Seborrheic eczema on the scalp and face

Seborrheic eczema (or seborrheic dermatitis) is a skin disorder that affects areas rich in sebaceous glands, especially the scalp.

It causes:

  • Itch
  • Skin redness and dandruff
  • Dandruff

The rash is not caused by excessive sebum production, but by an altered composition of the sebum.
In people affected by seborrheic dermatitis, this greasy liquid contains different fats compared to other people. For example, there is a:

  • increased proportion of cholesterol,
  • reduced levels of squalene (precursor of cholesterol), vitamin E and some polyunsaturated fatty acids.

A study by S. Passi, A. Morrone, C. De Luca, M. Picardo, F. Ipoolito, published on 1 October 1991 in the Journal of dermatological science, also shows a decrease in polyunsaturated fatty acids and vitamin E in the blood of affected persons.
The following factors can change the composition of the sebum:

  • Hormones (testosterone, androsterone, estrogens, etc.)
  • Medication
  • Nutrition

In young children, seborrheic dermatitis of the scalp is called cradle cap.
In adults, seborrheic dermatitis can also affect the following zones:

  • Face (beard area, eyebrows, moustache and behind the ears)
  • Breast
  • Back

Seborrheic dermatitis:

  • can embarrass a person if he develops on visible parts of the body;
  • is not contagious;
  • is not a sign of lack of personal hygiene.

Seborrheic dermatitis can occur after puberty at any age.
The severity is variable and it can last for years.
Seborrheic dermatitis can be a predisposing factor to a skin infection.


How does seborrheic eczema manifest itself?

The rash manifests itself in red spots:

  • covered with white, dry scales (on the scalp),
  • with yellowish oily scales (on the face).

Often the rashes affect only one or two places, but can also be very extensive.

Where does seborrheic eczema form?

1. On the scalp: seborrheic dermatitis can vary from mild dandruff on red spots to transuding dandruff.
The cradle cap of newborns is a mild form of seborrheic dermatite.

2. On the face: often affected are:

  • Area between the eyebrows
  • Nose
  • Zone between ears and cheeks

The eyelids can:

  • reddened
  • very sensitive,
  • be inflamed (seborrheic blepharitis).

3. In and around the ears: some people have inflammation inside, outside and behind the ears.
Crusts form, as well as the ears can swell. Inflammation in the ear canal (otitis externa) can lead to narrowing.

4. On the chest and between the shoulder blades: smooth, round and often scaly red spots appear on the skin.

5. Hidden areas: rarely wet areas are affected such as:

  • Skin under the breasts
  • Pubic region or the genital area
  • Armpits
  • Skin folds on the abdomen

In newborns, the skin in the diaper area is often affected.

Causes of seborrheic eczema

Exact causes of seborrheic dermatitis are not known.
Doctors make the following assumptions:

  • Interaction of hormone levels
  • Weakening of the immune system
  • Absence of certain substances in food, especially vitamins of group B
  • Diseases of the nervous system
  • Genetic predisposition

The excessive proliferation of a yeast fungus, called Malassezia furfur, can cause this disease.
Seborrheic dermatitis is hereditary.

Risk factors include:
1. Stress and fatigue
2. Cold, smog and moisture
3. Oily skin or acne
4. Too aggressive shampoos 5. Local application of alcohol-containing lotions
6. Overweight and poor diet
7. Alcohol and cigarettes
8. Neurological diseases, including Parkinson’s disease, craniocerebral trauma or stroke
10. Medication (corticosteroids

Symptoms of seborrheic eczema

As a rule, the symptoms of seborrheic dermatitis are:
1. Skin changes
2. Extensive plaques
3. Oily and oily skin areas
4. Dry, scaly, cracked, whitish, yellowish or oily skin
5. Increased itching on infected areas
6. Slight redness
7. Hair loss or alopecia

In most cases, those affected suffer from a chronic disease.
It is possible that the periods when symptoms improve (usually in summer due to increased sun exposure) and those when they worsen (usually in winter) alternate.

Diagnosis of seborrheic eczema

For diagnosis, the doctor must exclude the following skin diseases:

On the face
1. Rosacea: this disease does not cause scaly skin. The rosecea causes the formation of papules and pustules on:

  • Cheeks
  • Chin
  • Nose
  • Forehead

2. Systemic lupus erythematosus: it causes butterfly erythema on the cheeks.

On the scalp
1. Psoriasis: it can mask seborrheic dermatitis, in this case sebopsoriasis.
To rule out psoriasis on the scalp, the doctor examines the elbows and knees, which are often areas affected by this disease.
2. Infected eczema
3. Tinea capitis

On the upper body
1. Atopic eczema
2. Pityriasis rosea
3. Pityriasis versicolor
4. Lichen simplex

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