Seborrhoeic dermatitis

As Seborrheic Eczema or Seborrheic dermatitis or Crohn Unna a skin rash ( dermatitis) is called, which occurs especially on the scalp and face and is usually associated with flaking. The special shape of the rash in the newborn is known under the popular name of Grind or head gneiss and is often confused with cradle cap or equated with this.

• 7.1 Hair Shampoos 7.1.1 criticism

Epidemiology

The disease often occurs in infants aged less than three months. In addition, the seborrheic dermatitis occurs mainly between 20 and 40 years of age. This affects about 1-5 % of the total population, men are more likely than women. Women are affected preferentially in menopause.

Symptoms and complaints

The result is a skin rash (often with yellowish scales), the scalp ( gneiss) and adjoining areas, the skin around the nose, chin, eyebrows, eyelids and can affect the skin around the ears. In severe cases, may be affected and the sternum and the back along the spinal column. A severe itching may occur, but also completely absent.

Consequences and complications

By scratching the weakened skin can be injured and ignite addition and bleed. The affected area may affect cosmetically very much, but usually heal without scarring.

Causes

The pathogenesis of seborrheic dermatitis is not fully understood.

According to estimates, about half of all people have a genetic predisposition for the disease. But that does not mean that they actually become ill.

The state of the central nervous and immune system seems to be of importance. The Seborrheic dermatitis occurs in large amounts in Parkinson's disease and in AIDS patients; in the latter case up to 80% are affected.

Stress factors seem to play a role.

Sweating, atmungsinaktive clothing or occlusion due to unsuitable, ie oily skin care products promote the symptoms.

It is believed that the rash is a response to metabolic products of the yeast Malassezia furfur (previously called Pityrosporum ovale ). This actually harmless colonizers of human skin multiplies excessively in those affected and so reached clinical significance.

Diagnosis by exclusion

It is initially exclude the typical trigger for various fungal infections. These antifungal agents are used in the treatment of seborrheic dermatitis initially locally used.

• Skin fungi

Bifonazole, clotrimazole, econazole, isoconazole and antimycotic sertaconazole act.

• Yeast

It come from fungal diseases that affect deeper skin layers. These are also diseases caused by yeasts in which they are opportunistic pathogens. Octopirox = Piroctone olamine acts antifungal, antibacterial and anti-inflammatory in addition.

• Molds

Molds are also opportunistic pathogens. They are also treated with Piroctone olamine.

If symptoms continue, a systematic treatment is required.

Specific treatment

When pronounced findings and frequent recurrences will make use of systemic antifungal agents.

A cure in the true sense is not possible because there is a strong genetic component. However, it can be achieved long symptom-free periods. The treatment of seborrheic dermatitis occurs locally in the first place.

Pimecrolimus

The externally applied immunomodulator pimecrolimus is effective against the inflammatory response and, studies have shown an improvement of seborrheic dermatitis. It is recommended in combination with lithium succinate and zinc sulfate as a therapeutic measure.

Tacrolimus

The externally applied immunomodulator tacrolimus has been shown in studies of improvement of seborrheic dermatitis, which in addition to anti-inflammatory and fungicidal activity against Malassezia furfur could be detected.

Corticoids

Glucocorticoidhaltige creams are a treatment option that provides fast relief with respect to the symptoms of seborrheic dermatitis. If they are only applied for a short time, the side effects to be limited. Longer- term (eg months, or more than 14 days in a row ) or uncontrolled use of such preparations may have undesirable consequences, especially for the treated skin have.

Pansy (Viola tricolor)

Pansy exerting anti-inflammatory, antioxidant and cortisone- like. The efficacy in eczema could be confirmed in animal experiments, it is rated to treat mild seborrheic skin diseases positive. During the flowering season between May and August, the aboveground growing plant parts are collected and further processed to the drug. The application can be done internally and externally as a tea infusion, also exist shampoo and skin oil as a finished product. Adverse reactions, contraindications and sensitization are not known.

Skin Care

All options a Kontaktdermatose must be excluded. For this purpose, the laundry needs to be changed daily. Heat from the iron destroys most pathogens of opportunistic mycoses.

Hair shampoos

Hair shampoos with active ingredients ciclopirox olamine, selenium disulphide and Piroctone olamine as a contact poison against yeasts are immediately useful.

In milder cases help anti-dandruff shampoos, such as zinc pyrithione.

Shampoos with the active ingredient salicylic acid are recommended. Thus, the horny layers are softened and easier to exfoliate ( rub off dead skin layers). The same effect has also the home remedies apple cider vinegar.

Criticism

Shampoos offered in hairdressers and in drug stores do not require proof of efficacy. This also applies to cosmetic products from pharmacies. The mechanisms of action are not usually described. The preparations available in pharmacies as medical devices have been tested in clinical trials.

Washings

Washing the skin with a solution of vinegar or vinegar-based cleaner with salicylic acid and lower the pH of the skin and reduce the reproduction of mycelia. The required especially for yeasts pH is lowered so that at pH = 5, so that the fungal mycelia are damaged.

Regular cleaning of the affected areas with water and gently scrub with a washcloth can reduce visible flaking.

Regular washing with saline or a gentle scrub with basic salts, the pH value is raised again above pH = 5, this can be useful only after a successful diagnosis of exclusion. If successful, the symptoms may completely fade away after a short initial aggravation.

Cosmetic creams and lotions

Cosmetic products ( eg creams) containing the active ingredient Urea (urea, not to be confused with uric acid) show depending on the severity also successes. They help to alleviate acute conditions or to allow decay without further medication.

The subsequent use of buffered creams or lotions (citric acid buffer) can mitigate the discomfort and soften.

Prevention

Regular visits to the sun are the healing of the symptoms very beneficial, even UV radiation ( especially in winter) is recommended by many doctors. The reason for this is that the UV radiation inhibits the growth of the yeast Malassezia furfur, which is suspected as the cause of the rash.

With a very short haircut ( thus more air and sun comes to the affected areas ) and by frequently washing your hair at least every two days, the symptoms can be alleviated.