Askanesthetician's Blog

An esthetician explores skincare issues and concerns

PCOS and Your Skin October 24, 2013

Some of the most challenging skin issues I have ever tried to treat are those of women who have PCOS – polycystic ovarian syndrome.  It is hard for me to forget the skin of one client who by far had the worst acne I have ever tried to help get under control or the client who told me she wasn’t going to try to treat her acne since it was caused by an internal hormonal issue (PCOS) and since there was no cure for PCOS there was nothing she could do for her acne. Both clients got me thinking – is there really nothing you can do for someone’s acne if they suffer from an internal hormonal issue?  That question prompted this post.

First of all, though the focus of this post is skin and PCOS I think it is necessary to very briefly explain what PCOS is and its symptoms.  The Mayo Clinic explains:

Polycystic ovary syndrome (PCOS) is a common hormonal disorder among women of reproductive age. The name of the condition comes from the appearance of the ovaries in most, but not all, women with the disorder — enlarged and containing numerous small cysts located along the outer edge of each ovary (polycystic appearance).

Infrequent or prolonged menstrual periods, excess hair growth, acne and obesity can all occur in women with polycystic ovary syndrome. In adolescents, infrequent or absent menstruation may signal the condition. In women past adolescence, difficulty becoming pregnant or unexplained weight gain may be the first sign.

The exact cause of polycystic ovary syndrome is unknown. Early diagnosis and treatment may reduce the risk of long-term complications, such as type 2 diabetes and heart disease.

Polycystic ovary syndrome signs and symptoms often begin soon after a woman first begins having periods (menarche). In some cases, PCOS develops later on during the reproductive years, for instance, in response to substantial weight gain.

Signs and symptoms vary from person to person, in both type and severity. To be diagnosed with the condition, your doctor looks for at least two of the following:

  • Menstrual abnormality. This is the most common characteristic. Examples of menstrual abnormality include menstrual intervals longer than 35 days; fewer than eight menstrual cycles a year; failure to menstruate for four months or longer; and prolonged periods that may be scant or heavy.
  • Excess androgen. Elevated levels of male hormones (androgens) may result in physical signs, such as excess facial and body hair (hirsutism), adult acne or severe adolescent acne, and male-pattern baldness (androgenic alopecia). However, the physical signs of androgen excess vary with ethnicity, so depending on your ethnic background you may or may not show signs of excess androgen. For instance, women of Northern European or Asian descent may not be affected.
  • Polycystic ovaries. Enlarged ovaries containing numerous small cysts can be detected by ultrasound. Despite the condition’s name, polycystic ovaries alone do not confirm the diagnosis. To be diagnosed with PCOS, you must also have abnormal menstrual cycles or signs of androgen excess. Some women with polycystic ovaries may not have PCOS, while a few women with the condition have ovaries that appear normal.

Causes:

Doctors don’t know the cause of polycystic ovary syndrome, but these factors likely play a role:

  • Excess insulin. Insulin is the hormone produced in the pancreas that allows cells to use sugar (glucose) — your body’s primary energy supply. If you have insulin resistance, your ability to use insulin effectively is impaired, and your pancreas has to secrete more insulin to make glucose available to cells. The excess insulin might boost androgen production by your ovaries.
  • Low-grade inflammation. Your body’s white blood cells produce substances to fight infection in a response called inflammation. Eating certain foods can trigger an inflammatory response in some predisposed people. When this happens, white blood cells produce substances that can lead to insulin resistance and cholesterol accumulation in blood vessels (atherosclerosis). Atherosclerosis causes cardiovascular disease. Research has shown that women with PCOS have low-grade inflammation.
  • Heredity. If your mother or sister has PCOS, you might have a greater chance of having it, too. Researchers also are looking into the possibility that mutated genes are linked to PCOS.
  • Abnormal fetal development. Some research shows that excessive exposure to male hormones (androgens) in fetal life may permanently prevent normal genes from working the way they’re supposed to — a process known as gene expression. This may promote a male pattern of abdominal fat distribution, which increases the risk of insulin resistance and low-grade inflammation. Researchers continue to investigate to what extent these factors might contribute to PCOS.

There are different ways to treat PCOS symptoms, remember there is no cure.  Some ways to treat this condition is through medications and another way is through lifestyle changes such as the ones described by PCOS for Dummies:

How to Manage PCOS

If you’re willing to overhaul your diet and start a simple exercise program, you can gain a great deal of control over your PCOS symptoms. Insulin resistance causes many PCOS symptoms, and diet and exercise help control insulin resistance.

  • If you’re overweight, lose weight by limiting yourself to 1,500 calories per day. Losing weight is one of the biggest factors in controlling PCOS symptoms, particularly if you’re trying to get pregnant.
  • Eat regular meals (but don’t pile your plate), and have a couple of small snacks during the day.Don’t let yourself get hungry.
  • Follow a low-GI diet by substituting low-GI carbs for high-GI carbs. The glycemic index (GI) measures how a carbohydrate affects blood sugar. High-GI foods break down quickly into glucose while low-GI foods are absorbed more slowly. Low-GI foods stabilize your blood sugar, while high-GI foods cause a rapid rise in blood sugar levels. Refined sugars are high-GI foods, while fruits and vegetables are generally low-GI.
  • Limit the fat in your diet. Cut down particularly on saturated and trans fats (including fatty meat, butter, cakes, pastries, and cookies).
  • Use as little salt as possible. Look at labels of processed foods to try to keep your total sodium intake below 2,400 milligrams a day.
  • Eat at least five helpings of fruit and vegetables every day.
  • Get some physical activity every day. Half an hour is great, but an hour is even better to help keep your weight under control. Remember to start slowly and incorporate both aerobic and weight-bearing exercise into your routine. You don’t have to do all your exercise at one time — 10 minutes of exercise three times a day is just as good as 30 minutes all at once.

PCOS and Skin

As already mentioned above many women who suffer from PCOS also suffer from acne.  Their acne can be very bad with many papules and pustules and can be hard to control because of the excessive androgen in the body.  While birth control pills may help control some of the hormonal issues associated with this condition, what other lifestyle changes can help the acne caused by PCOS?  While I still believe that using anti-acne ingredients such as salicylic acid and retinol can help pores from becoming excessively clogged with dead skin cells and excess oil, are there any other solutions as well?  According to one article from the website Beauty Bible dietary changes may be the key to controlling PCOS related acne:

First – to explain the underlying situation – Dr Marilyn Glenville, author of Natural Solutions to PCOS, says this:

‘PCOS creates a vicious cycle of hormone imbalances, which has huge knock-on effects throughout the rest of your body. The problem often starts with the ovaries, which are unable to produce the hormones they should, and in the correct proportions. Linked to this is the common problem of insulin resistance. Women with PCOS very often have difficulties with blood sugar levels, which can cause weight gain and the excess insulin can stimulate your ovaries to produce yet more testosterone (the male hormone). Half of all women with PCOS do not have any problems with their weight, yet they can still have higher insulin levels than normal. ‘

The aim, Marilyn says, ‘is to balance your hormones in order to control the hormonal breakouts from the inside out. There is now overwhelming evidence to suggest that diet plays a significant role in helping with PCOS and also increasing the chances of conceiving.’

‘Adapting your eating habits so that you keep your blood-sugar levels on an even keel throughout the day is essential.  If your adrenal glands are over-stimulated by ever-fluctuating sugar highs and lows, they produce too much adrenaline – the stress hormone – and also too much testosterone, preventing ovulation altogether.’

Aim to eat little and often to keep your blood sugar under control and follow a low GI (glycemic index) diet, with little sugar of any kind, including fruit and fruit juices as well as the more obvious cakes, biscuits, etc.

The article also recommends taking various supplements though I recommend you speak to a doctor before following that advice.  I also found a personal testimonial about how one women changed her diet to successful control her PCOS acne:

According to Women’s Health UK, the elevated androgen level associated with PCOS causes the production of DHT, and this leads to acne. Additionally, insulin resistance is also typically part of PCOS, and insulin resistance further increases androgen levels. This leads to even higher DHT levels, and induces more acne breakouts.

Also, as PCOS women consume high amounts of refined carbohydrates, more negative changes occur in the body. Refined carbohydrates have a high glycemic index and consuming them increases your blood sugar. In response to the increase, your body produces more insulin, further increasing your androgen levels.

In short, it’s a terrible cycle that needs to be broken before clear skin can make an appearance.

What do I do about PCOS acne?
After learning all of this information, I finally decided that I should be treating the acne problem from the inside out, reasoning that my skin is only as good as what is circulating in my body. So, after talking to my OB/GYN and a Naturopath, I started tackling my hormonal problems the natural way. I began taking Vitex (Chastetree) to balance my hormones, and began a fairly strict low carb way of eating to treat the PCOS.

I stuck to plenty of fresh fruits and vegetables, ate meat and dairy, and kept my daily intake of carbohydrates below 45 grams (although this number will vary widely by person). I also made sure to drink at least 10 glasses of water every day.

Needless to say, I was thrilled when my skin began clearing up after only 2 weeks. There were fewer pimples, and my skin tone was more even. Motivated and excited, I carried on with my new way of life. Within 6 weeks, my skin was completely clear and smooth – I was cured of my terrible skin. I wanted to shout it from the rooftops! After nearly 15 years of trouble skin, I had a found a way to get the skin I had always dreamed of having.

Even more exciting – my PMS was practically gone, and “that time of the month” was no longer accompanied by a nightmarish number of breakouts.

To this day, my skin is still free of acne, and I couldn’t be happier about it. If you have the type of acne I did, and you think you might have PCOS, talk to your doctor, and try some low carb eating and Vitex – you have nothing to lose besides your breakouts!

I’ve addressed the issue of acne and diet numerous times in this blog (you can read my posts by clicking on the links below in the “further reading” section) so I am definitely a believer when it comes to linking acne and diet.  Do I think that simply changing your diet if you suffer from PCOS will clear your skin?  That’s a hard one to answer.  PCOS is a complicated condition so while it is good to hope for the best when making lifestyle and dietary changes you might have to temper your hopes as well.  Being under the care of the right doctor or naturopath can go a long way in helping you achieve clearer skin and control your PCOS.

Further Reading:

 

Oxygen in Skincare Products and Treatments – Update October 17, 2013

I’ve discussed the subject of oxygen in skincare products and treatments before (please see my previous posts Does Your Skin Need to Detoxify/Breathe? and Oxygenation Treatments: The Case For and Against), but since the subject continues to be addressed in other places I thought I would share some new information that I came across.

Before I share some new information I learned I should mention that the argument about oxygen in beauty products usually, though not always, boils down to a product manufacturer saying that oxygen in a product or a treatment is great for the skin and a doctor saying just the opposite.  For example in the The New York Times article Oxygen Bubbles Into Facial Care Products Robin White from the skincare company Philosophy states:

“Oxygen is known to give skin brightness and clarity. It works on clogged pores and dullness, and brings back radiance and freshness.”

Or check out these other two examples from the same article:

“As we age, the oxygen in our body is depleted, which results in lifeless skin,” said Michael Ann Guthrie, vice president for retail for Natura Bissé. “Our oxygen products are based on stabilized hydrogen peroxide, which delivers molecules directly into the skin. This active ingredient breaks down into water and oxygen, and then supplies the skin with oxygen, which enables it to breathe.”  …

Bliss has also created a number of oxygen-infused products. In 2010 and 2011, they introduced the Triple Oxygen Instant Energizing Mask ($54), Triple Oxygen Instant Energizing Cleansing Foam ($28), and Instant Energizing Eye Mask ($50). In the spring of this year, two new items will be added to the line, including a rich oxygenating cream. The company’s spas also offer two oxygen facials, a 75-minute treatment and a 30-minute one. Both promise luminosity, include an oxygen spray, and are among the spa’s most popular, said Susan Grey, regional vice president of spa operations for New York Bliss Spas. “Oxygen increases circulation, which increases the delivery of nutrition to the skin, and gives your skin energy,” she said. “It also kills bacteria which keeps post-facial breakouts away.” And, she said that as oxygen travels through the body, the skin is the last to receive it. “By time it gets there,” she added, “it’s a little tired.”

And for the dissenting opinions:

… “There’s no scientific evidence that oxygen can penetrate the skin or that it can stay in the product,” said Dr. Bruce Katz, a clinical professor of dermatology at the Mount Sinai School of Medicine and the director of the Juva Skin and Laser Center in New York. He added that very few products can penetrate the stratum corneum, the outer layer of the skin.

Celeste Hilling, the chief executive of Skin Authority, a skin-care company in San Diego, is one cosmetics-industry professional who needs convincing; she believes better results can be achieved with other elements, like vitamin D or peptides.

“Oxygen is an inert ingredient, meaning it’s nonactive,” Ms. Hilling said. “We need it in the bloodstream to breathe and to live, but oxygen is what’s aging our skin. It’s oxidizing it. Plus, skin can’t absorb it.”

The apothecary giant Kiehl’s is another dissenter. “Oxygen is a gas and cannot be incorporated as a stand-alone ingredient,” said Chris Salgardo, the company’s president. “Products on the market that speak to ‘oxygenating’ usually use hydrogen peroxide, or other ingredients that will generate oxygen as the product is applied to skin.” To obtain the benefits oxygenating products are typically used for, like dark spots, wrinkles, pore size and elasticity, Kiehl’s uses other ingredients like vitamin C and calcium.

But products promising oxygen continue to make appearances. According to the NPD Group, a market research company, total oxygen-infused facial skin care products generated $4.1 million in department store sales from January through October 2012 in the United States, an increase of 54 percent, compared with the same time in 2011.

“Oxygen is appealing in concept because everyone knows it’s very good for you,” said Dr. Jeffrey Spiegel, a facial plastic surgeon and the director of advanced facial aesthetics in Chestnut Hill, Mass. “But it’s not clear that adding oxygen to the skin is going to improve someone’s appearance. We also get enough oxygen to our skin by having healthy lungs and not smoking.”

So who is right?  Does our skin even need oxygen to be healthy?  According to Drs. Draelos and Pugliese in their book Physiology of the Skin, third edition (pages 249-253):

The skin uses very little oxygen.  In fact, it uses only 12.8 milliliters per minute, just a tad over two teaspoons of oxygen, which is only 4.8% of the oxygen taken into the lungs each minute.  Every 100 grams of skin uses only 0.3 mL/min.  One hundred grams of skin is a lot if you consider only the epidermis, because the dermis uses almost no oxygen.  …

Such a small amount of oxygen does not require the blood supply found in the skin.  This tells us that the skin is not an oxygen-using tissue.  In fact, it prefers to metabolize without oxygen.  …

Oxygen Therapy

Peroxides.  There are two forms of oxygen therapy used by estheticians.  One form is peroxides of some type – hydrogen peroxide, zinc peroxide or other basic elements such as calcium.  All of these compounds decompose to release oxygen and the hydroxide of the base element.  In the case of hydrogen peroxide, the most commonly found oxygen source in cosmetics, water and oxygen are produced.  As the oxygen is released, it reacts on the skin surface with anything that it can oxidize.  It becomes an effective bleaching agent and a weak germicide on the surface of the skin.  But that is all.  It cannot penetrate the skin.

Oxygen is a gas, and gas will diffuse into other gases before it will dissolve in anything else.  You can’t affect anything other than the outer stratum corneum with these topical products.  Any claim that oxygen penetrates the epidermis, or goes to the deeper layers of the epidermis, must be highly suspect.  All other benefits from so-called oxygen generating products are not based on true science.

Oxygen as a gas

This form of oxygen therapy is a waste of time and money.  Here is why.  One molecule weight of oxygen will fill 22.4 liters of atmospheric pressure.  No matter how much pressure is in the tank, that comes out will be at atmospheric pressure when it hits the air.

If you spray this oxygen over a face that is dry, what will happen?  Nothing.  It immediately will go into the air, as oxygen does not diffuse into dry protein.  OK, so wet the face.  How much will dissolve in the water, or whatever fluid used?  Under atmospheric pressure, or 152 mm Hg, 5 micro liters of oxygen will dissolve per milliliter of water, written as 5 µL/mL of water.  Think about that for a minute; the water you are using consists of 1,000 mL of oxygen in the air or 1 million micro liters of oxygen.  How much water can you get on the face at one time?  Maybe an ounce, or even two ounces if a cotton cloth was used.  Now you have 60 mL of water in which 3 X 60 or 180 µL of oxygen at a maximum can be dissolved.

Of the one liter of oxygen that you have used, you have, at the very best, an opportunity to have 0.180 mL dissolve in the solution on the face.  You have wasted 500 times more oxygen.  Now here is the sad part.  None of the oxygen gets into the skin to do any good.  Even if it did, by some unknown law, it still would be of no benefit to the skin because of the skin’s physiological makeup.  Increased skin oxygen is only beneficial if the skin has an insufficient oxygen supply.  It is not possible to aid skin oxygenation of the skin already has as much as it needs.

Summary

…  The skin uses very little oxygen since 90% of the metabolic process in the skin is anaerobic, or does not require oxygen.  Oxygen does not penetrate the skin at atmospheric pressure or in a solution.  The action of oxygen is mainly a surface action; as an oxidant it is an effective bleaching agent and a weak germicide.  Gaseous oxygen has no basis of use in topical system since it does not penetrate dry skin and has very limited solubility on wet skin.  The medical application of gaseous oxygen is limited and difficult to use.  No data exists to support the use of topical oxygen for any non-medical application, but it may be of value to persons with wounds that are receiving insufficient oxygen.

New developments in skin oxygenation include the use of oxygen-releasing foams and oxygen-releasing skin care products.  The problem with evaluating this type of technology is that the oxygen is always used with a moisturizer.  Separating the effect of the moisturizer on the skin versus the oxygen is almost impossible.  It is for this reason that the value of topical oxygen has never been proven.

Now that you’ve read both sides of argument what do you think?  Yay or nay on oxygenation treatments or products with oxygen?

Further Reading:

Image from openwalls.com

 

What Is Milia and How Do You Treat It? October 10, 2013

There are some skincare issues that, in my opinion, are more vexing than others.  To name a few –  hyperpigmentation, acne, and milia.  Just what is milia, how do you get it, and how do you treat it?

What is Milia and What Causes It?

According to Dr. Ellen Marmur in her book Simple Skin Beauty (pages 201-206) milia and whiteheads are very similar:

… both are closed-over keratin plugs – but milia is not associated with acne.  They are caused by aging and slower cell turnover.  Milia are tiny white bumps formed by trapped keratin compacted in the pore, but there is no bacteria or oil involved.  …

Milia is a case of keratin-obstructed pores caused by skin that isn’t shedding normally.  It is not an acne issue and happens frequently as we age; it generally starts to show up in your thirties.  Milia can also be a side effect of laser resurfacing, because the skin is growing at an accelerated rate (as a wound-healing response) and can trap keratin inside the pores.

The website Dermadoctor expands further on the causes of milia in an article by Dr. Audrey Kunin :

Milia are deep seeded white bumps that form when skin cells become trapped rather than exfoliate naturally. The trapped cells become walled off into tiny cysts that appear like white beads below the surface of the skin. Milia can occur on the skin or even on mucous membranes such as the inner surface of the cheek or the vermillion border of the lips.

As the surface is worn away, the tiny cyst may resolve on its own. Far too often, though, intervention to remove the cyst may offer more rapid resolution.

Why Me?

Milia form for a variety of reasons. Some you can fix, others aren’t so easily dealt with. But you need to scrutinize your skin care routine whenever milia make their appearance. Although some people naturally make milia, and I certainly expect everyone to have an occasional bump at one time or another, milia are often the result of a problem that has affected the skin’s surface.

Are there any skincare habits that contribute to the formation of milia?  According to Dr. Kunin yes there are:

  • No doubt the most common reason milia form is from smothering your skin with heavy skin care products or hair care items. Comedogenic creams and lotions may prevent the sloughing of dead epidermal skin cells. Hidden problem products include make-up removers not labeled oil-free or non-comedogenic, hair spray, hair mousse and gel, heavy sunscreens and some moisturizers. The eyelids are very thin and more likely to experience problems with milia due to cosmetics. Re-evaluate your eye make-up and eyelid make-up remover if you are finding this to be a concern.Certain lipsticks, lip balms and products meant to help with chapped lips may be the cause of little white pearly milia developing around the lipstick edge (aka vermillion border) of the lips. Again, if you see these forming, take a good look at the ingredients on the label.
  • Prolonged History Of Sun Damage
    The formation of milia can also be due to cumulative sun exposure. Aging skin forms a thicker epidermis that may make it far more difficult for skin cells to find their way out of the glands. And thicker skin also makes for more road blocks in the pathway to exfoliation.
  • Porphyria Cutanea Tarda
    Milia can also be associated with certain skin diseases, particularly blistering disorders such as Porphyria Cutanea Tarda. Fortunately, there are other symptoms associated with these blistering diseases. Blisters, for one and increased hair on the face and backs of hands and knuckles, for another. PCT is an unusual disorder. If you have milia, don’t initially jump to the conclusion you have a blistering condition.
  • Genetics
    Sometimes we just inherit certain undesirable skin tendencies.

What Can Be Done to Prevent and Treat Milia?

Both doctors I quoted above believe that regular exfoliation and retinols can help fight milia.  Dr. Kunin explains:

Exfoliation can go a long way in helping deal with milia prone non eyelid skin. By keeping the epidermis thin and smooth, you can cut down on their formation. By mentioning exfoliation, I’m not talking about scrubbing off the top layer of your skin!

Retinol is also very helpful for both fighting and preventing milia. Again, retinol should not be applied to the upper eyelids.

Sometimes milia won’t come out in spite of your best efforts. Then you may need the milia to be extracted by your dermatologist. In a physician’s office, milia are easily removed. The skin is cleansed with some rubbing alcohol or other antiseptic. The skin overlying the milia is gently opened with a sterile lancet or needle. Then pressure is applied with a comedone extractor, and the milia typically pop out. I find that one of the most difficult areas from which to remove milia is the upper eyelid. There simply isn’t a good way to press on the area and avoid the eyeball, so the lid has to be pulled either upwards or to the side, which is somewhat challenging.

Furthermore, since extensive sun exposure can cause milia be sure to be vigilant, if you weren’t already, with using a sunscreen that won’t clog pores.  And if you’ve tried everything to get rid of your milia and it isn’t working please see a professional.  Don’t go stabbing your face with a needle on your own.

Further Reading:

Image from jacintak.com

 

What Is Seborrheic Dermatitis? October 3, 2013

When I was in esthetics school we discussed skin diseases, and I do remember that seborrhea was mentioned.  According to my textbook from school (yes, I still have my textbook) they divide seborrhea and seborrhea dermatitis into two different categories:

Seborrhea: Severe oiliness of the skin; an abnormal secretion from the sebaceous glands

Seborrheic Dermatitis:  A common form of eczema

(From Milady’s Standard Fundamentals for Estheticians, 9th edition, page 203)

Before I became an esthetician I had come across a common form of seborrheic dermatitis which is cradle cap.  My son had had severe cradle cap as an infant so I was quite aware of what that was.  Yet once I was introduced to the concept of seborrhea as explained above, “severe oiliness of the skin”, I didn’t come across this condition at all while working in the US.  Then I moved back to Israel and I couldn’t believe how many people I encountered for facials that would tell me they had seborrhea.  I was surprised to say the least.  I couldn’t figure out how in one part of the world I had never come across this condition and in another part of the world I couldn’t seem to escape it.  I wondered if the definition of this skin condition had changed from country to country, from language to language.  The skincare companies that I worked with in the US never mentioned this condition to me or had products that treated it, unlike Israeli skincare companies that do both.  Truthfully I am still trying to figure this one out, but in the meantime I realized that I better brush up on my knowledge about seborrhea.

What is Seborrheic Dermatitis?

Dr. Carl Thornfeldt in his book The New Ideal In Skin Health defines seborrheic dermatitis as (page 86):

These lesions are usually found on areas of the body with more sebaceous glands, such as the forehead, eyebrows, around the nose and ears, scalp, midchest, and central trunk. It is characterized by greasy yellow scaling on erythematous patches of various thicknesses.  It usually has no itching.  It may be associated with rosacea.  Dandruff is a mild form on the scalp.  It is most common in infants (cradle cap) and elderly.  It may also be flared by physical and emotional stress.

Furthermore, according to the American Academy of Dermatology seborrheic dermatitis is characterized as:

The skin tends to have a:

  • Reddish color.
  • Swollen and greasy appearance.
  • White or yellowish crusty scale on the surface.

One or more of these rashes can appear on the body. Sometimes, the affected skin itches.

Seborrheic dermatitis can look like psoriasis, eczema, or a skin allergy.

What Causes Seborrheic Dermatitis?

The Mayo Clinic explains:

Doctors don’t yet know the cause of seborrheic dermatitis. Factors that may play a role include:

  • A yeast (fungus) called Malassezia. This fungus is one of the normal microscopic life forms that grow, along with certain bacteria, in your skin’s oily secretion (sebum). Creams, foams or lotions containing an antifungal agent, such as ketoconazole (Ketozole, Extina), often help reduce flare-ups, supporting the idea that this yeast is a contributing factor. But seborrheic dermatitis itself isn’t considered an infection, and it’s not contagious.
  • Change of season. Episodes are often worse in winter.
  • Neurological conditions. Seborrheic dermatitis may occur more frequently in people who have Parkinson’s disease and certain other neurological disorders.
  • Stress and fatigue. Stressful life events and situations may help trigger an episode or make it worse through mechanisms that aren’t yet understood. The role of neurological disorders and stress may be related through effects on the nervous system.
  • HIV/AIDS. Seborrheic dermatitis may occur more commonly and tend to be more severe in those with HIV/AIDS.

The American Academy of Dermatology expands on the causes and just who is affected by seborrheic dermatitis:

Who gets seborrheic dermatitis?

People of all colors and ages get seborrheic dermatitis. You have a higher risk if any of the following apply to you.

Age

People in these two age groups are most susceptible:

  • Infants 3 months of age and younger.
  • Adults between 30 and 60 years of age.

Medical conditions

Your risk increases if you have any of these medical conditions:

  • HIV (About 85 percent of people infected with HIV develop seborrheic dermatitis).
  • Acne, rosacea, or psoriasis.
  • Parkinson’s disease.
  • Epilepsy.
  • Stroke or heart attack (recovering from).
  • Alcoholism.
  • Depression.
  • Eating disorder.

Medical treatments

If you are taking any of the following medicines, your risk for seborrheic dermatitis increases:

  • Interferon.
  • Lithium.
  • Psoralen.

Facts about Seborrheic Dermatitis

For adults there is both good news and bad news about seborrheic dermatitis.  The good news is that the condition can be treated by a doctor and/or with proper home care.  The bad news is that this is chronic condition, with no cure. According to the Mayo Center:

Seborrheic dermatitis doesn’t affect your overall health, but it can be uncomfortable and cause embarrassment when it develops on visible parts of your body. It isn’t contagious, and it’s not a sign of poor personal hygiene. Seborrheic dermatitis tends to recur, but you may be able to manage flare-ups by recognizing its signs and symptoms and by using a combination of self-care steps and over-the-counter (nonprescription) medications.

How to Treat Seborrheic Dermatitis

First and foremost if you think that you are suffering from seborrheic dermatitis go see a dermatologist before trying to treat yourself.  The doctor can determine if you need prescription products or not to keep your condition under control.  Some skin conditions simply cannot be treated with over the counter products but with seborrheic dermatitis it depends on the severity of the condition.

The Mayo Clinic explains further how to treat this condition:

Seborrheic dermatitis tends to be chronic, and there’s usually no strategy that stops it permanently. But treatments — including many you can try at home — may control your signs and symptoms during a flare-up. The best approach for you depends on your skin type, the severity of your condition, and whether your symptoms affect your scalp or other areas of your body.

Creams and lotions that you apply to affected body areas and medicated shampoos are all mainstays of treatment. In very severe cases, physicians may prescribe oral medications with whole-body effects. Products are available with several kinds of active ingredients. Some preparations include active ingredients from more than one category.

The following over-the-counter treatments and self-care tips can help you control and manage seborrheic dermatitis.

  • Wash your hair with a medicated anti-dandruff shampoo according to the recommended schedule. If you don’t see results, try a shampoo with a different active ingredient.
  • Use an over-the-counter antifungal cream. Application of nonprescription-strength ketoconazole may be helpful.
  • Apply an anti-itch cream or lotion to the affected area. A short course of a nonprescription hydrocortisone cream containing at least 1 percent hydrocortisone can temporarily relieve itching.
  • Avoid harsh soaps and detergents. Be sure to rinse soap completely off your body and scalp.
  • Wear smooth-textured cotton clothing. This will help keep air circulating around your skin and avoid irritation.
  • Shave off your beard or mustache. Seborrheic dermatitis can be worse under mustaches and beards. If this is the case for you, shaving might ease your symptoms.
  • Avoid scratching whenever possible. Scratching can increase irritation, making you more uncomfortable and increasing your risk of infection.

What else can you do at home to keep your condition under control?  Dr. Thornfeldt recommends in his book using a gentle facial cleanser that doesn’t strip the skin’s pH.  He recommends that the homecare products that:

… contain ingredients such as low concentrations (<2%) azelaic acid, salicylic acid, zinc pryrithone and/or willow bark extract to help kill surface bacteria, reduce redness and scaling, and smooth skin texture.  (Page 87)

The American Academy of Dermatology recommends the following:

Adolescents and adults: Skin

  • Wash the skin daily with a soap that contains 2% zinc pyrithione.
  • Soften scale by:
    • Wetting the skin thoroughly before washing.
    • Applying a moisturizer after bathing.
    • Applying a tar cream, letting it sit on the skin for several hours before rinsing.
    • Applying a cream containing salicylic acid and sulfur.
    • Do not use petroleum jelly to soften the scales. It tends to worsen seborrheic dermatitis.

 

Bottom Line:  In adults seborrheic dermatitis is a chronic condition without an actual cure.  Proper home care coupled with prescription medications can help keep this skin condition under control.

 

Sources and Further Reading:

 

Image from http://www.aad.org

 

 
%d bloggers like this: