Introduction
Head gneiss (ICD-10 number L21) is the popular or colloquial term for the so-called “seborrhoeic eczema” of newborns. The head gneiss is a yellowish scaly skin rash, which mainly affects the hairy scalp (gneiss) and the adjacent skin areas, such as the face, but also in severe cases the spine or chest. The scaly skin rash (eczema) can be accompanied by itching.
The disease occurs particularly frequently in newborns under 3 months of age. In addition, the head gneiss can reappear in the 4th decade of life. Not every form requires treatment, but about 5 % of those affected suffer from a form of head gneiss requiring treatment. Men are slightly more frequently affected than women. The skin rash typically shows a phased progression, characterized by the alternation of mild and more severe phases of the disease.
Causes
The cause for the occurrence of head gneiss is not yet fully understood. It is known that sebum production is increased and skin fungi are involved in the development, which is why inflammation of the affected skin areas occurs. Since most sebaceous glands are found in the hairy areas, head gneiss also occurs mainly on the head.
Whether a congenital disposition plays a role is disputed, but has not been proven until today. Since the head gneiss occurs more frequently in the male sex (both in infancy and adulthood) than in the female, an influence of the male sex hormones (androgens) is also considered. As the concentration of male sex hormones (androgens) is even higher directly after birth, as these were transmitted via the mother, head gneiss occurs mainly in the first month of life. As soon as the concentration of the hormones decreases, the head gneiss usually disappears again – this is the assumption. Many adults affected also report that stress and climate conditions play a role.
Symptoms
Often the head gneiss, especially in babies, does not cause any discomfort and is not perceived as disturbing by the babies. It is characterized by a scaly, yellowish skin rash, which mainly affects the hairy scalp and occurs especially in the first weeks of life. Until the baby reaches the age of one year, it heals in most cases without consequences.
The rash usually does not itch. In exceptional cases, however, itching may occur. However, adults with head gneiss suffer from it more frequently.
The rash is oily and adhesive. In the course of time the crusty rash becomes brownish. In most cases, treatment is not necessary, as the eczema heals by itself without any consequences.
However, a subsequent infection of the gneiss of the head with fungi or bacteria (often through scratched areas) can lead to severe itching and other inflammatory symptoms such as fever, vomiting, diarrhea. However, this is relatively rare. Other parts of the body outside the head area may also be affected.
In these cases itching and inflammatory symptoms such as redness and pain are more frequent. Other affected body parts can be the axillary folds, the chest and spine area and, less frequently, the abdomen. When scraping off or roughly removing the scales, the skin may bleed slightly and scarring may occur during healing. Therefore it is absolutely necessary to refrain from scraping off the scales.
