Seborrheic dermatitis, known in the same way as seborrheic eczema, is a chronic skin disease. Its main cause is disturbances in the functioning of the sebaceous glands. Pathology occurs with severe inflammation in certain areas of the body. Without appropriate treatment, seborrheic dermatitis progresses rapidly. At the same time, it cannot be called incurable, the disease is successfully amenable to drug correction.
A characteristic feature of a skin ailment is the localization of skin lesions: most often rashes occur on the skin of the face, eyebrows and eyelashes, scalp, much less often in the behind-the-ear region, on the chest, between the shoulder blades there are symptoms of seborrheic dermatitis. Skin folds sometimes need treatment.
There are several types of the disease, depending on the location of the rash. Distinguish between seborrheic dermatitis:
- face;
- torso and skinfolds;
- scalp;
- generalized type.
Dry and oily dandruff
Most often, the pathology is localized on the head under the hair. A characteristic manifestation of this form of the disease is the occurrence of dandruff due to the intensive renewal of skin cells. In comparison with the rate of natural exfoliation of epidermal particles, with seborrheic dermatitis, this process is accelerated by 3-4 times. The reason for this phenomenon is considered to be the high activity of the fungus, which prevents the cells from going through the stage of dehydration. As a result, the scalp and hair are covered with noticeable whitish scales - dandruff.
Treatment of seborrheic dermatitis of the scalp depends on the type of disease - dry or oily. In the first case, dandruff appears pointwise, localized mainly in the back of the head, crown, and much less often spreads over the entire surface of the skin. With a dry type of seborrheic dermatitis, the foci do not have clear boundaries. In addition, hypersecretion of the sebaceous glands for this type of disease is not characteristic. Therefore, small grayish-white scales become dry and loose, crumble abundantly on the shoulders with light rubbing and are noticeable on clothes.
The oily type of dermatitis looks a little different, due to the increased production of sebum. Yellowish scales appear waxy and shiny, due to the abundant secretion of fat, they quickly stick together, attaching tightly to the epidermis. In comparison with the dry type of dermatitis, dandruff is separated not by small, but by largeheavy particles resembling flakes of shoveled snow. Owners of oily hair know that the freshness of the hairstyle after each wash of the head and the volume disappear literally the next day, the curls become greasy, greasy, unkempt - with seborrheic dermatitis this happens even faster. On the surface of the epidermis, foci of redness appear, which are very itchy. Excoriation occurs as a result of scratching.
Inflammatory type of dermatitis under the hair
This type of disease is characterized by scaly erythema with bright edging. The edges of seborrheic plaques can connect, and the lesions merge into whole foci, occupying a huge surface of the skin. Seborrheic dermatitis of the scalp with severe inflammation will take longer to heal.
Among the symptoms most often patients are concerned about itching. As the disease progresses, seborrheic plaques become covered with whitish or yellow scales, spread to the border of the forehead and scalp, forming a characteristic "seborrheic crown". In some patients, purulent yellowish-gray crusts form at the site of inflammatory foci, under which unpleasantly smelling erosive oozing is hidden.
As soon as the dermatitis begins to progress, the rash spreads to the skin of the forehead, neck, ears and ear areas, manifested by the formation of deep painful cracks. In isolated cases, there is an increase in lymph nodes.
Rashes on the face
Judging by the photo, seborrheic dermatitis on the face (treatment will be different from the disease of the scalphead) is most often localized in the chin, forehead, nasolabial triangle in the form of reddening of individual areas with clear boundaries. The skin is very flaky and itchy. Over time, the spots become covered with a dense scaly film formed as a result of impregnation with the secret secreted by the sebaceous glands.
At the initial stage of the disease, small white particles are noticeable, but with intensive exfoliation, they increase in size and turn yellow. Connecting with each other, they increase the area affected by dermatitis. Weeping areas with seborrheic dermatitis, uncomplicated by a bacterial infection, are not observed.
In case of damage by pathogenic microflora, vesicular rashes appear. Along with hyperemia and peeling of the integument, a blistering rash occurs. The papule is usually located in the center of the plaque. In men, pustules appear in the place of vesicular formations - this is noticeable in many photos. In the treatment of seborrheic dermatitis, places of active growth of stubble (in the mustache, beard) in the stronger sex are more often needed. Against the background of blockage of the ducts of the sebaceous glands, sebum stagnates, and this, in turn, leads to the appearance of acne.
In some cases, the pathological process affects the eyelids, which leads to the development of seborrheic blepharitis. The symptoms of dermatitis in adults, in the treatment of which an ophthalmologist should also participate, are often accompanied by signs of bacterial conjunctivitis: the eyes turn red, the eyelids swell, and painful cracks may appear. On the edgeeyelashes accumulate scales that stick together the hairs, which can make it difficult for the patient to open his eyes after sleep.
Seborrheic dermatitis on the body: the main symptoms
Focuses of the disease are most often localized on the chest, back, between the shoulder blades. The rash is represented by a pink or yellowish papular rash covered with scales. In the absence of timely treatment of seborrheic dermatitis, the plaques gradually increase, acquire clear boundaries. The epidermis in the lesions may have a he althy natural appearance, with a papular rash on the margins, so that the plaques appear to have an annular circumference.
Painfully tolerated seborrheic dermatitis on the body, affecting large skin folds (axillary, inguinal, under the mammary glands). Eruptions on the skin have an inflamed appearance due to erythema of a bright red or dark red hue, and their surface is covered with cracking crusts.
How the generalized form of the disease manifests itself
In this case, we are talking about the stage of seborrheic dermatitis, in which enlarged and connected lesions lead to the development of secondary erythroderma. The skin often acquires a pink or brownish tint, cracks, weeping, and swelling appear on the surface. In common cases, the pathological process is complicated by candidal and pyococcal microbial flora. Often, patients notice an increase in body temperature, itching, deterioration in general well-being. Generalized seborrheic dermatitis often accompanies the development of HIV infection.
Principles of treatment
Nowlet's move on to consideration of the issues of therapy, having received an idea of the symptoms of seborrheic dermatitis from the photo. The treatment of this disease consists in the use of external antimycotic drugs acting on the fungi Pityrosporum ovale, and in severe cases, the use of systemic hormonal drugs. Increased production of sebum is a favorable background for the reproduction of this microorganism, which contributes to the progression of dermatitis.
It is important to understand that it is not possible to completely normalize the functioning of the sebaceous glands with any drug. There is only one way to stabilize their activity and reduce the production of sebum - by strengthening the immune system and eliminating the causes that provoke this violation. That is why the treatment of seborrheic dermatitis involves the use of methods aimed at combating the fungus Pityrosporum ovale and stopping individual symptoms.
It is worth noting several pharmacological groups that affect the vital activity of this microorganism:
- azoles;
- terbinafine;
- olamines;
- zinc preparations;
- sulfur preparations;
- Amorolfine derivatives.
Preparations for seborrhea on the face and body
For the treatment of seborrheic dermatitis in adults that affects smooth skin, drugs of these groups are prescribed in the form of ointments, gels, creams. They have strong antimycotic properties, therefore, with seborrhea, they are prescribed in the first place:
- "Nizoral cream". Ketoconazole in its composition inhibits the growth of fungi. The medicine is applied tothe affected surface with a thin layer, the course of treatment does not exceed 1 month.
- Cream or aerosol "Zinokap". At the acute stage of the disease, in the presence of oozing, it is recommended to use an aerosol. In addition to the antimycotic substance, it contains ethyl alcohol, due to which the drug has a drying effect, relieves inflammation. Cream "Zinocap" with dexpanthenol is prescribed for moderate inflammation in order to start regeneration processes.
- "Lamikon". The ointment actively fights Pityrosporum ovale. In addition, the drug can be applied to the face, chest, and other parts of the body.
In cases where the disease occurs with a bacterial infection, local antibiotics are prescribed ("Fucidin", "Levomekol", "Baneocin"). In the inflammatory type of seborrheic dermatitis, preparations containing corticosteroid components are used. They can be produced in the form of ointments, emulsions, creams (Elokom, Lokoid, Advantan, Afloderm, Dermovate). To accelerate the processes of tissue regeneration, the course of external treatment is supplemented with the use of keratolytic solutions (salicylic acid, "Resorcinol"). An excellent effect in the treatment of seborrheic dermatitis in the folds of the skin is the use of "Castellani liquid".
During the period of remission, it is important to take care of strengthening local immunity. For this purpose, external immunomodulators "Protopic" and "Epidel" are used. Vitamin and mineral complexes, which include vitamins A, E, B, selenium and zinc, will help improve the condition of the skin. The course of application is usually 3-6months.
In addition, the treatment of the disease requires the correction of the principles of systemic skin care. Treatment of seborrheic dermatitis on the face may be ineffective if you wash your face with hard water - it is better to replace it with special moisturizing and cleansing compounds. Among the high-quality lotions that have earned a lot of flattering reviews from patients suffering from seborrheic dermatitis, it is worth noting Bioderma products presented in the Sensibio line for sensitive skin.
As a physiotherapeutic treatment, exposure to ultraviolet light is used. Thanks to the procedures, it is possible to significantly extend the period of remission.
Treatment of seborrheic dermatitis of the scalp
Unlike seborrhea in open areas of the body, the therapy of this zone has some peculiarities. The basis of the treatment of scalp dermatitis is medicated shampoos aimed at combating the fungus and inhibiting the activity of the sebaceous glands.
The use of tar, zinc products is common. They have an antifungal and anti-inflammatory effect, inhibit the growth and reproduction of pathogens. At the same time, pharmacy shampoos gently affect the scalp, quickly eliminate scaly plaques at the hair roots.
In addition to shampoos with one active ingredient, complex products are often used that contain a lot of useful substances and microelements that improve skin condition. Due to the simultaneous effect of several therapeutic components at once,the fungi are under attack, and the duration of the remission stage is greatly increased. Usually combined shampoos are prescribed for oily seborrheic dermatitis. Preparations dry the affected areas of the skin, eliminating erythema, swelling. Thus, the benefits of using them are much higher.
If symptoms worsen, daily shampooing may be required. At the same time, it should be borne in mind that the body quickly gets used to therapeutic detergent compositions, so the effect of their use may weaken over time. Therefore, to achieve the desired therapeutic result, it is important to periodically change the detergent and use additional preparations to suppress the infection (most of them contain components with salicylic acid and tar).
The most effective and popular shampoos for treating seborrheic dermatitis of the scalp are:
- Nizoral;
- Sulsen;
- Sebozol;
- Friederm Zinc;
- "Friederm Tar";
- "Psorilom tar";
- Alerana;
- "Libriderm Zinc";
- "Cynovit";
- Schonenberger.
In some cases, if the treatment of seborrheic dermatitis on the head with antifungal shampoos does not bring positive changes, experts recommend taking additional hormonal drugs. Use them in the treatment of seborrhea should be extremely careful, as most of them have serious contraindications and side effects.
Sulsena Scalp Paste
Other, no less effectivemeans for the treatment of seborrheic dermatitis are special pastes. They are used after shampooing. The most popular paste for the treatment of seborrheic dermatitis of the scalp is Sulsena. The drug is released in 1% or 2% concentration of the active substance in a 75 ml tube. For the chronic stage of the disease, 1% of the composition is sufficient; during exacerbation, 2% of Sulsen is used. The paste is thoroughly rubbed in a circular motion into clean and damp hair roots, kept for half an hour and washed off with warm water.
Despite the fact that this drug belongs to the budget price segment (the average cost is 70-100 rubles), there are a lot of positive reviews about it. In addition, the paste is used very economically - it should be applied to the hair once a week, and for one procedure it is enough to squeeze out about 5 ml of paste from the tube. The course of treatment with "Sulsena" is 3-5 months.
Alternative Methods
In addition to pharmaceutical preparations, folk remedies have proven themselves well in the treatment of seborrheic dermatitis. In the treatment of this skin disease, herbs and other natural ingredients are also used for prophylactic purposes. The most successful in the application is calendula, sage, burdock and oak bark. Based on these plants, formulations are prepared for the treatment of seborrheic dermatitis in adults:
- Decoction of calendula, plantain and chamomile. All components (each 1 tablespoon) mix and pour into a thermos, then pour 300 ml of boiling water. Therapeuticthe phytomixture should be infused, so it is more convenient to prepare the remedy for the night, and in the morning, after washing the head, the infusion is rubbed into the root zone and not washed off until the next water procedures.
- Alcoholic infusion of St. John's wort. For 100 g of dry St. John's wort, 500 ml of medical alcohol is used. The mixture is removed in a dark place for a week. After seven days, the medicine is ready for external use. To prepare the solution, take 1-2 tbsp. l. tincture and diluted with a glass of water. Using a cotton or gauze pad, the therapeutic composition should be rubbed into the scalp.
Another way of folk treatment of seborrheic dermatitis is the use of sea or table s alt. With the help of this simplest natural mineral, scalp massage is done. The benefits of s alt peeling can hardly be overestimated, as it prevents hair loss, promotes exfoliation of dead cells and improves blood circulation. After the massage, the hair should be thoroughly rinsed with water.
In the treatment of seborrheic dermatitis with folk remedies, there are recipes for homemade shampoos. So, for example, egg is considered the simplest - to use it, it is enough to use 2 yolks and mix them with warm water, lather well on your head and rinse. As a therapeutic shampoo, kefir or an infusion of oak bark with yogurt is also often used.
Seborrhea diet and other recommendations
Therapy of this skin pathology implies the observance of some dietary restrictions, regardless of the stage of the disease. The mechanism of development of seborrheic dermatitisis directly related to the secretion of sebum, so the diet completely eliminates the consumption of fatty foods and drinks. It must be selected by the attending physician. The approximate diet is compiled according to the principle of safe and hypoallergenic nutrition. The fundamental components of the daily menu of a patient with seborrhea should be:
- Fresh juices, dried fruit compotes, herbal infusions, still water.
- Low-fat meats - pork, lamb and beef are completely excluded from the diet.
- Fish - best steamed.
- Vegetables including pumpkin, zucchini, cabbage and asparagus.
- Milk and dairy products.
- Oatmeal, pearl barley and buckwheat.
At the same time, sweets and pastries should be abandoned at least for the period of exacerbation of the disease. You will also have to say goodbye to fried, pickled, fatty, smoked and too spicy dishes during the treatment of seborrheic dermatitis. Banned alcohol, fast food and potential allergens (nuts, mushrooms, honey, seafood, strawberries, etc.).
In addition, it is important to constantly maintain hygiene, while not overusing soap and detergents for the epidermis. For men suffering from seborrheic dermatitis on the face, it is advisable to get rid of excess vegetation, since the hairline is a comfortable breeding ground for fungal organisms. When purchasing underwear, you need to give preference to clothes made from natural materials (cotton, linen). These fabrics are highly absorbent and providefull air circulation, preventing the manifestation of inflammation and irritation of the epidermis.
