Seborrhea, also known as seborrheic eczema or also seborrheic dermatitis, is a skin inflammation. The greasy, scaly inflammation occurs on the hairy head, trunk as well as face. Those areas of the skin affected by seborrhea show redness, with greasy, yellowish scales also appearing. In a few cases, patients complain of severe itching.
What is seborrhea?
What the exact causes of seborrhea are, is not yet one hundred percent known. However, medical experts assume that it is an inflammation of the hair follicles. The medical profession uses the term seborrhea (or also seborrheic dermatitis or also seborrheic eczema) to describe skin inflammations. Primarily, such inflammations occur on skin areas that have a large number of sebaceous glands. Excessive secretions of the sebaceous glands are characteristic, so that subsequently a very strong greasy film is formed on the skin.
Causes
The reasons and causes of seborrhea are varied. The skin has several cell layers, which – in healthy people – are subject to a permanent renewal process. Skin cells are formed inside the skin, which displace the old outside of the skin. The old skin cells die, allowing new cells to form. The skin cells that fall off during this renewal process are not visible. However, if seborrhea is present, the skin cells are shed in large, very greasy scales. There is a disorder of skin renewal. The exact causes of seborrhea are not yet fully known. However, medical experts assume that it is an inflammation of the hair follicles. The causes are possible infections with yeast fungi (such as Pytriosporum orbiculare, Pytriosporum ovale or Malassetia furfur). These harmless “inhabitants” can multiply to such an extent that seborrhea can be triggered. Promoting factors are for example hormonal factors (e.g. testosterone) or also climatic influences (humidity as well as heat). Sometimes physical and psychological stress can also play a role. Especially if the patient repeatedly complains of “relapses”, which are possible in a chronic course of the disease. Thereby, seborrhea in the actual sense is not a disease in its own right, but a symptom, which in turn hardly says anything about the causative disease.
Diseases with this symptom
- Pityriasis versicolor
- Seborrheic eczema
- Blepharitis
Diagnosis and course
The physician already makes – only on the basis of the skin examination – the diagnosis of seborrhea. Here we speak of the so-called “eye diagnosis”. However, there are also cases in which it cannot be clearly clarified whether seborrhea is present. Sometimes other forms of skin disease (such as atopic or allergic eczema) can trigger similar symptoms reminiscent of seborrhea. Psoriasis – psoriasis – can also show a similar skin appearance. It is important for the medical professional to rule out other diseases before making a diagnosis of seborrhea. Sometimes allergy tests can provide an indication of whether seborrhea is actually present. There is also the possibility that the skin scales are examined microscopically, so that the doctor can make sure that seborrhea is indeed present. The problem with the disease is that seborrhea can take a chronic course. Especially if seborrhea occurs in infancy, there is a risk of possible other infections, so that the already affected areas of skin can be attacked by other fungi or bacteria. Even in adulthood, it is possible for bacteria to infect other areas of the skin or sometimes to settle on the regions already affected; this is referred to by physicians as a superinfection. Furthermore, seborrhea – especially in infants – can take such a severe course that a so-called Erythrodermia desquamativa Leiner occurs. This stage is observed mainly in the second month of the child’s life. The entire skin is affected, and the infant vomits, has high fever and is plagued by diarrhea. Prognosis is good, especially in infancy. Seborrhea usually heals by itself – after several weeks. Adults, however, suffer from a chronic course that recurs in episodes. The clinical picture is similar to psoriasis or neurodermatitis.The probability that seborrhea will heal completely is extremely low. Only if careful care measures are taken can sufferers control the symptoms so well that relapses of the disease can sometimes be avoided.
Complications
Seborrheic eczema or seborrheic dermatitis predominantly affects the face, scalp and both sides of the upper body. In newborns, the symptom is called gneiss, grind, or cradle cap. This symptom usually heals on its own by the ninth month of life. Seborrhea occurs as a dermatitis variant during adolescence and at the age of 40 to 50 years. Stress and medications promote an outbreak. Immunodeficient people, patients with Parkinson’s disease as well as Down syndrome are more affected by the symptom. The resulting complications, depending on the severity, can reduce the patient’s enjoyment of life. These include crusting, bacterial infections from constant scratching, bleeding, scarring, and hair loss. As the disease progresses, sufferers often find themselves in a depressed state. Adults suffering from seborrhea are considered chronically ill and must expect a new outbreak at any time. Another complication of eczema can be sebaceous gland hyperplasia as well as rhinophyma. In the latter diagnosis, the enlargement of the sebaceous glands causes the nose to change in a bulbous manner, especially in older men. In extreme cases, the sebaceous glands must be surgically excised. Seborrhea should be treated immediately and treated under dermatological supervision. This saves many sufferers an almost unbearable ordeal. In addition, permanent cosmetic impairment and further problems are excluded.
When should you go to the doctor?
Seborrhea is relatively harmless to health and usually recedes on its own. However, if the psoriasis turns out to be unusually large or if accompanying symptoms such as itching and redness develop, this should be discussed with the family doctor or pediatrician. In the case of weeping or bleeding areas as well as inflammations, a visit to the dermatologist is recommended. Seborrheic eczema on the face, neck or hands and feet should be clarified if it causes discomfort or has a negative effect on the general condition. If left untreated, the cosmetic blemish can develop into an emotional burden, sometimes resulting in severe psychological problems. Physical secondary symptoms can also develop from untreated seborrhea. It is therefore advisable to have seborrhea clarified and, if necessary, treated in the early stages. Otherwise, the skin disease can take a chronic course and promote bacterial or fungal infections. Seborrhea in children and adolescents must always be medically clarified. If psoriasis is detected and treated early, a severe course can usually be avoided.
Treatment and therapy
Seborrhea usually requires therapy, which has two parts. On the one hand, treatment is based on the acute stage, and on the other hand, maintenance therapy is prescribed to be applied “between episodes” of the disease. In the acute stage, it is important that the affected person receives medication which subsequently has a fungicidal effect (so-called antimycotics). These agents can be applied directly – in the form of an ointment – to the affected areas. There are also shampoos and lotions that contain the same active ingredient. If the symptoms are persistent and pronounced, antimycotics can also be administered in tablet form. If there are additional infections – i.e. a superinfection – the patient must take antibiotics. In extremely inflamed forms, the physician will also prescribe glucocorticoids (as an ointment). The glucocorticoids should curb the inflammatory reaction. However, glucocorticoids are not administered as part of a permanent therapy. If there is extremely pronounced scaling, keratolytics must be used. These sometimes include urea and salicylic acid; these substances soften the skin scales. Subsequently, the skin scales come off, so that an improvement of the clinical picture occurs.
Outlook and prognosis
In the case of seborrhea, it is not always necessary to see a doctor and complications do not necessarily occur. If the disease is not treated, the course of the disease depends on the hygiene of the patient.If this is deficient, the skin usually remains oily and further complications arise. Thus, seborrhea can cause inflammation and wounds on the skin, which in extreme cases leave scars or lead to severe infection. In case of mild seborrhea, the prognosis is rather positive. Ordinary shower gels and soaps are usually sufficient to reduce oily skin and relieve any accompanying symptoms such as itching or odor development. Seborrhea as a result of frequent showering can be alleviated with special, gentle care products for sensitive skin. A visit to the doctor is recommended if the skin has suddenly become greasy and the symptoms cannot be alleviated by washing. If seborrhea is treated quickly and specifically, the symptom can be eliminated quickly and reliably. In addition, in order to prevent oily skin after successful therapy, the causes must be treated.
Prevention
A general prevention is not possible. However, those who tend to have oily skin or sweat a lot must make sure that they cleanse and care for their skin regularly. It is important that skin-neutral substances are used in the process. In many cases, care with clear water is sufficient.
What you can do yourself
Seborrhea, i.e. the overproduction of skin oils by the sebaceous glands, is often considered merely a cosmetic problem, especially in the form of seborrhea oleosa, which is associated with oily skin and greasy hair. The possibilities for therapeutic influence on the usually particularly severely affected areas on the forehead, nose and chin are considered to be small. Pharmacies offer a range of medicinal and cosmetic creams and ointments that have an astringent effect and are supposed to reduce skin shine. It is also helpful to use mattifying toner or mattifying powder. Special products are available in pharmacies and drugstores that reduce skin shine for hours. In natural medicine, attempts are made to treat the problem causally. Recommended here is often a “blood purification” with nettle tea or an intestinal cleansing followed by several weeks of therapeutic fasting. A number of medicinal herbs are also used, in particular field horsetail, dock, birch, blackberry, watercress, bear’s garlic, buttercup, horehound, chamomile, burdock, agrimony, blackthorn, waterthorn, chicory and wormwood. The herbs are used in different ways. Some herbalists recommend preparing a decoction or alcoholic tinctures to apply to the skin. Steam baths are also said to be effective, with salt water or chamomile tea being used in particular. Treatment with apple cider vinegar is considered to be particularly effective. For this purpose, organic apple cider vinegar is mixed with water in a ratio of 1 : 1 and then the affected skin areas are rubbed with it.
