Seborrheic Dermatitis: Causes and Hair Loss Concerns

Q: Seborrheic Dermatitis: Causes and Hair Loss Concerns

Hello： The medication you mentioned is a topical corticosteroid, which is generally used until the condition is completely resolved before discontinuation. <br>Sometimes, raised tumors may appear (likely seborrheic keratosis, commonly known as age spots). <br>This is not exclusiv

Does seborrheic dermatitis cause this phenomenon?

Hello Doctor: Last year, I visited a dermatologist and was diagnosed with early-stage androgenetic alopecia and seborrheic dermatitis.
The doctor prescribed a topical solution to apply when I experience redness and itching.
Now that I've finished the medication, my condition has improved significantly, and I rarely experience itching.
However, I often notice small raised bumps on both sides of my scalp, which, when scratched off, reveal pale yellow particles that are sticky and attached to fine hairs.
I understand that these fine hairs are due to androgenetic alopecia, and I am taking medication to manage it.

I would like to ask you, Doctor, if these pale yellow particles are a result of seborrheic dermatitis? Could they be causing the already fragile fine hairs to be coated in (sebum?), making them more prone to falling out? Additionally, could you advise me on whether I should wash my hair twice a day? For the past six months, I have been washing it once daily, but I always feel uncomfortable when I go out.
However, I am concerned that washing it twice might lead to excessive oil production.
(I tend to have oily skin; more than an hour after washing my face, my T-zone becomes oily, and I feel my hair is greasy when I wake up in the morning.) I am worried that while I manage my androgenetic alopecia, seborrheic dermatitis might affect my scalp and lead to continued hair loss.
Thank you for your guidance.

Pizzaro, 20~29 year old female. Ask Date: 2009/04/10

Dr. Zhang Zhibo reply Dermatology

Hello: The medication you mentioned is a topical corticosteroid, which is generally used until the condition is completely resolved before discontinuation.
Sometimes, raised tumors may appear (likely seborrheic keratosis, commonly known as age spots).
This is not exclusive to the elderly; it tends to occur more frequently in sun-exposed areas.
If you have male pattern baldness, the lack of hair protection may make you more susceptible to sun exposure and aging.
If you are experiencing peeling with yellowish crusty flakes, it is likely just seborrhea.
Typically, male pattern baldness leads to hair loss, and it is rare for patients with seborrheic dermatitis to experience significant hair loss! Some over-the-counter shampoos can also treat seborrhea (those containing ZPT or Ketoconazole have anti-seborrheic properties), and coal tar shampoos commonly prescribed in clinics can also be effective.
However, they should be left on the scalp for at least 10 minutes before rinsing for better efficacy.

Reply Date: 2009/04/10

More Info

Seborrheic dermatitis (SD) is a common skin condition that can significantly impact both the scalp and hair health. It is characterized by red, itchy patches, and can lead to flaking and scaling. The condition is often associated with an overgrowth of a yeast called Malassezia, which is naturally found on the skin. Factors such as stress, hormonal changes, and environmental conditions can exacerbate the symptoms of SD.
In your case, the presence of yellowish, oily particles on your scalp could indeed be related to seborrheic dermatitis. These particles are often sebum (oil) mixed with dead skin cells, which can accumulate due to the inflammation caused by SD. When the scalp is inflamed, it can lead to an increase in oil production, which may trap hair follicles and contribute to hair loss, particularly in individuals predisposed to androgenetic alopecia (male pattern baldness). The fine hairs you mentioned could be miniaturized due to the effects of both SD and androgenetic alopecia, making them more susceptible to falling out.

Regarding your question about washing your hair, it is essential to strike a balance. Washing your hair daily can help remove excess oil and flakes associated with seborrheic dermatitis, but over-washing can also strip the scalp of its natural oils, potentially leading to increased oil production as a compensatory mechanism. For individuals with oily scalps, washing hair once a day is often sufficient, but if you find that your scalp feels uncomfortable or excessively oily, you might consider washing it twice a day with a gentle, medicated shampoo designed for seborrheic dermatitis. Look for shampoos containing ingredients like ketoconazole, zinc pyrithione, or selenium sulfide, which can help control the yeast and reduce inflammation.

It is also crucial to follow your dermatologist's recommendations regarding topical treatments. If you notice that your symptoms are worsening or not improving, it may be necessary to revisit your dermatologist for a reassessment. They may adjust your treatment plan or suggest additional therapies to manage both seborrheic dermatitis and hair loss effectively.

In summary, the yellowish particles you observe are likely related to seborrheic dermatitis, which can complicate hair loss issues. Regular washing with appropriate products can help manage the symptoms, but it is essential to monitor how your scalp responds and adjust your routine accordingly. If you have concerns about your hair loss or the effectiveness of your current treatment, do not hesitate to consult your dermatologist for further guidance. They can provide tailored advice based on your specific condition and needs.

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