Within the skin, there is a type of exocrine gland, known as sebaceous glands, found in high concentrations on the scalp, face, and upper back. Sebaceous glands secrete an oily substance, called sebum, which lubricates as well as protects the skin. Inflammation and irritation of the sebaceous glands may result in seborrheic dermatitis. Seborrheic dermatitis is thought to be a chronic yet mild form of eczema. In adults, seborrheic dermatitis may appear as scaly, red lesions above the lip. Seborrheic dermatitis can also occur in infants where it is known as cradle cap. In general, seborrheic dermatitis is slightly more common in men than in women. Patients with certain diseases that affect the immune system (such as HIV/AIDS) and the nervous system, such as Parkinson’s disease, are also at increased risk of developing seborrheic dermatitis. It is worth noting that seborrheic dermatitis is not contagious.
The exact mechanism of pathology for seborrheic dermatitis has yet to be fully understood. Clinical evidence has shown that punitive soaps & detergents; cold, dry weather; stress & anxiety; genetics; and hormones have all been attributed as common triggers of seborrheic dermatitis.
Symptoms appear on the face as the scalp. Seborrheic dermatitis frequently develops on the scalp, where symptoms may range from dry flakes (dandruff) to yellow, greasy scales with reddened skin. Common symptoms associated with seborrheic dermatitis on the face and upper torso include: dry, irritated skin; greasy/oily skin; redness, swelling; and may at times feel a burning sensation.
We may begin by collecting your chief complaint with an emphasis on how itchy and dry your skin may feel as well as obtain any relevant medical history; for example, if any blood relatives have had seborrheic dermatitis, eczema, or, other forms of dermatitis. Next, we may objectively assess your skin by scraping a bit skin to rule out a fungal infection. In some cases, we may order a skin biopsy where a portion of the skin is removed and sent to the laboratory to rule out psoriasis, atopic dermatitis, or other similar appearing conditions.
We will determine what therapeutic regimen is best for you based on the severity of the condition. For minor cases, topical antifungal creams or medicinal shampoos (e.g. ketoconazole, selenium sulfide, and zinc pyrithione) may clear any significant symptoms. For advanced cases, we may prescribe a corticosteroid medication, topical calcineurin inhibitors [(TCIs), e.g. as Tacrolimus, Pimecrolimus], or an antifungal medication in the hopes of reducing the inflamed skin.