Seborrhoeic dermatitis 465863 225657685 2008-07-14T19:40:41Z 217.155.42.100 {{Infobox_Disease | Name = Seborrhoeic dermatitis | Image = Seborrhoeic dermatitis.jpg | Width = 250 | Caption = | DiseasesDB = 11911 | ICD10 = {{ICD10|L|21||l|20}} | ICD9 = {{ICD9|690}} | ICDO = | OMIM = | MedlinePlus = 000963 | eMedicineSubj = derm | eMedicineTopic = 396 | MeshID = D012628 }} '''Seborrhoeic [[eczema]]''' (also '''Seborrheic dermatitis''' [[American English|AmE]], '''seborrhea''') is a skin disorder affecting the scalp, face, and trunk causing scaly, flaky, itchy, red skin. It particularly affects the [[sebum]]-gland rich areas of skin. ==Causes== The cause of seborrhoeic dermatitis remains unknown, although many factors have been implicated. The widely present [[yeast]], ''[[Malassezia furfur]]'' (formerly known as ''Pityrosporum ovale''), is involved,<ref>{{cite journal |author=Hay R, Graham-Brown R |title=Dandruff and seborrheic dermatitis: causes and management |journal=Clin Exp Dermatol |volume=22 |issue=1 |pages=3–6 |year=1997 |pmid=9330043 |doi=10.1046/j.1365-2230.1997.d01-231.x}}</ref><ref>{{cite journal |author=Nowicki R |title=[Modern management of dandruff] |journal=Pol Merkur Lekarski |volume=20 |issue=115 |pages=121–4 |year=2006 |pmid=16617752}}</ref> as well as genetic, environmental, hormonal, and immune-system factors.<ref>Am Fam Physician 2000;61:2703-10,2713-4</ref><ref>{{cite journal |author=Janniger C, Schwartz R |title=Seborrheic dermatitis |journal=Am Fam Physician |volume=52 |issue=1 |pages=149–55, 159–60 |year=1995 |pmid=7604759}}</ref> A theory that seborrhoeic dermatitis is an inflammatory response to the yeast has not been proven.<ref>{{cite journal |author=Parry M, Sharpe G |title=Seborrheic dermatitis is not caused by an altered immune response to Malassezia yeast |journal=Br J Dermatol |volume=139 |issue=2 |pages=254–63 |year=1998 |pmid=9767239 |doi=10.1046/j.1365-2133.1998.02362.x}}</ref> Those afflicted with seborrhoeic dermatitis have an unfavourable epidermic response to the infection, with the skin becoming inflamed and flaking. [[Image:Seborrhoeic dermatitis head.jpg|200px|right|thumb|Acute form of seborrhoeic dermatitis on scalp]] In children, excessive [[vitamin A]] intake can cause seborrhoeic dermatitis.<ref> {{cite web |url=http://www.nlm.nih.gov/medlineplus/ency/article/000350.htm |title=MedlinePlus Medical Encyclopedia: Hypervitaminosis A |publisher=www.nlm.nih.gov |accessdate=2008-03-19 |last= |first= }} </ref> Lack of [[biotin]],<ref name="aafp"> {{cite web |url=http://www.aafp.org/afp/20060701/125.html |title=Seborrheic Dermatitis: An Overview - July 1, 2006 -- American Family Physician |publisher=www.aafp.org |accessdate=2008-03-19 |last= |first= }} </ref> [[pyridoxine]] (vitamin B6)<ref name="aafp"/><ref name="emedicine"> {{cite web |url=http://www.emedicine.com/NEURO/topic278.htm |title=eMedicine - Nutritional Neuropathy : Article by R Andrew Sewell |publisher=www.emedicine.com |accessdate=2008-03-19 |last= |first= }} </ref> and [[riboflavin]] (vitamin B2)<ref name="aafp"/> may also be a cause. == Hair loss == Side effects to inflammation may include temporary hair loss. If severe outbreaks are untreated for extended intervals, permanent hair loss may result, because of damage to hair follicles. == Treatments == [[Soap]]s and [[detergent]]s such as [[sodium laureth sulfate]]{{Fact|date=July 2008}} may precipitate a flare-up, as they strip moisture from the top layers of the skin, and the drying property of these can cause flare-ups and may worsen the condition.{{Fact|date=May 2007}} Accordingly a suitable alternative should be used instead. Among dermatologist recommended treatments are shampoos containing [[coal tar]], [[ciclopiroxolamine]] [[ketoconazole]], [[selenium sulfide]], or [[zinc pyrithione]].<ref>{{cite journal |author=Schwartz R, Janusz C, Janniger C |title=Seborrheic dermatitis: an overview |journal=Am Fam Physician |volume=74 |issue=1 |pages=125–30 |year=2006 |pmid=16848386 | url=http://www.aafp.org/afp/20060701/125.html}}</ref> For severe disease, [[keratolytic]]s such as [[salicylic acid]] or [[coal tar]] preparations may be used to remove dense scale. Topical [[terbinafine]] solution (1%) has also been shown to be effective in the treatment of scalp seborrhoea,<ref>{{cite journal |author=Faergemann J, Jones J, Hettler O, Loria Y |title=Pityrosporum ovale (Malassezia furfur) as the causative agent of seborrheic dermatitis: new treatment options |journal=Br J Dermatol |volume=134 Suppl 46 |issue= |pages=12–5: discussion 38 |year=1996 | month=Jun |pmid=8763461 |doi=10.1111/j.1365-2133.1996.tb15652.x}}</ref> as may lotions containing [[alpha hydroxy acid]]s or [[corticosteroids]] (such as [[fluocinolone acetonide]]). [[Pimecrolimus]] topical lotion is also sometimes prescribed. Chronic treatment with topical corticosteroids may lead to permanent skin changes, such as [[atrophy]] and [[telangiectasia]].<ref>{{cite journal |author=Smith J, Wehr R, Chalker D |title=Corticosteroid-induced cutaneous atrophy and telangiectasia. Experimental production associated with weight loss in rats |journal=Arch Dermatol |volume=112 |issue=8 |pages=1115–7 |year=1976 |pmid=952530 |doi=10.1001/archderm.112.8.1115}}</ref><ref>{{cite journal |author=Scheinfeld N |title=Seborrheic dermatitis |journal=Skinmed |volume=4 |issue=1 |pages=49–50 |year=2005 |pmid=15654167 | url=http://www.medscape.com/viewarticle/499706 |doi=10.1111/j.1540-9740.2005.03961.x}}</ref> [[UV-A#Explanation|UV-A]] and [[UV-B#Explanation|UV-B]] light inhibit the growth of ''M. furfur'',<ref>{{cite journal |author=Wikler J, Janssen N, Bruynzeel D, Nieboer C |title=The effect of UV-light on pityrosporum yeasts: ultrastructural changes and inhibition of growth |journal=Acta Derm Venereol |volume=70 |issue=1 |pages=69–71 |year=1990 |pmid=1967880}}</ref> although caution should be taken to avoid sun damage. Those with seborrhoeic dermatitis might benefit from [[biotin]] supplements. One might also try a humidifier by the bed, as well as a gentle moisturizer with or without oatmeal. Applying [[milk of magnesia]] may help clear up seborrheic dermatitis; one may apply on the face while showering and rinse off at the end of the shower.<ref>{{citation| last1 = Graedon| first1 = Joe| last2 = Graedon| first2 = Teresa |title=The People's Pharmacy |newspaper = Atlanta Journal Constitution Evening Edge |publisher = Atlanta Journal Constitution |date = [[2008-04-17]]|pages=15}}</ref> ===Plant-based treatments=== {{main article|phytotherapy}} The [[World Health Organization]] mentions ''[[Aloe vera]]'' gel as a yet to be scientifically proven [[traditional medicine]] treatment for Seborrhoeic dermatitis.<ref> {{cite web |url=http://www.who.int/medicinedocs/en/d/Js2200e.6 |title=WHO Monographs on Selected Medicinal Plants - Volume 1: Aloe Vera Gel |publisher=www.who.int |accessdate=2008-03-18 |last= |first= }} </ref> *''[[Arctium lappa]]'' (Burdock) oil<ref name="green"> {{cite web |url=http://books.google.com/books?id=N-Uus_kjkNUC&pg=PA154&lpg=PA154&dq=plants+for+treating+seborrhea&source=web&ots=u4fzYOLFsb&sig=cpWVYu2MB5a3dqNC17QRX7qYhcw&hl=en#PPA154,M1 |title=The Green Pharmacy: New Discoveries ... - Google Book Search |publisher=books.google.com |accessdate=2008-03-19 |last= |first= }} </ref> *''[[Chelidonium majus]]'' (Celandine)<ref name="green"/> *''[[Glycyrrhiza glabra]]'' (Licorice)<ref name="green"/> *''[[Melaleuca]]'' (Tea tree) species<ref name="green"/> *''[[Plantago]]'' (Plantain) species<ref name="green"/> *''Symphytum officinale'' ([[Comfrey]])<ref name="green"/> *''[[Zingiber officinale]]'' (Ginger) root juice<ref name="green"/> ==See also== *''[[Echinopsis peruviana]]'' ==References== {{reflist|2}} ==External links== <!-- NOTE: Links to online support groups, patient websites, blogs, etc., are banned under Wikipedia's External Links policy --> * [http://dermnetnz.org/dermatitis/seborrhoeic-dermatitis.html Seborrhoeic Dermatitis at DermNet] *[http://www.aafp.org/afp/20060701/125.html Seborrheic Dermatitis: An Overview - July 1, 2006 -- American Family Physician] {{Diseases of the skin and subcutaneous tissue}} [[Category:Skin diseases]] [[bg:Себорея]] [[ca:Dermatitis seborreica]] [[de:Seborrhoisches Ekzem]] [[es:Seborrea]] [[fr:Dermite séborrhéique]] [[gl:Dermatite seborreica]] [[it:Dermatite seborroica]] [[he:דהנת]] [[mk:Себороичен дерматит]] [[ms:Penyakit panau]] [[nl:Seborrhoïsch eczeem]] [[ja:脂漏性湿疹]] [[pt:Dermatite seborréica]] [[ro:Seboree]] [[sv:Seborré]]