Seborrheic Dermatitis: Causes, Treatments, and Skincare Tips

Consultation Inquiry

Hello Dr.
Cheng,
Two weeks ago, I suddenly experienced redness and itching on my forehead, eyelids, sides of my nose, and chin (all areas where sebaceous glands are more active).
Subsequently, I noticed some flaking.
I assumed it was seborrheic dermatitis, so I temporarily stopped using all skincare products and purchased some topical steroids.
The condition improved, but it seemed to recur after I resumed using my regular skincare products about a week later.

I would like to ask you—could it be that the skincare products are unsuitable for me? However, I have been using them for about five years without any allergic reactions.
Could it be due to my skin type or external irritants? If it is indeed seborrheic dermatitis, what would be the most appropriate treatment approach?
I would greatly appreciate it if you could take the time to address my concerns.
Thank you!

Zhenyi, 20~29 year old female. Ask Date: 2001/06/23

Dr. Zheng Lizhen reply Dermatology

Based on your description, your issue may be seborrheic dermatitis.
Please visit a dermatologist in person and do not purchase over-the-counter medications for self-treatment.
Seborrheic dermatitis cannot be completely cured, as the exact cause remains unclear, and thus definitive treatment is not yet possible.
Some researchers believe that Malassezia yeast may be one of the contributing factors to seborrheic dermatitis.
Additionally, factors such as staying up late, insomnia, fatigue, high stress, smoking, alcohol consumption, and illness can exacerbate the condition.
For regular hair washing, you may choose shampoos containing tar, zinc pyrithione, salicylic acid, or ketoconazole.
Gently massage the shampoo into your scalp and leave it on for about ten minutes before rinsing.
Other topical and oral medications should be tailored by your physician according to your specific situation.

Reply Date: 2001/06/23

More Info

Seborrheic dermatitis is a common skin condition characterized by red, flaky, and itchy patches, often occurring in areas rich in sebaceous (oil) glands, such as the scalp, face, and upper back. Your description of symptoms on the forehead, eyelids, sides of the nose, and chin aligns with this condition. It is important to understand that seborrheic dermatitis is a chronic condition that can flare up due to various factors, including stress, hormonal changes, and environmental triggers.

The fact that you experienced improvement after stopping all skincare products suggests that your skin may have been reacting to one or more ingredients in those products. Even if you have used the same products for years without issue, it is possible for skin sensitivities to develop over time. Ingredients in skincare products, particularly those that are heavily fragranced or contain alcohol, can irritate sensitive skin and exacerbate conditions like seborrheic dermatitis.
In terms of treatment, while topical steroids can provide temporary relief from inflammation and itching, they are not a long-term solution and can lead to skin thinning and other side effects if used excessively. Instead, a more sustainable approach involves the use of medicated shampoos and topical treatments specifically designed for seborrheic dermatitis. Look for products containing active ingredients such as:
1. Ketoconazole: An antifungal agent that helps reduce the yeast population on the skin, which is thought to play a role in seborrheic dermatitis.

2. Zinc pyrithione: This ingredient has antifungal and antibacterial properties and can help reduce flaking and irritation.

3. Salicylic acid: This helps to exfoliate the skin and reduce scaling.

4. Coal tar: This can help slow down skin cell turnover and reduce inflammation.

When using these treatments, it is advisable to apply them as directed, often leaving them on the affected areas for a specified duration before rinsing. Regular use of these medicated products can help manage flare-ups and maintain skin health.

In addition to topical treatments, consider lifestyle modifications that may help reduce flare-ups. These include:
- Managing stress: Stress can exacerbate seborrheic dermatitis, so incorporating stress-reducing activities such as yoga, meditation, or regular exercise may be beneficial.

- Maintaining a consistent skincare routine: Use gentle, non-irritating cleansers and moisturizers that are free from fragrances and harsh chemicals.

- Avoiding known triggers: If you notice certain products or environmental factors worsen your condition, it may be best to avoid them.

Lastly, it is crucial to consult with a dermatologist for a personalized treatment plan. They can provide guidance on the most effective products for your specific skin type and condition, as well as monitor your progress and make adjustments as needed. Seborrheic dermatitis can be managed effectively with the right approach, allowing you to maintain healthy skin and minimize flare-ups.

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