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| __NOTOC__
| | #REDIRECT[[Seborrheic dermatitis]] |
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| {{SI}}
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| {{CMG}}; {{AE}} {{JH}}.
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| ==Overview==
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| Seborrhoeic [[eczema]] (also known as Seborrheic dermatitis [[American English|AmE]], '''seborrhea''') is a skin disorder affecting the scalp, face, and trunk causing scaly, flaky, itchy, red skin. It particularly affects the [[sebum]]-gland rich areas of skin.
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| ==Causes==
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| The cause of seborrhoeic dermatitis remains unknown, although many factors have been implicated. The widely present [[yeast]], ''[[Malassezia furfur]]'' (formerly known as ''Pityrosporum ovale''), is involved,<ref>{{cite journal |author=Hay R, Graham-Brown R |title=Dandruff and seborrheic dermatitis: causes and management |journal=Clin Exp Dermatol |volume=22 |issue=1 |pages=3-6 |year=1997 |pmid=9330043 |doi=10.1046/j.1365-2230.1997.d01-231.x}}</ref><ref>{{cite journal |author=Nowicki R |title=[Modern management of dandruff] |journal=Pol Merkur Lekarski |volume=20 |issue=115 |pages=121-4 |year=2006 |pmid=16617752}}</ref> as well as genetic, environmental, hormonal, and immune-system factors.<ref>Am Fam Physician 2000;61:2703-10,2713-4</ref><ref>{{cite journal |author=Janniger C, Schwartz R |title=Seborrheic dermatitis |journal=Am Fam Physician |volume=52 |issue=1 |pages=149-55, 159-60 |year=1995 |pmid=7604759}}</ref> A suggestion that seborrhoeic dermatitis is an inflammatory response to this yeast has yet to be proven.<ref>{{cite journal |author=Parry M, Sharpe G |title=Seborrheic dermatitis is not caused by an altered immune response to Malassezia yeast |journal=Br J Dermatol |volume=139 |issue=2 |pages=254-63 |year=1998 |pmid=9767239 |doi=10.1046/j.1365-2133.1998.02362.x}}</ref> Those afflicted with seborrhoeic dermatitis have an unfavourable epidermic response to the infection, with the skin becoming inflamed and flaking.
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| In children, excessive [[vitamin A]] intake can cause seborrhoeic dermatitis.<ref>
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| {{cite web
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| |url=http://www.nlm.nih.gov/medlineplus/ency/article/000350.htm
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| |title=MedlinePlus Medical Encyclopedia: Hypervitaminosis A
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| |publisher=www.nlm.nih.gov
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| |accessdate=2008-03-19
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| |last=
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| }}
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| </ref> Lack of [[biotin]],<ref name="aafp">
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| {{cite web
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| |url=http://www.aafp.org/afp/20060701/125.html
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| |title=Seborrheic Dermatitis: An Overview - July 1, 2006 -- American Family Physician
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| |publisher=www.aafp.org
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| |accessdate=2008-03-19
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| |last=
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| }}
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| </ref> [[pyridoxine]] (vitamin B6)<ref name="aafp"/><ref name="emedicine">
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| {{cite web
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| |url=http://www.emedicine.com/NEURO/topic278.htm
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| |title=eMedicine - Nutritional Neuropathy : Article by R Andrew Sewell
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| |publisher=www.emedicine.com
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| |accessdate=2008-03-19
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| |last=
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| }}
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| </ref> and [[riboflavin]] (vitamin B2)<ref name="aafp"/> may also be a cause.
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| == Hair loss ==
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| Side effects to inflammation may include temporary hair loss. If severe outbreaks go untreated for long periods of time, permanent hair loss may result due to damaged hair follicles.
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| Expect two to six months before hair growth may resume.
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| ==Physical examination==
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| ===Gallery===
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| ====Skin====
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| =====Head=====
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| <gallery>
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| Image: Seborrhoeic_dermatitis_01.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_04.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_05.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_06.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_07.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_09.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_10.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_13.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_15.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_19.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_20.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| </gallery>
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| =====Ear=====
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| <gallery>
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| Image: Seborrhoeic_dermatitis_08.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_21.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_22.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| </gallery>
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| =====Neck=====
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| <gallery>
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| Image: Seborrhoeic_dermatitis_14.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| </gallery>
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| =====Trunk=====
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| <gallery>
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| Image: Seborrhoeic_dermatitis_01.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_03.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_11.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| Image: Seborrhoeic_dermatitis_12.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| </gallery>
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| =====Extremities=====
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| <gallery>
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| Image: Seborrhoeic_dermatitis_18.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| </gallery>
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| =====Genitales=====
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| <gallery>
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| Image: Seborrhoeic_dermatitis_17.jpeg| Seborrheic dermatitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=424>
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| </gallery>
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| ==Treatments==
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| ===Medical Therapy===
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| [[Soap]]s and [[detergent]]s such as [[sodium laureth sulfate]] may precipitate a flare-up, as they strip moisture from the top layers of the skin, and the drying property of these can cause flare-ups and may worsen the condition. Accordingly a suitable alternative should be used instead.
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| Among dermatologist recommended treatments are shampoos containing [[coal tar]], [[ciclopiroxolamine]] [[ketoconazole]], [[selenium sulfide]], or [[zinc pyrithione]].<ref>{{cite journal |author=Schwartz R, Janusz C, Janniger C |title=Seborrheic dermatitis: an overview |journal=Am Fam Physician |volume=74 |issue=1 |pages=125-30 |year=2006 |pmid=16848386 | url=http://www.aafp.org/afp/20060701/125.html}}</ref> For severe disease, [[keratolytic]]s such as [[salicylic acid]] or [[coal tar]] preparations may be used to remove dense scale. Topical [[terbinafine]] solution (1%) has also been shown to be effective in the treatment of scalp seborrhoea,<ref>{{cite journal |author=Faergemann J, Jones J, Hettler O, Loria Y |title=Pityrosporum ovale (Malassezia furfur) as the causative agent of seborrheic dermatitis: new treatment options |journal=Br J Dermatol |volume=134 Suppl 46 |issue= |pages=12-5: discussion 38 |year=1996 | month=Jun |pmid=8763461}}</ref> as may lotions containing [[alpha hydroxy acid]]s or [[corticosteroids]] (such as [[fluocinolone acetonide]]). [[Pimecrolimus]] topical lotion is also sometimes prescribed.
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| Chronic treatment with topical corticosteroids may lead to permanent skin changes, such as [[atrophy]] and [[telangiectasia]].<ref>{{cite journal |author=Smith J, Wehr R, Chalker D |title=Corticosteroid-induced cutaneous atrophy and telangiectasia. Experimental production associated with weight loss in rats |journal=Arch Dermatol |volume=112 |issue=8 |pages=1115-7 |year=1976 |pmid=952530 |doi=10.1001/archderm.112.8.1115}}</ref><ref>{{cite journal |author=Scheinfeld N |title=Seborrheic dermatitis |journal=Skinmed |volume=4 |issue=1 |pages=49-50 |year=2005 |pmid=15654167 | url=http://www.medscape.com/viewarticle/499706 |doi=10.1111/j.1540-9740.2005.03961.x}}</ref>
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| [[UV-A#Explanation|UV-A]] and [[UV-B#Explanation|UV-B]] light inhibit the growth of ''M. furfur'',<ref>{{cite journal |author=Wikler J, Janssen N, Bruynzeel D, Nieboer C |title=The effect of UV-light on pityrosporum yeasts: ultrastructural changes and inhibition of growth |journal=Acta Derm Venereol |volume=70 |issue=1 |pages=69-71 |year=1990 |pmid=1967880}}</ref> although caution should be taken to avoid sun damage.
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| Those with seborrhoeic dermatitis might benefit from [[biotin]] supplements. One might also try a humidifier by the bed, as well as a gentle moisturizer with or without oatmeal. Applying milk of magnesia may help clear up seborrheic dermatitis; one may apply on the face while showering and rinse off at the end of the shower.<ref>{{citation| last1 = Graedon| first1 = Joe| last2 = Graedon| first2 = Teresa |title=The People's Pharmacy |newspaper = Atlanta Journal Constitution Evening Edge |publisher = Atlanta Journal Constitution|page=15 |date = [[2008-04-17]]}}</ref>
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| ===Plant-based treatments===
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| {{main article|phytotherapy}}
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| The [[World Health Organization]] mentions ''[[Aloe vera]]'' gel as a yet to be scientifically proven [[traditional medicine]] treatment for Seborrhoeic dermatitis.<ref>
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| {{cite web
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| |url=http://www.who.int/medicinedocs/en/d/Js2200e.6
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| |title=WHO Monographs on Selected Medicinal Plants - Volume 1: Aloe Vera Gel
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| |publisher=www.who.int
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| |accessdate=2008-03-18
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| |last=
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| </ref>
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| *''[[Arctium lappa]]'' (Burdock) oil<ref name="green">
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| {{cite web
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| |url=http://books.google.com/books?id=N-Uus_kjkNUC&pg=PA154&lpg=PA154&dq=plants+for+treating+seborrhea&source=web&ots=u4fzYOLFsb&sig=cpWVYu2MB5a3dqNC17QRX7qYhcw&hl=en#PPA154,M1
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| |title=The Green Pharmacy: New Discoveries ... - Google Book Search
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| |publisher=books.google.com
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| |accessdate=2008-03-19
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| |last=
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| </ref>
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| *''[[Chelidonium majus]]'' (Celandine)<ref name="green"/>
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| *''[[Glycyrrhiza glabra]]'' (Licorice)<ref name="green"/>
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| *''[[Melaleuca]]'' (Tea tree) species<ref name="green"/>
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| *''[[Plantago]]'' (Plantain) species<ref name="green"/>
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| *''Symphytum officinale'' ([[Comfrey]])<ref name="green"/>
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| *''[[Zingiber officinale]]'' (Ginger) root juice<ref name="green"/>
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| ==Related Chapter==
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| *''[[Echinopsis peruviana]]''
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| ==References==
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| {{Reflist|2}}
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| ==External Links==
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| * [http://dermnetnz.org/dermatitis/seborrhoeic-dermatitis.html Seborrhoeic Dermatitis at DermNet]
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| *[http://www.aafp.org/afp/20060701/125.html Seborrheic Dermatitis: An Overview - July 1, 2006 -- American Family Physician]
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| {{Diseases of the skin and subcutaneous tissue}}
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| [[Category:Skin diseases]]
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| [[Category:Primary care]]
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