Overview of seborrhoeic dermatitis.

  • Seborrheic dermatitis is a chronic skin condition that primarily affects areas with many oil glands, such as the scalp, face, and chest.
  • It often presents as red, itchy, and flaky patches on the skin.
  • The exact cause is not fully understood, but factors like genetics, hormones, and yeast overgrowth may contribute.
  • While it can occur at any age, it’s more common in infants (cradle cap) and adults between the ages of 30 to 60.
  • Seborrheic dermatitis is not contagious and is not related to poor hygiene.
  • Management typically involves medicated shampoos, creams, or ointments prescribed by a dermatologist.
  • Lifestyle changes, such as avoiding triggers like harsh detergents and stress, can also help manage symptoms.
  • While there is no cure, most patients can effectively control their symptoms and prevent flare-ups with proper treatment and care.

Signs and symptoms of seborrhoeic dermatitis

  • Seborrheic dermatitis varies in severity and appearance, taking on different looks depending on the skin type.
  • The skin may reveal redness and variations in pigmentation compared to surrounding skin, accompanied by yellow flaking on the surface.
  • It can be in isolated areas or cover a larger area, with common sites including:
    • Scalp: Ranging from mild flakiness and dandruff to inflamed skin with significant scaling and sometimes  weeping.
    • Face: Typically affecting the eyebrows, creases around the nose and cheeks, and occasionally leading to red, swollen, and flaky eyelids, known as seborrheic blepharitis.
    • Ears: Inflammation may occur within the ear canal, on the outer ear, and behind the ears, potentially leading to bacterial infections, oozing, and crusting; inflammation and flaking in the ear canal, known as otitis externa, can cause blockage.
    • Chest and between shoulder blades: this presents as well-defined, round, flat, occasionally pink or red (or darker in individuals with darker skin types) areas with yellow greasy scales.
    • Skin Folds: Seborrhoeic dermatitis often goes for moist areas like the skin under the breasts, in the groin, under the arms, or in skin folds on the abdomen, resulting in pink, shiny skin with surface cracks.

Diagnosis of seborrhoeic dermatitis

  • Diagnosis typically relies on a visual examination of the rash, and additional tests are usually unnecesaary.
  • Some tests we might do if needed are as follows:
    • Blood tests: Recommended if seborrheic dermatitis is severe, unresponsive to treatment, and there is a risk of HIV, as early HIV treatment improves patient health.
    • Skin scrapings: Conducted when scalp ringworm is suspected to detect tinea fungus (mycology).
    • Skin biopsy: In cases where differentiation from other rashes is challenging, a skin biopsy, involving the microscopic examination of a skin sample, may be done to confirm the diagnosis.

Seborrhoeic dermatitis treatments

Seborrheic dermatitis has no known cure, with treatment aimed at improving or clearing the skin; in babies, it often resolves naturally.

Treatment approaches for seborrheic dermatitis include general skincare practices and specific prescribed therapies.

General Measures:

  • Use mild, soap-free cleansers on the skin and affected areas during washing.
  • Apply a lightweight moisturizer post-washing to enhance the skin barrier.
  • Opt for non-comedogenic makeup products that do not clog pores.
  • Fruit consumption may help reduce flare-ups.

Antifungals:

  • Antifungal medications reduce yeast levels on the skin and are commonly used to treat seborrheic dermatitis.
  • Antifungal creams and shampoos, such as clotrimazole, miconazole, ketoconazole, and nystatin, can be prescribed for long-term use.
  • In cases of widespread or treatment-resistant rashes, oral antifungal medication may be recommended.

Anti-inflammmatories:

  • Short-term application of mild topical corticosteroids (creams, gels, ointments, or scalp lotions) can be useful. Topical calcineurin inhibitors, (steroid sparing treatments), can be used for longer durations under medical guidance.
  • For thick, scaly areas, especially on the scalp, treatments containing coconut oil and salicylic acid are useful to soften and remove scales. These treatments enhance the penetration of other therapies and should be used before applying them.

FAQs

What sort of appointment should I make?

Your first appointment should be a 30 minute ‘skin diagnosis and treatment’  appointment. Subsequent appointments can usually be 15 minute follow up appointments.

Can I claim for my appointment on insurance?

You need to speak to your insurer prior to your appointment. Some insurers will reimburse you for the appointment, but you will need to present any documentation at the time of your appointment for the doctor to sign. Please note that all our doctors are registered with the GMC on the GP register not the consultant register. Please ensure you make this clear to your insurers at the outset.

How it works

From the moment you book your appointment to post-treatment care, we’re here to support you.

  • Booking your appointment
    With Oxona, there’s no need for a referral and you can book your appointment online, over the phone or by email. All appointments require a pre-paid deposit due at the time of booking.
  • Consultation
    Our specialists will give you the time you need to discuss your problem, making sure you are truly heard. Your questions will be answered with understanding and impartial advice, so you feel ready to make an informed decision.
  • Treatment plan
    Our treatment plans are based on you as an individual, rather than off the shelf. Taking into account your symptoms, medical history and any anxieties, we’ll explore all available options and respect your decisions.
  • Aftercare
    Your care doesn’t end after your treatment. Our team are on hand to offer free post-operative support, and to answer any questions about your treatment plan.
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New clinic opened in Didcot on Monday 15 April to meet additional demand.