Askanesthetician's Blog

An esthetician explores skincare issues and concerns

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

Advertisements
 

What is Sebum? It’s More Interesting Than You Think April 21, 2011

If you suffer from oily skin, shiny skin, or acne you’ve probably given the amount of oil or sebum your body produces some thought.  Probably that thought is: “Why does my body produce so much oil and how can I stop it?”.  Well before you try to entirely rid your skin of oil keep a few things in mind. 

According to the Skin Type Solutions  blog:

In simplest terms, sebum is just oil secreted by your skin’s sebaceous glands. Sebum is actually Latin for “fat,” which makes sense, and every square inch of your skin—with the exception of the palms of your hands and the soles of your feet—has it.

Most of us tend to focus on the negative side of sebum, such as its ability to make your face look shiny, and its connection with acne. But the presence of sebum is actually good for your skin since it protects the skin from losing moisture. Yet another good thing about sebum is that it contains a lot of vitamin E, an antioxidant that protects the skin from aging as well as cancer. (The skin on the lips does not make sebum, which is why this area is more prone to skin cancer.)

Dermatologists are intrigued by the components of sebum, which seems to be determined by your individual genetic makeup. Upon taking a closer look, researchers have found sebum contains triglycerides, diglycerides, fatty acids, wax esters, squalane and cholesterol—why is why cosmetic chemists incorporate some of these ingredients in anti-aging creams. It was once believed that squalane levels in the sebum contributed to acne, but again, no definitive link has been made. Squalane is often added to skin creams so those with oily and acne-prone skins should avoid this ingredient to be on the safe side.

 

If you have acne then you have to deal with the excessive production of sebum by your body which contributes to breakouts.   According to the book Breaking Out (page 20):

People who are prone to acne tend to produce higher-than-average amounts of sebum.  This gives them oily skin – seborrhea, as it is called.  Seborrhea has no direct link with what you eat; the fats and oil in your diet are broken down by the digestive system, and there is no pathway from there to the skin.

Nor is sebum production influenced by anything you apply to your skin.  No matter how dry or tight they may make your face feel, astringent soaps, lotions, or cosmetics that mop up oil on the skin’s surface cannot retard sebum output.  Nor, contrary to popular belief, do they stimulate the sebaceous glands to overcompensate by stepping up oil production to lubricate the dried-out surface.  Sebum output is strictly under the domination of hormones that are indifferent to cleansers, toners, and other topical oil-control treatments.

The connection between hormones and sebum does not necessarily mean that if you have excess oil on your face, your body is producing an overabundance of testosterone, or that your skin boasts an excess follicle-stimulating DHT.  It is instead, typically, a sign that your sebaceous follicles are super-sensitive to these hormones and that they overreact to them, sending out the gush of shine-creating oil that is the most common feature of acne-prone skin.

 

So perhaps the next time you look at your oily face try to turn a negative into a positive and remember that the sebum in your skin can be beneficial.  But if your shiny face is bothering you, and I sympathize greatly since my face can look like an oil slick by the afternoon, follow my tips in my post Shine Free: How to Deal with Excessively Oily or Shiny Skin  for solutions.

 

Shine Free: Part II – This One is For Men July 27, 2010

Recently I wrote a post about how to deal with excessively oily or shiny skin – a problem numerous people experience.  I have to admit that the advice I gave in the post was really directed at women and not men.  So I was pleased to see the following article in The New York Times (yes, readers I am once again mentioning an article from The New York Times.  What can I say?  I love reading The New York Times):  Seeking to Shine (Not to Be Shiny).  The article is all about how men also suffer from oily and shiny skin and what they can do to combat the problem.  It turns out that:

Although many men prefer not to use moisturizer — or, at least, prefer not to admit that they do — enough have embraced anti-shine products to make the category blossom. Mintel, the market research firm, predicts that there will be 36 new “mattifying moisturizers” for men in 2010, a 56 percent increase over the number introduced in 2008.

The overall market for men’s grooming products has flourished. Retail sales reached $5.6 billion in 2009, up from $3.8 billion in 2004, an increase of 46 percent, according to Packaged Facts, a market research firm.

 

So good news – men now have as many product options as women when it comes to combatting shiny and oily skin, and they do not need to use products marketed towards women.  I guess this is a bit of sexual equality in reverse.

 

 
%d bloggers like this: