I have previously discussed seborrheic dermatitis which is also known as seborrheic eczema or scalp eczema in some detail and I would highly recommend some extra reading links here and here for those of you who want some extra detail. It remains a very popular topic as it can be difficult to tackle and can be very uncomfortable to live with. Here is a summary of what you need to know.
1. What is seborrheic dermatitis
The word itis refers to inflammation (pain, swelling, redness) and derma refers to skin therefore dermatitis is inflammation of the skin. Seborrheic refers to sebaceous glands that produce oil. Therefore putting it all together, seborrheic dermatitis is inflammation of areas of the skin that have many oil producing glands and rich in sebum (e.g scalp, face, upper back/chest).
2. What are the signs?
Inflammation — pain, swelling, redness- is a key indicator. Additionally for the scalp, scaling and flaking similar to dandruff but which may be greasy and yellow in colour.
3. What causes it?
It is not fully understood but a type of fungus Malassezia (yes the same one that causes dandruff) is thought to play a role. Now to be clear we ALL have Malassezia it is perfectly normal to have this fungus on skin, people with seborrheic dermatitis are NOT dirty. Those with seborrheic dermatitis appear to be very sensitive to this fungus and therefore develop the characteristic inflammation.
4. How to treat seborrheic dermatitis
Go to your doctor
It is really important to get diagnosed properly by a doctor if you think you have seborrheic dermatitis. This is because it has overlaps with other skin conditions such as psoriasis or even simple dandruff. Additionally steroid treatments or even pills may be necessary for some and this really requires a doctor’s monitoring.
Avoid natural oils
Oleic acid is a fatty acid(oil-like) which is found in almost all natural oils including coconut, shea butter, olive and castor oil. Oleic acid is the food that the fungus Malassezia loves. If you cannot part with your natural oil pick one with low oleic acid content e.g jojoba or castor oil and avoid placing the oil on the scalp.
Anti dandruff shampoos
These often really do work. They contain effective antifungal agents such as pyrithione zinc and ketoconazole. There are prescription strength shampoos available too if the over the counter stuff is not working for you.
As seborrheic dermatitis has fungal involvement, the natural route involves an antifungal approach. The catch here is that many natural oils which contain oleic acid may also be antifungal in nature e.g neem and coconut oil. One study from scientists in Iran showed that henna extracted in water has some antifungal activity on Malassezia — the correct fungus to target. The only downside is that the henna was left for around 3 days at a time. This is typically not the norm for most henna users but it is not to say that it cannot work within a shorter time period as this was not tested (JJmicrobiol, p125, 2010). A separate study showed that a raw honey /water solution left on hair for 3 hours daily could stop itching and flaking in 1–2 weeks (Eur J Med Res 2001, pg 306–308,2001).
Many people with seborrheic dermatitis report flare ups when stressed (including depression) or when unwell. Working with your doctor is important as some medication can also be a trigger.
Ladies, do any of you struggle with seborrheic dermatitis? How do you cope?
Additional References for this article
1. Current Science, pp1336-1345, 2002
2. J Investig Dermatol Symp Proc, pp 15–19, 2007
3. J Investig Dermatol Symp Proc ‚pp194–7, 2005
4. Science ‚pp304–307, 2004
5. JEADV, pp 16–26, 2014
6. Annales de Dermatologie et de Vénéréologie, pp 833–837, 2007