Seborrheic dermatitis, with a prevalence of around 5% in the community, is one of the chronic and inflammatory skin diseases that causes eczema-like lesions on many surfaces of the body, mostly the scalp. Although the actual factor that is effective in the emergence of the disease is not known exactly, it is possible to say that it is related to many factors such as stress, depression, fatigue, vascular diseases, seasonal changes, dietary habits, food allergies. It is extremely important to have accurate information about the signs and symptoms of the disease, and to properly control this chronic inflammatory disease picture, which can progress quite rapidly, especially since the symptoms that occur during the periods of severe disease affect the quality of life of the person very negatively.
What is Seborrheic Dermatitis?
Seborrheic dermatitis is a chronic inflammatory skin disease that initially causes red-colored lesions on the skin surface and progresses with yellow, oily, dandruff-like crusts on these lesions in the progressive stage. These characteristic lesions, which occur in areas with dense sebaceous glands on the skin surface, are mostly involved in the scalp, eyebrows, eyelids, nose edges, lips, inner and outer parts of the ear, sternal region, axilla, under the breast, navel, inguinal and gluteal folds. . Skin lesions, which have a dense and erythematous appearance in terms of capillaries, also have the appearance of scaly (dandruff) plaque.
The first signs often appear in adolescence and young adulthood, but many signs of the disease tend to become more severe after the age of 50. Although the main underlying factor is not known precisely, some mite species called demodex, various drugs, some hormones, various factors related to nutrition, and especially the local immune response due to Malassezia species, and adverse environmental conditions that are known to be associated with many diseases today. can cause seborrheic dermatitis.
What Causes Seborrheic Dermatitis?
There are various conditions that can result in seborrheic dermatitis.
Types of Malassezia
Malassezia is the most common cause of seborrheic dermatitis. It concentrates on fungal cells called Pityrosporum Ovale, known as Furfur or its yeast form. These fungal species are essentially cells that live harmlessly in the skin and support healthy skin flora. However, many factors such as the use of various drugs, excessive alcohol consumption, intense exposure to harmful sun rays, hormonal irregularities, unhealthy eating habits cause the deterioration of this floral balance prevailing on the skin surface and the uncontrolled proliferation of fungal cells. Then, the skin defense system creates an immune response against the fungal cells that increase excessively on the skin surface, and dermatitis, also known as seborrheic eczema, occurs. Various inflammatory molecules such as oleic acid and malassezine produced by malassezia are secreted in the lesioned skin. While the secretion of oleic acid causes a dandruff appearance on the skin surface, the secretion of malassesin causes the immune system to be stimulated uncontrollably and the symptoms associated with the disease become chronic by recurring. It is a small mite genus that lives in or near hair follicles. Only Demodex Folliculorum and Demodex Brevis types are seen in humans and their density is less than 5/cm2 on healthy skin. Studies show that the density of demodex increases both on the lesion and on the normal skin surface, especially in people who develop seborrheic dermatitis in the hair. Therefore, if seborrheic dermatitis causes hair loss, it would be useful to bring to mind the possibility of demodex-related dermatitis. . In addition, the drugs that cause seborrheic dermatitis are not limited to the antibiotic group. Lithium, which is used in the treatment of psychiatric diseases, buspirone effective in the treatment of generalized anxiety disorder, cimetidine, which has a stomach-protective effect, and drugs used for many other diseases may cause seborrheic dermatitis as a result of a mechanism whose cause has not been clearly explained.
Hormonal Factors
Seborrheic dermatitis usually occurs during adolescence, when hormonal activity is extremely rapid. The fact that the first signs of the disease are seen in adolescence, and that it is more common in males, draws attention to the effect of androgen hormones on the sebaceous glands. However, the regression of seborrheic dermatitis findings, especially in infants between 3 and 4 weeks after birth, indicates that androgen-like hormones in the blood of the baby from the mother increase sebum production from the sebaceous glands and supports the relationship between hormonal factors and seborrheic dermatitis.
Other Factors
Seborrheic dermatitis is greatly affected by adverse environmental conditions in addition to many lifestyle-related factors such as nutrition, sports, sleep patterns, and alcohol use. Lack of biotin (B7) and pyridoxine (B6) vitamins, inadequacy of essential fatty acids taken with diet, low zinc, abnormal high levels of copper and magnesium can lead to seborrheic dermatitis lesions by increasing seborrhea secretion and sebum level.
Many studies conducted to date have focused on various mechanisms associated with seborrheic dermatitis, but at the end point it has been concluded that the disease is mostly caused by the regional immune response developed against malassezia species.
What are the Symptoms of Seborrheic Dermatitis?
Different clinical symptoms may occur at different times in a person diagnosed with seborrheic dermatitis. In general, lesions with an erythematous, dry dandruff appearance may occur in which the density of capillaries increases, but during periods of severe disease, especially in cases of facial seborrheic dermatitis, the lesions become more oily scaly and sticky. The resulting lesions are often described as thin yellow-oily crusts on the sides of the nose, nasolabial folds, inner and back parts of the ear, at and around the eyebrows, on the scalp surface and on the hair border, on a red-pink colored background. Most of the patients do not experience discomfort such as pain, soreness or itching, but it can cause various cosmetic problems, especially during adolescence.
Old on scalp Extremely common lesions cause destruction of hair follicles and regional baldness in the later period. Since sebaceous glands will disappear in areas where hair root destruction and permanent hair loss are experienced, no new lesion associated with seborrheic dermatitis develops in that area after this point.
How is the Treatment of Seborrheic Dermatitis?
Innovations in the treatment of seborrheic dermatitis are considered. It can be said that the most appropriate treatment plan is to be planned according to the body region where the signs and symptoms related to the disease occur. Scalp, face, ear and nose area and other body parts such as trunk, back, groin, armpits are treated with different methods. Shampoos with supportive ingredients such as tea tree, selenium sulfide and ketoconazole are recommended. With the regular use of these shampoos, the intensity of dandruff is quickly controlled and the signs of seborrheic dermatitis may disappear over time. In order to see the most accurate effect during application, it is recommended to leave the shampoo on the scalp for 5-10 minutes.
Treatment of Seborrheic Dermatitis on the Face
To be able to treat the signs of seborrheic dermatitis around the face, ears and nose, first check the fungal density in the area. Antifungal creams are preferred. Although controlling the fungal density may alleviate the symptoms associated with the disease, signs of redness and tenderness may persist for a long time. In order not to cause cosmetic anxiety, cortisone-containing and immunomodulatory creams can also be used for a short time on the face areas where redness is intense. It is seen on surfaces such as the bottom and groin. Anti-fungal body shampoos are very effective for the treatment of seborrheic dermatitis that occurs in these areas. In order to get the most accurate result regarding the treatment, it is recommended to keep the shampoo on those body areas for at least 5 minutes and then rinse it carefully.
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