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Seborrhiasis – Causes, Symptoms and Treatment
Seborrhiasis is a chronic skin condition characterised by scaly, inflamed patches of skin. It commonly affects the scalp, face, and upper body.
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Seborrhiasis is a chronic skin condition characterised by scaly, inflamed patches of skin. It commonly affects the scalp, face, and upper body.
What is Seborrhiasis?
Seborrhiasis is a term occasionally used as an alternative or colloquial name for seborrhoeic dermatitis (also known as seborrhoeic eczema). It is a chronic inflammatory skin condition that primarily affects areas of the body rich in sebaceous (oil-producing) glands. These include the scalp, face (particularly the nasolabial folds, eyebrows, and forehead), ear canals, central chest, and back. The condition tends to follow a relapsing-remitting course, with periods of flare-ups alternating with remission.
Causes
The exact cause of seborrhiasis has not been fully established, but several contributing factors are recognised:
- Yeast overgrowth (Malassezia species): Naturally occurring skin yeasts of the Malassezia genus are considered the primary trigger. Overgrowth can provoke an excessive immune response in susceptible individuals.
- Excess sebum production (seborrhoea): Overactive sebaceous glands create an environment that promotes yeast proliferation.
- Genetic predisposition: A family history of the condition suggests a hereditary component.
- Immune system dysfunction: Individuals with weakened immune systems, such as those living with HIV or organ transplant recipients, are at higher risk.
- Neurological conditions: People with Parkinson disease or those who have had a stroke are more prone to seborrhoeic skin changes.
- Stress and environmental factors: Psychological stress, cold weather, and dry air can trigger or worsen flare-ups.
Symptoms
The symptoms of seborrhiasis vary depending on the affected area of the body:
- Yellowish-white, greasy scales on the scalp, face, or trunk
- Reddened, inflamed skin
- Itching (pruritus)
- In infants: cradle cap (crusta lactea) on the scalp
- Burning or tight sensation on the skin
- Crusting around the eyebrows and eyelashes (seborrhoeic blepharitis)
Diagnosis
Seborrhiasis is typically diagnosed clinically through a visual examination of the skin by a dermatologist. The characteristic appearance of greasy scales and reddened skin in typical body regions is usually sufficient for diagnosis. In uncertain cases, a skin biopsy (removal of a small tissue sample for microscopic examination) or a fungal test may be performed to rule out other conditions such as psoriasis or contact eczema.
Treatment
A complete cure for seborrhiasis is generally not possible; however, symptoms can be well managed. Treatment depends on the severity of the condition and the affected body area:
Medical Treatment
- Antifungal agents: Shampoos, creams, or gels containing ketoconazole, ciclopirox, or selenium sulfide help reduce Malassezia colonisation.
- Corticosteroids: Short-term use of corticosteroid preparations reduces inflammation and relieves itching.
- Calcineurin inhibitors: Active ingredients such as tacrolimus or pimecrolimus can be used as a steroid-sparing alternative, particularly on the face.
- Zinc-containing preparations: Zinc sulfide or zinc pyrithione have antiseptic and sebum-regulating properties.
Skincare Measures
- Regular use of medicated shampoos (2 to 3 times per week)
- Gentle cleansing with pH-neutral products
- Avoiding known triggers such as stress
- Moderate sun exposure may relieve symptoms, as UV light inhibits fungal growth
Course and Prognosis
Seborrhiasis is a chronic condition that often recurs in flare-ups throughout a person's lifetime. With a consistent skincare and treatment routine, the condition can be effectively managed. Flare-ups may be triggered by stress, respiratory infections, hormonal changes, or seasonal variations. Regular follow-up with a dermatologist is recommended to monitor and adjust treatment as needed.
References
- Naldi L, Rebora A. - Seborrheic Dermatitis. New England Journal of Medicine, 2009; 360(4): 387-396.
- Borda LJ, Wikramanayake TC. - Seborrheic Dermatitis and Dandruff: A Comprehensive Review. Journal of Clinical and Investigative Dermatology, 2015; 3(2): 1-22.
- Schwartz RA, Janusz CA, Janniger CK. - Seborrheic Dermatitis: An Overview. American Family Physician, 2006; 74(1): 125-130.
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