Seborrheic Dermatitis

A skin condition characterized by greasy or dry, white scales on the skin of the scalp (dandruff), eyebrows, forehead, face, folds around the nose, behind ears, in the external ear canal, or on skin of the trunk, especially over the breastbone or in skin folds. It is not contagious. It is especially of concern to athletes because extra heat and sweat can aggravate skin irritation and trigger the production of more scales.

Causes

The exact cause of seborrheic dermatitis is unknown. However some researchers believe that it is cause by

Sweating
Stress
Hot, humid weather or cold, dry weather
Infrequent shampoos
Oily skin
Other disorders, such as acne rosacea, acne or psoriasis
Obesity
Parkinson's disease
Use of drying lotions that contain alcohol

Signs and symptoms

Flaking, white scales over reddish patches on the skin and scalp. Scales anchor to hair shafts. They may itch, but they are usually painless unless complicated by infection.

Diagnosis

Diagnosis can be made based on a visual examination. It should be differentiated from other forms of eczema, psoriasis, and rosacea.

Treatment

Basic treatment consists of using shampoos containing zinc pyrithione (Head and shoulders, ZNP bar), selenium sulfide (Selsun blue and prescription strength Selsun) or ketoconazole (Nizoral AD and prescription strength Nizoral). A person may need to try several shampoos to find the one that works best, and then rotate between several medicated and non-medicated shampoos to maintain effectiveness. It's important to massage the shampoo onto the scalp and other affected areas and leave it in place for a few minutes before rinsing thoroughly. Other shampoo ingredients that are sometime helpful are salicylic acid, coal tar, and sulfur.

Steroid lotions may be used in adolescents and adults.

For infants with cradle cap, warm olive oil applied to the scalp and gently rubbed in will loosen the scales, and mild corticosteroid preparations can minimize inflammation. Shampoos with zinc or ketoconazole also can help.

Home Treatment

Shampoo vigorously and as often as once a day. The shampoo you use is not as important as the way you scrub your scalp. Loosen scales with your fingernails while shampooing, and scrub at least 5 minutes.
Lubricate skin before drying off after baths and showers.
Aloe vera gel can be as effective as a mild cortisone cream, without the potential side effects.

Prevention

Cannot be prevented. To minimize severity or frequency of flare-ups:

Shampoo frequently.
Dry skin folds thoroughly after bathing.
Wear loose, ventilating clothing.

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