1. What is seborrheic dermatitis?
An inflammatory, scaly disease that occurs on the scalp, face and occasionally other areas. Despite the name seborrhea, the composition of the sebum and the overflow are usually normal. The disease tends to occur in areas where the sebaceous glands are more developed. Inflammation usually occurs when the body reacts to the bacterium Sphaerococcus furfur and produces oil breakdown.
2. What causes seborrheic dermatitis?
The exact cause of seborrheic dermatitis is not known, but it is generally believed to be related to endocrine disorders, especially hyperandrogenism. In addition to this, it may also be related to immune status, genetic, hormonal, neurological and environmental factors. It is also related to digestive disorders, excessive consumption of sweets, excessive fat, mental stress, overexertion, bacterial infection, and vitamin B deficiency. On top of excessive seborrhea, seborrheic dermatitis can be complicated by acne symptoms secondary to fungal (oval furfur spores) and bacterial (Propionibacterium acnes) infections. Allergic reactions to fungi and bacteria can also occur, and autoimmune reactions can also lead to eczema-like lesions and disseminated seborrheic dermatitis.
3. In which groups of people can seborrheic dermatitis occur?
Seborrheic dermatitis can occur at any age, with the majority of adults between the ages of 20 and 50.
4.Where does seborrheic dermatitis occur?
Seborrheic dermatitis occurs in areas where there are more sebaceous glands, such as the scalp, face, chest and folds. The head and face in particular are the most common. It is rare for seborrheic dermatitis to develop systemically.
5. What are the signs of seborrheic dermatitis of the head?
It occurs on the scalp and starts as mildly flushed patches covered with grayish-white bran-like scales with mild itching, the rash expands and greasy scaly map-like patches can be seen; in severe cases, it is accompanied by oozing, thick crusts and a foul odor and can invade the whole head. Hair may fall out and thinning.
6.What are the manifestations of seborrheic dermatitis on the face?
Facial damage is mostly seen on the nose, nasolabial folds and eyebrow arches, with light red spots, covered with greasy yellow scales, often full of oil. Severe patients have yellowish-red scaly papules on the hairline, behind the ears, external auditory canal, brow, nose, nasolabial folds, and upper sternum. Marginal blepharitis and conjunctival irritation may occur.
7. What are the manifestations of seborrheic dermatitis in the trunk area?
On the chest and scapula, it starts as a small reddish-brown follicular papule with greasy scales, and then gradually becomes a central, finely scaled, dark red papule with a dark red margin and larger greasy annular patches. The folds are mostly seen in the armpits, under the breasts, umbilicus and groin, etc. They are well-defined erythematous patches with few flakes and moist, often accompanied by vesicles and oozing.
8.What are the signs of seborrheic dermatitis in young children?
Seborrheic dermatitis can also occur in newborns, mostly between 2 weeks and 6 months after birth, and manifests as thick yellow crusty damage on the scalp (“cradle cap”); cracks and yellow scales behind the ears; red papules on the face; and persistent diaper rash. Thick, adherent, scaly plaques that can reach 1-2 cm in diameter can occur on the scalp in older children.
9. What are the complications or or concomitant diseases of seborrheic dermatitis?
Seborrheic dermatitis is generally chronic, prone to recurrent attacks, often accompanied by folliculitis, blepharitis, facial often in conjunction with acne, rosacea mite dermatitis, psoriasis. Sometimes it can also be accompanied by skin allergies or sensitive skin.
10.What do patients with seborrheic dermatitis need to pay attention to in their diet?
Seborrheic dermatitis should pay attention to the regulation of diet in life, eat more vegetables, try to drink less alcohol, do not eat too much greasy, sweet and spicy food. To avoid stimulating or promoting the increase of skin oil. Eat more vitamin-rich foods, especially vitamin A foods in moderation to correct abnormal sebaceous keratinization of hair follicles and prevent hair follicle blockage. Some people study that zinc deficiency may also produce seborrheic dermatitis, so the diet can be supplemented with foods high in zinc, such as animal liver, nuts, etc. to correct the relative lack of zinc content in the human body.
11.Why should seborrheic dermatitis patients avoid staying up late and exerting themselves?
Therefore, seborrheic dermatitis patients should maintain a regular life and ensure that they have enough sleep. The actual fact is that you will be able to get a lot more than just a couple of hours of work.
12, seborrheic dermatitis patients why should not face computer work or play computer games for a long time?
The actual fact is that you can find a lot of people who are not only interested in the actual products and services, but also in the products and services of the company.
The actual fact is that you can find a lot of people who have a lot of time to get a lot of money.
The reason is that the psychological-neuro-endocrine-immune trunk of the body consists of a complex body regulation “network” that affects and regulates each other, and bad moods can cause negative regulation leading to a decrease in the body’s immunity The actual endocrine disorder will trigger or aggravate the symptoms of seborrheic dermatitis. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things.
14.Is seborrheic dermatitis hereditary or contagious?
There is no research evidence that seborrheic dermatitis is contagious, so patients do not have to worry about infecting their family members with the disease, but there is a genetic component to the disease, and if there is a clear family member with seborrheic dermatitis, the chances of the offspring occurring are higher than those without a family history.
15. Is seborrheic dermatitis related to seasonal factors?
Domestic and international research data show that the incidence and local severity of seborrheic dermatitis is related to genetic factors, mental or physical stress, but also to climatic factors, which are usually aggravated in winter.
16.What do patients with seborrheic dermatitis need to pay attention to in terms of hygiene?
Patients with seborrheic dermatitis should choose cleaning products suitable for their skin type, clean and maintain the seborrheic dermatitis and non-seborrheic dermatitis area partitions, pay attention to disinfecting washcloths and changing pillowcases regularly. Do not scratch or rub the affected area.
17.How should seborrheic dermatitis of the head be treated?
The actual hair should not be washed too often, do not use strong alkaline soap when washing hair, use neutral soap or sulfur soap. Adults wash their hair with zinc mercaptopyridine, selenium sulfide, sulfur, salicylic acid or tar shampoo once a day until the scalp is under control, and then twice a week. A corticosteroid lotion (e.g., 0.01% dermatologic solution or 0.025% deprenyl acetate lotion) must be rubbed into the scalp or other hair area twice daily until scaling and flushing are controlled. Shampoos alone are not effective if used. Those with furunculosis infection can wash their hair with a solution of Celebrex containing 1% ketoconazole.
18.What medications are used for seborrheic dermatitis on skin other than the head?
The famous Merck Manual describes the treatment of this disease: seborrheic dermatitis behind the ears, nasolabial folds, eyelid margins and the back of the nose can be applied with 1% hydrocortisone cream 2-3 times a day, and the symptoms can be improved quickly; then, if needed, the cream can also be used once a day, hydrocortisone cream is the best glucocorticoid for facial seborrheic dermatitis, but should not be used continuously for more than a week to avoid Hormone-dependent dermatitis. Note that fluorinated steroids can produce side effects (e.g., capillary dilation, atrophy, and perioral dermatitis). In chronic patients, 2% ketoconazole cream or other imidazole drugs (twice daily for 1-2 weeks) can provide relief for several months.
19.What medications can be used for seborrheic dermatitis in infants and children?
In infants, use an infant shampoo with 1% hydrocortisone cream applied twice a day. For thicker damage on the scalp in children, apply olive oil containing 2% salicylic acid or corticosteroid gel with a toothbrush on the affected area at bedtime and wash the hair with shampoo once daily until the thick scales disappear.
20.What are the internal medications for seborrheic dermatitis?
There are many internal medications available for seborrheic dermatitis, such as vitamin B6, B2 or vitamin B complex, niacinamide, etc. For severe itching, antipruritic sedatives such as antihistamines are available, and antibiotics such as tetracycline or erythromycin are available for obvious inflammation or secondary infection. The specific use of dermatological consultation is required in regular dermatology clinics. Do not self-medicate.
21.What are the topical medications for seborrheic dermatitis?
There are also many topical applications for seborrheic dermatitis. The topical therapy is based on the treatment principle of removing fat, sterilization, anti-inflammation and anti-itching. The commonly used drugs are sulfur, levulinic acid, coal tar, salicylic acid, selenium sulfide, imidazole, etc. Different dosage forms can be chosen according to different parts of the disease. The specific treatment plan should be formulated after consultation at a regular dermatology clinic, and patients should not self-medicate.
22.How does Chinese medicine view and treat seborrheic dermatitis?
Chinese medicine believes that the occurrence of seborrheic dermatitis is related to the deficiency of kidney yin, the delusive movement of phase fire, or the upward rush of blood heat in the lung and stomach, and the heat toxin cannot be unblocked, resulting in local metabolism and blood microcirculation disorders. And secondary symptoms of rash, papules or patches with greasy scales. Chinese patent medicine compound pearl acne tablets contain pearl layer powder, honeysuckle, antelope horn powder, buffalo horn concentrated powder, northern ginseng, red peony, scutellaria and other ingredients, which have the effect of clearing heat and detoxifying, activating blood circulation and resolving blood stasis, and have better efficacy on seborrheic dermatitis and acne. Chinese herbal masks also have good effects on seborrheic dermatitis. The combination of Chinese and Western medicine will have a more lasting effect on the treatment of this disease.
23.What skin diseases should seborrheic dermatitis be differentiated from?
Seborrheic dermatitis should be differentiated from psoriasis of the head and face, hormone-dependent dermatitis, erythematous aspergillosis, atopic dermatitis and other diseases. Patients should not self-diagnose or self-medicate according to the description in books or on the internet.
24.Why can tacrolimus ointment treat seborrheic dermatitis?
Tacrolimus is an immunomodulator with a macrolide structure, which is suitable for topical application because of its small molecular weight and good skin permeability. Its mechanism of action is to bind to the cytoplasmic protein FK-BP of T lymphocytes, inhibit the phosphodiesterase activity of calcium-regulated phosphoprotein phosphatase, and then inhibit the expression and release of various cytokines and inflammatory mediators, resulting in a powerful anti-inflammatory effect; at the same time, it can promote the synthesis of skin collagen and the restoration of skin barrier function. Therefore, this drug can replace the anti-inflammatory effect of hormone preparations and avoid the adverse effects caused by long-term topical application of hormone preparations. Tacrolimus is available in two concentrations of 0.03% and 0.1%, with low concentration suitable for children and high concentration for adults. It is especially suitable for patients with seborrheic dermatitis of the face.
25.Why can pimecrolimus cream treat seborrheic dermatitis?
Pimecrolimus and tacrolimus ointment are both local immunomodulators and have roughly the same mechanism of action, and also have better therapeutic effects on seborrheic dermatitis. It is a drug that prolongs the remission period of the disease. Pimecrolimus cream is available in only one concentration and can be used by patients over 2 years of age, especially for patients with facial seborrheic dermatitis. The instructions for pimecrolimus cream are detailed in the article on this site .
26.How to use Tacrolimus Ointment and Pimecrolimus Cream in patients with facial seborrheic dermatitis?
Tacrolimus is an ointment preparation that works quickly but is oily and can be used for the first week or two. Pimecrolimus is a cream preparation that works slightly slower than Tacrolimus, but has a mild and comfortable texture and can be used for maintenance treatment after the main discomfort is controlled. It can be used twice daily initially and then changed to once daily or every other day or every two days as appropriate once symptoms are controlled ……. Gradually lengthen the interval between doses.
27.What are the adverse effects of tacrolimus and pimecrolimus preparations?
Topical application of this product may cause local symptoms such as burning sensation (burning sensation, tingling, pain) or itching of the skin. Local symptoms are most common during the first day or two of using this product, and once they occur, a cold towel can be applied to the face for half an hour. After repeated use, the above adverse reactions will gradually reduce or disappear.
28.Can pregnant women and newborns use tacrolimus ointment or pimecrolimus cream?
There is no sufficient experience or information on the safety of these two drugs for pregnant and lactating women at home and abroad, therefore, the use of tacrolimus ointment or pimecrolimus cream is not recommended for these two types of women.
29. Can seborrheic dermatitis be cured with drugs?
The above mentioned we have talked about many triggering and aggravating factors of seborrheic dermatitis, so the treatment of seborrheic dermatitis, like the treatment of other diseases, cannot rely solely on medication to achieve the purpose of the cure, for example, through reasonable medication, seborrheic dermatitis is basically cured, but the patient can not change the night, bad emotions and bad eating habits and many other triggering factors, then seborrheic dermatitis will come back. Only the combination of prevention and treatment can be the root of the ultimate cure for the disease. The actual fact is that you can find a lot of people who need to be medicated for life, but seborrheic dermatitis can be cured without medication after reasonable treatment and protection, so seborrheic dermatitis should not be treated in a hurry, so as not to delay treatment or aggravate the condition.
30.Can seborrheic dermatitis be treated by self-purchase of medication according to the above treatment plan?
The internet consultation only provides a general direction of treatment, and the condition of seborrheic dermatitis is very different in terms of clinical manifestation and site of onset, and the medication is also very much related to individual factors such as gender, age, skin quality and the presence of bacterial infection. The dermatology clinic of the hospital must be consulted, consulted and treated.