Skin Diseases - Seborrhoeic Dermatitis

Seborrhoeic Dermatitis (Dandruff)

What is seborrhoeic dermatitis?

Seborrhoeic dermatitis is a common, chronic or relapsing form of dermatitis that mainly affects the scalp and face. Dandruff presents as bran-like scaly patches scattered within hair-bearing areas of the scalp.

Who gets seborrhoeic dermatitis?

Infantile seborrhoeic dermatitis affects babies under the age of 3 months and usually resolves by 6–12 months of age.

Adult seborrhoeic dermatitis tends to begin in late adolescence. Prevalence is greatest in young adults and in the elderly. It is more common in males than in females.

What are the clinical features of seborrhoeic dermatitis?

Seborrhoeic dermatitis affects scalp, face (creases around the nose, behind ears, within eyebrows) and upper trunk. Associated with itching and scaling.

Diagnosis

Diagnosed by its clinical appearance and behaviour. As Malassezia is a normal component of skin flora, its presence on microscopy of skin scrapings is not diagnostic. Skin biopsy may be helpful but is rarely indicated.

Treatment:

Treatment of seborrhoeic dermatitis often involves several of the following options.

  • Keratolytics.
  • Topical antifungal agents.
  • Mild topical corticosteroids.
  • Topical calcineurin inhibitors.
  • In resistant cases in adults, oral antifungals or phototherapy may be recommended.

Scalp Treatment

  • Medicated shampoos containing ketoconazole, ciclopirox, selenium sulphide, zinc pyrithione, coal tar, and salicylic acid.
  • Steroid scalp applications.
  • Tar cream.

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