What is seborrheic dermatitis?

From the Guidelines

Dermatitis seborreica debe ser tratada con medicamentos antifúngicos tópicos para reducir la cantidad de levadura presente y medicamentos antiinflamatorios tópicos para reducir la inflamación y el picor. La dermatitis seborreica es una condición común que afecta las áreas con glándulas sebáceas, como las orejas, el cuero cabelludo, la cara central y otras áreas de la piel 1. Los síntomas incluyen escamas amarillentas grasosas, picor y inflamación secundaria causada por la levadura Malassezia.

Tratamiento

• Los medicamentos antifúngicos tópicos, como el ketoconazol, pueden ser efectivos en el tratamiento de la dermatitis seborreica 1.
• Los medicamentos antiinflamatorios tópicos, como los corticosteroides, también pueden ser utilizados para reducir la inflamación y el picor 1.
• Es importante mantener una rutina de cuidado de la piel regular con limpiadores suaves y evitar desencadenantes como el estrés y las temperaturas extremas.

Prevención

• La prevención de la dermatitis seborreica incluye evitar el uso excesivo de productos químicos en la piel y mantener una buena higiene 1.
• También es importante evitar el contacto con sustancias que puedan causar reacciones alérgicas, como los metales o los productos químicos 1.

From the FDA Drug Label

Seborrheic dermatitis: Ketoconazole Cream 2% should be applied to the affected area twice daily for four weeks or until clinical clearing. If a patient shows no clinical improvement after the treatment period, the diagnosis should be redetermined. For Dermatitis seborreica, also known as seborrheic dermatitis, the recommended treatment with ketoconazole cream 2% is to apply it twice daily to the affected area for four weeks or until clinical clearing 2.

From the Research

Definition and Symptoms of Dermatitis Seborreica

• Dermatitis seborreica, also known as seborrheic dermatitis (SD), is a common chronic inflammatory skin disorder that mostly affects young adults in areas rich in sebaceous glands, such as the scalp, face, and trunk 3.
• The clinical presentation of SD may range from mild patches to diffuse scalp scaling in adolescents and adults, while in infants, it mainly occurs on the scalp as yellowish, scaly patches ("cradle cap") 3.
• The characteristic symptoms of SD include scaling, erythema, and itching, which occur most often on the scalp, face, chest, back, axilla, and groin 4.

Causes and Triggers of Dermatitis Seborreica

• The exact causes of SD are not fully understood, but several environmental triggers are likely to promote its development, including fungal colonization by Malassezia spp., sebaceous gland activity, immunosuppression, endocrine, neurogenic, and iatrogenic factors 3.
• In children, early occurrence in the first trimester suggests the role of excessive sebaceous gland activity from maternal hormones, along with cutaneous microbiome alterations 3.

Diagnosis of Dermatitis Seborreica

• The diagnosis of SD is usually clinical, and specific laboratory and/or instrumental investigations are seldom required 3.
• The skin changes are thought to result from an inflammatory response to a common skin organism, Malassezia yeast 4.

Treatment of Dermatitis Seborreica

• Treatment of SD is aimed at modulating sebum production, reducing skin colonization by Malassezia spp., and controlling inflammation 3.
• Topical antifungal agents, such as ketoconazole, ciclopirox, and miconazole, are commonly used to treat SD, as well as anti-inflammatory agents, such as topical corticosteroids and calcineurin inhibitors 3, 5, 4.
• In severe and/or resistant cases, the use of systemic antifungal drugs, such as terbinafine and itraconazole, as well as UVB phototherapy, may be considered 3.
• Alternative therapies, such as tea tree oil, Quassia amara, and Solanum chrysotrichum, have also been reported 5.
• Oral fluconazole has been studied as a potential treatment for SD, but its efficacy is still uncertain 6.

Treatment Options for Specific Areas

• For mild-to-moderate scalp SD, topical antifungals, such as ketoconazole, ciclopirox, and miconazole, or anti-inflammatory agents, such as mild-to-moderate potency corticosteroids, can be used 3, 4.
• For facial or body areas SD, topical ketoconazole, ciclopirox, clotrimazole, mild-to-moderate potency corticosteroids, lithium succinate/gluconate, and topical calcineurin inhibitors can be used 3, 5.
• For infants with "cradle cap", baby shampoos enriched with emollient agents and vegetable oils, or medical device shampoos with anti-inflammatory and antifungal properties, can be used 3.