Seborrheic dermatitis, which is also known as seborrheic eczema, is a chronic skin disease. Its main reason is a malfunction of the sebaceous glands. Pathology proceeds 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 medical 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, the scalp, much less often in the behind-the-ear area, on the chest, between the shoulder blades there are symptoms of seborrheic dermatitis. Skin folds sometimes need treatment.
There are several types of disease, depending on the location of the rashes. There are seborrheic dermatitis:
- persons;
- torso and skin folds;
- scalp;
- generalized type.
Dry and greasy 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 intensive renewal of skin cells. Compared with the rate of natural exfoliation of epidermal particles, with seborrheic dermatitis, this process is accelerated 3-4 times. The reason for this phenomenon is the high activity of the fungus, which prevents the cells from passing through the dehydration stage. 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, localizing mainly in the nape, crown, 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 is not characteristic of this type of disease. Therefore, small grayish-white scales become dry and friable, abundantly show off on the shoulders with light rubbing and are noticeable on clothes.
The fatty type of dermatitis looks a little different, which is associated with increased production of sebum. The yellowish scales appear waxy and shiny, due to the abundant release of fat, they quickly stick together, tightly attached to the epidermis. Compared to the dry type of dermatitis, dandruff is not separated by small, but large, heavy particles resembling flakes of shovel snow. Owners of oily hair know that the freshness of the hairstyle after each shampoo and volume disappears literally the next day, the curls become greasy, greasy, unkempt - with seborrheic dermatitis, this happens even faster. On the surface of the epidermis there are foci of redness, which are very itchy. As a result of combing, excoriation occurs.
Inflammatory type of dermatitis under the hair
This type of disease is characterized by flaky erythema with a bright border. The edges of the seborrheic plaques can connect, and the lesion sites merge into whole foci, occupying the vast surface of the skin. For the treatment of seborrheic dermatitis of the scalp, which is accompanied by severe inflammation, it will take more time.
Among the symptoms, most often patients are itchy. 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 on the site of inflammatory foci, under which unpleasantly smelling erosive soaks hide.
As soon as dermatitis begins to progress, the rash passes to the skin of the forehead, neck, ears and behind the ear, manifested by the formation of deep painful cracks. In isolated cases, an increase in lymph nodes is noted.
Rash on the face
Judging by the photo, seborrheic dermatitis on the face (treatment will differ from the scalp disease) is most often localized in the area of the chin, forehead, nasolabial triangle in the form of redness of individual areas with clear boundaries. The skin at the same time greatly peels and itches. Over time, the spots become covered with a dense scaly film formed as a result of impregnation with the secretion 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 of dermatitis. Wet areas with seborrheic dermatitis, uncomplicated bacterial infection, is not observed.
In case of damage by pathogenic microflora, vesicular rashes appear. Along with hyperemia and peeling of the integument, a blistering rash occurs. Papule, as a rule, is located in the center of the plaque. Pustules appear in men at the site of vesiculate formations - this is noticeable in many photos. In the treatment of seborrheic dermatitis, places of active growth of bristles (in the area of a mustache, beard) in representatives of 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. Symptoms of bacterial conjunctivitis often join the symptoms of adult dermatitis in the treatment of which an ophthalmologist must also participate: reddened eyes, swollen eyelids, painful cracks may appear. On the edge of the eyelashes, scales accumulate that stick together the hairs, because of which, after sleep, it may be difficult for the patient to open his eyes.
Seborrheic dermatitis on the body: the main symptoms
The foci of the disease are most often localized on the chest, back, between the shoulder blades. Rashes are represented by a pink or yellowish papular rash, covered with scales. In the absence of timely treatment for seborrheic dermatitis, the plaques gradually increase and acquire clear boundaries. The epidermis in the lesions can have a healthy natural appearance, while on the outskirts there is a papular rash, so it seems that the plaques have a ring-shaped circle.
Seborrheic dermatitis is painfully transmitted on the body, affecting large skin folds (axillary, inguinal, under the mammary glands). Rashes on the skin have an inflamed appearance due to erythema of a bright red or dark red hue, and cracking crusts cover their surface.
How does the generalized form of the disease manifest
In this case, we are talking about the stage of seborrheic dermatitis, in which enlarged and connected foci lead to the development of secondary erythroderma. The skin often acquire a pink or brownish tint, cracks, weeping, and swelling occur on the surface. In common cases, the pathological process complicates the candida and pyococcal microbial flora. Often, patients note an increase in body temperature, itching, worsening of their general well-being. Generalized seborrheic dermatitis is often associated with the development of HIV infection.
Treatment principles
Now we turn to the consideration of treatment issues, 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 Pityrosporum ovale fungi, and in severe cases, the use of systemic hormonal drugs. Increased sebum production is a favorable background for the reproduction of this microorganism, which contributes to the progression of dermatitis.
At the same time, it is important to understand that no drugs can fully normalize the work of the sebaceous glands. It is possible to stabilize their activity and reduce the production of sebum only in one way - strengthening immunity 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 relieving individual symptoms.
It is worth noting several pharmacological groups that affect the vital activity of this microorganism:
- azoles;
- terbinafins;
- olamines;
- zinc preparations;
- sulfur preparations;
- amorolfine derivatives.
Preparations for seborrhea on the face and body
For the treatment of seborrheic dermatitis in adults, which 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 primarily:
- Nizoral Cream. Ketoconazole in its composition inhibits the growth of fungi. The medicine is applied to the affected surface with a thin layer, the course of treatment does not exceed 1 month.
- Cream or aerosol "Tsinokap". In the acute stage of the disease in the presence of weeps, it is recommended to use an aerosol. In addition to the antimycotic substance, ethanol is present in it, so that the drug has a drying effect, relieves inflammation. Cream “Tsinokap” with dexpanthenol is prescribed for moderate inflammation in order to start regenerative processes.
- Lamicon. The ointment is actively fighting Pityrosporum ovale. In addition, the drug can be applied to the face, chest, and other parts of the body.
In those cases, if the disease proceeds with a bacterial infection, local antibiotics are prescribed (Futsidin, Levomekol, Baneotsin). 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, Dermoveit). To accelerate the processes of tissue regeneration, the external treatment course 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 gives the use of "Castellani liquid."
During the period of remission, it is important to take care of strengthening local immunity. For this purpose, the external immunomodulators Protopic and Epidel are used. Vitamin-mineral complexes, which include vitamins A, E, B, selenium and zinc, will help improve the condition of the skin. The course of use is usually 3-6 months.
In addition, the treatment of the disease requires the correction of the principles of systemic skin care. Treatment of seborrheic dermatitis on the face can be ineffective, if washed with hard water - it is better to replace it with special moisturizing and cleansing compounds. Among the quality lotions that have earned a lot of flattering reviews from patients suffering from seborrheic dermatitis, it is worth noting the products of the Bioderma company, 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 treatment of this zone has some features. The basis of the treatment of dermatitis of the scalp is medical shampoos aimed at combating fungus and inhibiting the activity of the sebaceous glands.
The use of tar, zinc agents is common. They have an antifungal and anti-inflammatory effect, inhibit the growth and reproduction of pathogens. At the same time, pharmacy shampoos gently act on the skin of the head, quickly eliminate scaly plaques at the roots of the hair.
In addition to shampoos with one active ingredient, complex preparations are often used, containing a lot of useful substances and trace elements that improve the condition of the skin. Due to the simultaneous effect of several therapeutic components at once, the fungi undergo a total blow, and the duration of the remission stage is significantly increased. Usually combined shampoos are prescribed for oily seborrheic dermatitis. The drugs dry the affected areas of the skin, eliminating erythema, swelling. Thus, the benefits of their use are much higher.
With exacerbation of symptoms, daily use of shampoo may be required. It should be borne in mind that the body quickly gets used to therapeutic detergents, 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 drugs to suppress infection (most of them contain components with salicylic acid and tar).
The most effective and popular shampoos for the treatment of seborrheic dermatitis of the scalp are:
- "Nizoral";
- Sulsen
- "Sebozol";
- "Friderm Zinc";
- "Friderm Tar";
- "Psoriloma tar";
- Alerana;
- "Libriderm Zinc";
- "Zinovit";
- Schonenberger.
In some cases, if the treatment of seborrheic dermatitis on the head with antifungal shampoos does not bring positive changes, experts recommend additionally taking hormonal drugs. Use them in the treatment of seborrhea should be extremely careful, since most of them have serious contraindications and side effects.
Sulsena paste for scalp
Other, equally effective agents for the treatment of seborrheic dermatitis are special pastes. They are used after shampooing. The most popular paste for treating seborrheic dermatitis of the scalp is Sulsena. The drug is released in a 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, with exacerbation, 2% of Sulsen is used. Rub the paste thoroughly in a circular motion into the clean and moist hair roots, stand it for half an hour and rinse 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 consumed very economically - it should be applied to the hair once a week, and for one procedure it turns out to be enough to squeeze about 5 ml of paste from the tube. The course of treatment "Sulsenoy" is 3-5 months.
Alternative methods
In addition to pharmacy drugs, folk remedies have proven themselves well in the treatment of seborrheic dermatitis. In the treatment of this skin ailment, herbs and other natural ingredients are also used for prophylactic purposes. The most successful in use is calendula, sage, burdock and oak bark. Based on these plants, compositions are prepared for the treatment of seborrheic dermatitis in adults:
- Decoction of calendula, plantain and chamomile. All components (each 1 tbsp. L.) Mix and pour in a thermos, then pour 300 ml of boiling water. Therapeutic phytomix should be infused, therefore it is more convenient to prepare the product at night, and in the morning, after washing the hair, the infusion is rubbed into the root zone and is not washed off until the next water procedures.
- Alcoholic extract of St. John's wort. For 100 g of dried hypericum, 500 ml of medical alcohol is used. The mixture is cleaned 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 tinctures and diluted with a glass of water. Using a cotton or gauze disk, the therapeutic composition should be rubbed into the scalp.
Another way of alternative treatment for seborrheic dermatitis is the use of sea or table salt. Using this simplest natural mineral, a scalp massage is performed. The benefits of salt peeling can hardly be overestimated, since it prevents hair loss, helps exfoliate dead cells and improves blood circulation. After massage, the hair should be thoroughly rinsed with water.
In the treatment of seborrheic dermatitis with folk remedies, there are recipes for home shampoos. So, for example, the egg is considered to be the simplest - for its use it is enough to use 2 yolks and mix them with warm water, foam well on the head and rinse. As a therapeutic shampoo, kefir or infusion of oak bark with yogurt is also often used.
Diet for seborrhea and other recommendations
Therapy of this skin pathology implies compliance with some nutritional restrictions, regardless of the stage of the disease. The mechanism of development of seborrheic dermatitis is directly related to the release of sebum, so the diet completely eliminates the consumption of fatty foods and drinks. . . :
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- Milk and dairy products.
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At the same time, sweets and pastries should be abandoned at least for a period of exacerbation of the disease. You will also have to say goodbye to fried, pickled, fatty, smoked and too spicy dishes for the duration of treatment for seborrheic dermatitis. Alcohol, fast food, and potential allergens (nuts, mushrooms, honey, seafood, strawberries, etc.) are banned.
In addition, it is important to constantly maintain hygiene, while not abusing soap and detergent compositions for the epidermis. Men suffering from seborrheic dermatitis on the face, it is advisable to get rid of excess vegetation, since the hair is a comfortable environment for the reproduction of fungal organisms. When purchasing underwear, you need to give preference to clothes made from natural materials (cotton, linen). Such tissues absorb moisture well and provide complete air circulation, preventing the manifestation of inflammation and irritation of the epidermis.