the Scalp & Hair
When seborrheic dermatitis affects the scalp, it leads to an excessive build-up of sebum dead skin cells and fungal or yeast overgrowth. This creates an ideal environment for irritation and inflammation. Both of these can negatively impact hair health. The mildest manifestation of seborrheic dermatitis on the scalp is dandruff whilst the most serious is hair loss. The main ways seborrheic dermatitis causes hair loss are:
- Inflammation: Persistent inflammation weakens hair follicles which making them more prone to shedding. The scalp’s irritated state can disrupt the normal hair growth cycle and causes hair to fall out prematurely.
- Scratching: The intense itching associated with seborrheic dermatitis often leads to excessive scratching. Repeated trauma to the scalp can damage hair follicles which then leads to breakage or shedding.
- Fungal Overgrowth: The yeast Malassezia plays a key role in seborrheic dermatitis. This fungal overgrowth can exacerbate irritation and inflammation. This further weakens hair follicles and contributes to hair thinning.
- Sebum Build-Up: Excessive oil production leads to clogged hair follicles, which can hinder hair growth. Over time, clogged follicles can become inflamed, which may accelerate hair shedding.
The good news is that hair loss caused by seborrheic dermatitis is usually temporary if it is treated promptly and properly. Once the underlying condition is treated and managed, hair typically regrows.
Seborrheic Dermatitis on the Face
While the scalp is one of the most common areas affected, seborrheic dermatitis can also occur on the face. Arguably, this can be equally if not more distressing. On the face, seborrheic dermatitis typically appears around the eyebrows, nose, eyelids and hairline. It can sometimes be mistaken for acne or rosacea due to the red patches. The most common symptoms and signs of seborrheic dermatitis on the face include:
- Red and scaly patches
- Oily or shiny skin
- Itching or burning sensation
- Flaky skin around the eyebrows or nose
Scalp Treatments
If you’re dealing with seborrheic dermatitis of the scalp, it’s essential to follow a targeted treatment plan that addresses both the symptoms and underlying causes. The main goals of treatment are to reduce inflammation, control fungal overgrowth and manage sebum production. You’ll also need to be consistent with the treatment and follow a maintenance protocol to stop it form returning. Here are the most effective seborrheic dermatitis scalp treatment options that can also stop any related hair loss:
- Medicated Shampoos: The cornerstone of seborrheic dermatitis scalp treatment is medical shampoos which are usually available over the counter. These normally contain active ingredients like Ketoconazole, Zinc pyrithione, Selenium sulfide and Salicylic acid. Ketoconazole is an antifungal agent that helps reduce Malassezia yeast levels on the scalp. Zinc pyrithione is both an antifungal and antibacterial ingredient that reduces dandruff and calms inflammation. Selenium sulfide works differently in that it helps slow down the overproduction of skin cells and reduce itching. Lastly, Salicylic acid is an exfoliating agent that helps remove excess dead skin and sebum from the scalp. You might find one or more of these ingredients in a shampoo. You will usually need to use these shampoos 2-3 times a week foe a number of weeks. After that, the advise is to then continue using it at a lower frequency (once every 1-2 weeks for example) to maintain your results.
- Topical Steroids: In more severe cases, your doctor may recommend topical steroids to help reduce inflammation and itching. These treatments are usually short-term to avoid potential side effects, but they can be highly effective in calming acute flare-ups.
- Tea Tree Oil: For those seeking natural remedies, tea tree oil has antifungal and anti-inflammatory properties that can help soothe the scalp. However, it’s important to dilute tea tree oil with a carrier oil to avoid irritation.
- Scalp Care: Maintaining good scalp hygiene is crucial in managing seborrheic dermatitis. Regular washing with a gentle shampoo can help reduce oil build-up and prevent further irritation. Avoid using harsh chemicals or heat styling tools that may aggravate the scalp
Face Treatment Options
Treating seborrheic dermatitis on the face requires a more gentle approach as the skin in this area is often more sensitive than the scalp. The following are best known seborrheic dermatitis treatments for the face:
- Avoid Triggers: Stress, alcohol, and spicy foods can worsen this condition. Managing your triggers can help reduce flare-ups.
- Topical Antifungal Creams: These help control the yeast responsible for triggering seborrheic dermatitis. Over-the-counter options containing ketoconazole or clotrimazole creams.
- Non-Steroidal Anti-Inflammatory Creams: Prescription creams like pimecrolimus and tacrolimus are powerful alternatives to steroid creams. They can be used for longer durations without the risk of thinning skin.
- Skincare: Use a mild cleanser to wash your face twice a day. Avoid harsh scrubs or alcohol-based products, which can exacerbate irritation. It’s also essential to keep the skin well-hydrated. Choose a gentle hydrating fragrance-free moisturisers that won’t clog pores or aggravate the skin.
Seborrheic dermatitis is a very common condition that can affect skin on the face, scalp or other parts of the body. It is important to understand the underlying causes and triggers as that will allow you to find the nest treatment option for you. There are many great treatments for seborrheic dermatitis on the scalp which can also reduce any related hair shedding. If on the face, treatment requires a slightly more cautious approach but there are also a number of good options. Just remember that consistency is important and to also holistically treat your skin and the underlying causes of your symptoms. Seeking help early from a medical professional can also ensure that your diagnosis is correct and provide prescription treatments especially where over the counter options have failed.
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