Seborrheic Dermatitis: Dermaclub’s guide to natural treatment

Seborrheic Dermatitis: Dermaclub’s guide to natural treatment

Seborrheic dermatitis (SD) is one of the most common and well-known types of dermatitis.
The two variants are:

• seborrheic dermatitis on the scalp
• seborrheic dermatitis on the body

Seborrheic dermatitis on the scalp

Seborrheic dermatitis causes dandruff, so it is commonly mistaken that seborrheic dermatitis and dandruff are the same thing.
Dandruff, that is, the flaking of small white lamellae, can also be caused by external factors.
These are mainly:

• Use of harsh shampoos
• Inadequate rinsing
• Frequent washing
• Scratching the scalp during washing
• Hair cosmetics (lotions, rubs)
• Hair salon treatments (dyeing, styling, etc.)
• Excessive drying with hot air

In such cases, when the cause is removed, the dandruff will simply disappear. In contrast, and unlike simple dandruff, seborrheic dermatitis is a disorder of the maturation and desquamation of the stratum corneum and should be considered a minor, yet very real, pathological skin condition. The causes of seborrheic dermatitis are traced back to the individual, in that they are mainly due to genetic predisposition and/or environmental factors, such as stress and seasonality. Seborrheic dermatitis will worsen when subjected to the external factors mentioned above but, unlike simple dandruff, it will not heal by eliminating them. Seborrheic dermatitis of the scalp is barely visible in those with hair. Seborrheic dermatitis can often be spotted with the presence of dandruff on the hair or clothing. The condition often causes itching and the will to scratch.

In bald individuals and in more severe forms of seborrheic dermatitis, adherent plaques composed of yellowish scales can be seen.

In addition to desquamation of silver-colored lamellae, seborrheic dermatitis is characterized by scalp redness and itching.

Generally, seborrheic dermatitis on the scalp does not cause particular discomfort, but will likely cause frustration due to the constant presence of dandruff on the hair or clothes.
In some cases, however, seborrheic dermatitis can be very itchy and will cause the individual to continuously scratch the area, to the point of causing hair loss due to trauma.
This causes some areas to be affected by hair thinning and/or cuts or grazes caused by scratching. Sometimes, seborrheic dermatitis affects the whole scalp area, but stops along the hairline. In other cases, seborrheic dermatitis extends outside the hairline, which makes it particularly visible and even more bothersome.

Infantile variant of SD of the scalp

Seborrheic dermatitis on the scalp has a variant that appears in the first few months of life, but may continue for several years.
It is popularly called cradle cap (milky crust) and may appear before hair growth begins. Cradle cap causes yellowish scales to form and adhere to each other, creating larger patches that do not flake away. While the infant is still bald or with little hair, the condition is not particularly bothersome, however as the child and their hair grow, it will cause the same irritation and itching as the adult form.

Seborrheic dermatitis on the body

Seborrheic dermatitis affects well-defined areas, as shown in the image

Face

The facial area is that which is most commonly affected.
Seborrheic dermatitis appears mainly around the folds between the nose and cheeks extending to the cheekbones and eyebrows, but may also affect the nose and forehead.

Ears

While seborrheic dermatitis may appear in the auricle (pinna), it more commonly affects the external ear canal.
Dermatitis of the ear canal will cause itching and scaling but, due to its location, it is often misinterpreted as an allergic reaction or mycosis. Incorrect treatments such as cortisone or antifungals are prescribed, which will do nothing for the actual condition of seborrheic dermatitis.

Chest

The presternal and interscapular areas are very common sites of seborrheic dermatitis.

Genitals

Seborrheic dermatitis can affect both male and female genitalia, including the pubic area, and causes reddening, scaling and itching.

Folds

The folds most commonly affected by seborrheic dermatitis are the axillary, inguinal and intergluteal folds.
In these locations, seborrheic dermatitis does not cause desquamation, but will be red and very moist. Occasionally the retroauricular fold may also be affected, which becomes particularly moist and may fissure.

Causes of seborrheic dermatitis

Seborrheic dermatitis is not considered as a skin disease, but as a state of unstable epidermal cell growth. Cells of the epidermis usually grow to form a compact stratum corneum, with a perfect balance between cell loss through desquamation and the replacement of lost cells.
Seborrheic dermatitis disrupts this balance, causing the lamellae of the stratum corneum to accumulate one on top of the other until they form patches of scales that then detach and are very visible on hair or clothing.
Altered desquamation will always accompany inflammation of the skin, which will appear reddened.

Clumped scaling in seborrheic dermatitis
The causes of this instability are not known.
When seborrheic dermatitis regresses either by treatment or spontaneously, the skin will return to normal.

Seborrheic dermatitis: triggering and worsening factors

In individuals naturally predisposed to the condition, seborrheic dermatitis can be triggered by many factors, of which the most credited are:

• psychophysical stress,
• change of season,
• some ongoing illnesses,
• use of certain medications and/or drugs

Psychophysical stress is probably the main trigger or aggravator of seborrheic dermatitis in those predisposed to the condition. In the same individuals, seborrheic dermatitis itself is often an additional stressor that further aggravates the skin condition, creating a vicious circle.
The change of seasons between summer and autumn, and between winter and spring are well-known worsening moments for patients suffering from seborrheic dermatitis.
Some diseases, such as Parkinson’s disease or AIDS, are marked by the onset or aggravation of atopic dermatitis, although the association between atopic dermatitis and seborrheic dermatitis is unclear.
The use of some medications, such as beta blockers to control high blood pressure, certainly aggravates atopic dermatitis. Cortisone and other pharmaceuticals also worsen the condition.

Seborrheic dermatitis: what not to do

Cortisone is frequently prescribed for the treatment of seborrheic dermatitis.
When first applied, cortisone shows almost immediate positive results, but actually induces atopic dermatitis.
Indeed, the use of cortisone on seborrheic dermatitis will cause similar problems to those encountered when applied to atopic dermatitis or psoriasis (see related papers).
In practice, cortisone induces addiction, which means the user has to apply more and more of the product for the same result to be achieved.
As soon as cortisone use is suspended, there is an inevitable “rebound” and the seborrheic dermatitis will worsen. This will likely be accompanied by atrophy, dilation of vessels and hair growth.
Therefore, cortisone should never be used to treat seborrheic dermatitis.
Another pharmaceutical that is commonly prescribed for seborrheic dermatitis are imidazole antifungals such as econazole, miconazole or ketoconazole.
Their prescription is based on the theory that the pityrosporum skin fungi genus is responsible for seborrheic dermatitis, however there is little to support this hypothesis and antifungals are not an effective cure for the condition.

Seborrheic dermatitis: the natural cures recommended by Dermaclub

To treat seborrheic dermatitis, it is not necessary to resort to drugs or pharmaceuticals. In fact, the condition responds well to sun exposure and the application of sulfur and salicylic acid.
The sun exerts undoubtable benefits on seborrheic dermatitis, just as it does for atopic dermatitis and psoriasis. However, UV lamps should not be used as they are irritants and may worsen the condition.
Together with salicylic acid, sulfur has powerful properties against seborrheic dermatitis. A small amount of vaseline-free, evanescent cream containing colloidal sulfur and salicylic acid in a pure, low-concentration form should be massaged to the area to treat once a day. DermaClub recommends 2S Cream. If the seborrheic dermatitis is on the hairline, apply a small amount of 2S Cream one evening a week and massage well, before washing the hair the next morning.
A fast-rinsing non-foaming shampoo such as Dermictiol Shampoo is recommended.
Washing the hair shouldn’t take too long and it’s important not to rub the scalp with the shampoo. To dry the hair, use a cotton terry cloth in order to reduce stress on the hair and scalp. For all other parts of the body affected by seborrheic dermatitis, including the external ear canal, treatment consists of massaging the affected area with 2S Cream every evening.
Once the seborrheic dermatitis has gone into remission, 2S Cream can be discontinued and resumed if there are signs of a recurrence. Below are some examples of treatment of seborrheic dermatitis with 2S Cream.