Adults And Older Children
Treatment of seborrheic dermatitis of the scalp should include shampooing at least twice a week, because less frequent shampooing enables proliferation of Malassezia. Antifungal shampoos are highly effective in controlling the dandruff of seborrheic dermatitis. Keratolytic shampoos and tar shampoos used daily or every other day until dandruff is controlled and twice/week thereafter are also helpful. If antifungals and keratolytics fail to sufficiently relieve pruritus, topical corticosteroid solutions are used. Although the scalp is one of the areas least susceptible to the adverse effects of topical corticosteroids , adverse effects can occur with long-term use, so topical corticosteroids should be used only as needed. Because seborrheic dermatitis tends to be chronic and often recurs with cessation of treatment, long-term use of antifungal shampoos is often required. Seborrheic dermatitis in beard and eyebrow areas is treated similarly to seborrheic dermatitis of the scalp. However, beard and eyebrow areas are more prone to the adverse effects of topical corticosteroids. Thus, corticosteroids should be used less frequently, and lower potency corticosteroid solutions should be used when possible.
How The Two Conditions Are Similar And Different
The similarities. Seborrheic dermatitis and psoriasis tend to be lifelong conditions. They can take an emotional toll too, especially when the patches are very noticeable. Both can often be managed. Psoriasis usually needs stronger medicines than seborrheic dermatitis.
Both can also flare. This happens when youâre exposed to certain triggers that are unique to you, like the weather or stress.
Neither condition is contagious. You canât pass it to someone or get it from someone. But both conditions can run in families. So having one can be in your genes.
The differences. Psoriasis is an autoimmune disease. That means your immune system is sending out faulty messages, and your body responds by growing skin cells too quickly.
Psoriasis plaques are itchy like seborrheic dermatitis, but they can also be painful. About one-third of people with psoriasis get a form of arthritis as the disease gets worse.
The scales on psoriasis plaques are thicker than those of seborrheic dermatitis, with more defined edges. Their color is closer to silver than the white or yellow of seborrheic dermatitis scales.
Clinical Presentation And Differential Diagnosis
Seborrheic dermatitis is characterized by the development of pruritic, erythematous patches with easily detachable, greasy large scales. Although it may appear in various anatomical locations, it tends to occur in areas that contain numerous sebaceous glands, such as the scalp, face, upper chest, and back . Seborrheic dermatitis of the scalp commonly presents as dandruff, a milder eruption, characterized by smaller dry, flaking scales. In HIV-positive individuals, the onset of the lesions may be sudden the lesion can be more widespread and recalcitrant with an associated discharge. When seborrheic dermatitis appears on the face, it tends to affect the lateral sides of the nose and nasolabial folds as well as the eyebrows and glabella.
Don’t Miss: Herbal Remedies For Scalp Psoriasis
How Is Psoriasis Treated
Psoriasis of the scalp may be harder to treat. Topical corticosteroids may help reduce inflammation and slow the growth of skin cells.
Psoriasis can also be treated with light therapy. Systemic treatment may be beneficial for stubborn psoriasis. This may involve injectable medications. It may take a combination of treatments to get psoriasis under control.
Who Gets Seborrheic Dermatitis
About 11% of the population has seborrheic dermatitis. It occurs most often in infants younger than three months old and in adults ages 30 to 60. It is more common in men than in women, and in Caucasians more than African Americans.
If you are born with naturally oily skin, you are more likely to get this type of dermatitis. A history of psoriasis in your family makes you vulnerable as well. If you live in a dry, cold region, the weather doesnt cause the seborrheic dermatitis, but it does make it worse.
If you have these health issues, youre more prone to seborrheic dermatitis:
Immunosuppressions:
Don’t Miss: Plaque Psoriasis And Rheumatoid Arthritis
Eczema: Red Itchy Irritated Skin
Like psoriasis, eczema is a chronic skin condition that often causes intense itching. Scratching causes redness and inflammation of the skin, leading to a worsening of the eczema. Scratching can also cause a secondary bacterial infection. The most common type of eczema is caused by a reaction to irritants like detergents, soaps, or household cleansers. So if you have eczema, you should be careful to use mild soap and regularly moisturize your sensitive skin. Your doctor may prescribe a steroid cream or other medications if eczema is severe.
Diagnosis And Treatment Of Seborrheic Dermatitis
GARY W. CLARK, MD, MPH, Madigan Army Medical Center, Tacoma, Washington
SARA M. POPE, MD, MPH, Puget Sound Family Medicine Residency Program, Naval Hospital, Bremerton, Washington
KHALID A. JABOORI, MD, Madigan Army Medical Center, Tacoma, Washington
Am Fam Physician. 2015 Feb 1 91:185-190.
Patient information: A handout on this topic is available at .
Seborrheic dermatitis is a common skin condition in infants, adolescents, and adults. The characteristic symptomsscaling, erythema, and itchingoccur most often on the scalp, face, chest, back, axilla, and groin. Seborrheic dermatitis is a clinical diagnosis based on the location and appearance of the lesions. The skin changes are thought to result from an inflammatory response to a common skin organism, Malassezia yeast. Treatment with antifungal agents such as topical ketoconazole is the mainstay of therapy for seborrheic dermatitis of the face and body. Because of possible adverse effects, anti-inflammatory agents such as topical corticosteroids and calcineurin inhibitors should be used only for short durations. Several over-the-counter shampoos are available for treatment of seborrheic dermatitis of the scalp, and patients should be directed to initiate therapy with one of these agents. Antifungal shampoos and topical corticosteroids can be used as second-line agents for treatment of scalp seborrheic dermatitis.
Don’t Miss: Best Lotion For Scalp Psoriasis
Seborrheic Dermatitis: Itchy Scaly Patches
A psoriasis skin rash tends to itch, burn, and feel sore. Patches of psoriasis commonly occur on your knees and elbows. Many people also have scalp psoriasis. The common skin rash seborrheic dermatitis also causes scaly, itchy skin patches. It can occur on your scalp, where it may be called dandruff, or on your face and chest. While doctors don’t know the exact cause of seborrhea, it occurs across the age spectrum, in babies as well as in adults, and is usually treated with creams and lotions.
How Is Seborrheic Dermatitis Diagnosed
Seborrheic dermatitis is an easy condition to diagnosis because of its appearance on the affected skin and where it appears on your body. No blood, urine or allergy tests are needed. Your dermatologist may perform a skin biopsy to rule out other diseases if your condition does not respond to treatment.
Recommended Reading: How Often Do You Take Humira For Psoriasis
Ringworm: Fungal Infections Of The Skin And Nails
Tinea is a type of fungal infection that resembles some symptoms of psoriasis. Psoriasis can cause the thick fingernails symptomatic of fungal nail infections, and both can cause red, itchy skin rashes. When tinea grows on your skin, it can cause a scaly, red skin rash that clears in the middle, called ringworm . Fungal infections of the skin and nails can be hard to treat. Antifungal medications work, but you may need to take them for a long time.
Sos: Is Sebopsoriasis Curable
There arent any tried-and-true cures for sebopsoriasis, psoriasis, or seborrheic dermatitis right now . Some people swear by essential oils, while others say its all about what you eat. But the jurys still out.
Though your dermatologist can help you treat, manage and prevent symptoms, you cant necessarily kick it for good. However, with the right maintenance regimen, you can help keep it under control.
With a professional, you can track your symptoms to determine the triggers for your condition, such as:
Also Check: Start Of Psoriasis On Elbow
What Is Sebopsoriasis Anyway
About 2 to 3 percent of people have psoriasis and at least 3 percent have seborrheic dermatitis. Both cause red or purplish , patchy scales. Unlike psoriasis though, seborrheic dermatitis can occur on the face, scalp, central chest area, and groin.
When a doc diagnoses you with both conditions, that means you have sebopsoriasis. It typically appears on the face or scalp in the form of red patches or plaques and yellow, greasy-ish scales.
Treatment Of The Seborrheic Psoriasis
To treat seborrheic psoriasis was the most effective, you need to use drugs recommended by a dermatologist.
Usually start with the use of an antifungal therapeutic shampoo containing ketoconazole or zinc pyrithione – daily for 10-14 days.
To soften and remove crusts suitable ointments: salicylic, tar, with urea. Thus, Keratolan ointment , which can be applied up to three times a day, copes well with squamous eruptions.
Reduce the intensity of hyperkeratosis ointments and creams containing vitamin D3 or its derivatives. For example, ointment Calcitriol is applied to the affected areas twice a day for one to three months.
Read Also: Can You Have Multiple Types Of Psoriasis
Getting The Right Diagnosis
As with any medical condition, seeking a proper diagnosis is critical to developing the right treatment plan. “The first and the most important part of caring for your skin condition is to get the right diagnosis,” says Dr. Shi. “Various skin rashes can often look similar and have very different treatment approaches. For example, some over-the-counter psoriasis treatments work by reducing skin thickness and scaling, and if used incorrectly on eczema skin, can actually cause an eczema flare.”
Dr. Shi says, “More often than not, people with these conditions may require a prescription strength medication. Therefore, it’s better to see a dermatologist to confirm the correct diagnosis and get an individualized treatment plan.” As each of the three conditions will fluctuate in severity over time, a treatment plan may require different approaches.
Cradle Cap: A Type Of Seborrheic Dermatitis
Many infants get cradle cap. This is a type of seborrheic dermatitis that develops in babies. Scaly, greasy patches form on the babys scalp. The patches can become thick and crusty, but cradle cap is harmless. Cradle cap usually goes away on its own within a few months.
Babies also get seborrheic dermatitis in their diaper area and elsewhere. In the diaper area, the red rash often is mistaken for diaper rash. A few babies get seborrheic dermatitis that covers much of the body with red, scaly patches.
No matter where the seborrheic dermatitis forms, it tends to permanently disappear between 6 months and 1 year of age.
Also Check: Vitamin D Cream For Psoriasis
Who Develops These Conditions
Anyone can get psoriasis of the scalp. Theres no way to prevent it. Its more likely to occur in adults who have psoriasis elsewhere on their body.
The exact cause of psoriasis isnt known, but it involves an overreaction of the immune system. It tends to run in families, so its likely theres a genetic link.
Anyone can get seborrheic dermatitis, too. However, males develop it more often than females. Some things that may play a role in developing seborrheic dermatitis include:
- a family history of seborrheic dermatitis
- oily skin
How Is Seborrheic Dermatitis Treated
Treatment may depend on the severity of your condition. Everyone responds differently to medication, so it may take a few tries to find the right solution for you.
For some people, dandruff clears up on its own. Over-the-counter shampoos and medication are usually enough to improve flaking and soothe itching. If not, ask your doctor about prescription-strength products.
In babies, cradle cap doesnt always require treatment. It generally resolves well before the first birthday. In the meantime, use a mild baby shampoo. Massage the scalp gently using a very soft brush. Be gentle breaking the skin can lead to infection. If youre concerned about your babys scalp, see their pediatrician.
Read Also: How Long Does It Take To Get Rid Of Psoriasis
How Do Health Care Professionals Diagnose Seborrheic Dermatitis
The diagnosis of seborrheic dermatitis is usually made clinically, meaning that the doctor recognizes it on the basis of its appearance. Occasionally, a scraping of skin scales treated with potassium hydroxide is examined using a microscope to exclude a fungal infection. A skin biopsy is rarely required for diagnosis.
What Is Seborrheic Dermatitis
Seborrheic Dermatitis is almost like a hybrid dandruff. All dandruff is a result of a fungus that builds up on the scalp. Overtime, this fungus can grow and spread into what is known as seborrhoea. This seborrhoea can also grow on other oil-producing glands like the face or chest.
Unlike more normal forms of dandruff, seborrhoea can cause extreme itching, discomfort, redness and inflammation. It is usually characterized by an oily type of flake that falls off the scalp and spreads into hair.
Recommended Reading: Beginning Stages Of Scalp Psoriasis
How Is Sebopsoriasis Diagnosed
Sebopsoriasis is diagnosed by its clinical appearance following a detailed history and examination. A skin scraping for mycology may reveal Malassezia, but this is not diagnostic, as the yeast is a normal component of skin flora .
Skin biopsy is rarely performed in sebopsoriasis. It shows histopathological features intermediate between psoriasis and seborrhoeic dermatitis.
In Babies: Cradle Cap
Cradle cap is seborrheic dermatitis that commonly develops in babies between 2 weeks and 12 months. You might notice red or dark, scaly or crusty yellow patches on their scalp. Or it could start in the face or diaper area and spread elsewhere. Itâs usually not serious and often goes away on its own in a few weeks. Talk to your doctor if symptoms worsen or lead to other problems like infection.
Also Check: Photos Of Plaque Psoriasis On Scalp
Epidemiology Of Psoriasis And Seborrheic Dermatitis In Children
According to the National Psoriasis Foundation, 125 million people worldwide have psoriasis including 8 million Americans. Its incidence varies and appears to be associated with genetic background and geographic area.
Most children who develop psoriasis are aged between 8 and 11 years, though the condition can appear at any age. The most important risk factor for early-onset psoriasis is a family history of the disease. Children who develop psoriasis can present with mainly cutaneous manifestations, but juvenile psoriatic arthritis does occur in the pediatric population. Children with other systemic inflammatory conditions, such as diabetes, asthma, or arthritis, are more likely to develop psoriasis. It is slightly more common in girls than in boys.
Image : Acute condition of Seborrhoeic Dermatitis on a shaved Scalp. by NetRoY. License: CC BY-SA 3.0
Seborrheic dermatitis is more common in children compared to psoriasis. The estimated prevalence of seborrheic dermatitis, regardless of the diseases severity, is around 20% of the general population. The peak of incidence of seborrheic dermatitis is usually seen in young children who have just reached puberty. The condition has an equal incidence in both sexes but is usually more severe in boys.
Infants who develop seborrheic dermatitis can present with cradle cap, flexural eruption, or erythroderma. These severe presentations are rarely seen in older children and adults.
Causes Of The Seborrheic Psoriasis
If you adhere to this interpretation, then the causes of seborrheic psoriasis are the same as the psoriasis itself, that is, the disease develops in the presence of appropriate endocrine, immune or neurologically mediated factors. However, according to the journal Clinical Dermatology, seborrheic psoriasis is simply a combination of seborrheic dermatitis and psoriasis, in which both diseases develop simultaneously and ordinary psoriasis on the head looks a little different, and foreign experts call it another way – sebopsoriasis or seborrheic-like psoriasis .
Indeed, the coexistence of psoriasis with seborrheic dermatitis is not uncommon, moreover, both diseases have even some symptomatic similarity, quite often causing problems with their differentiation when diagnosed. But, after all, how does psoriasis differ from seborrheic dermatitis?
First of all, each disease has its own causes, while the pathogenesis of psoriasis is not associated with any infectious agents. Details of why psoriasis can develop, what are the risk factors for its occurrence, and also the pathogenetic features of this disease, please read the special material fully devoted to this issue – Causes of psoriasis
But seborrheic dermatitis is associated with an abnormal increase in the production of sebaceous glands of the skin of the protective lipid secretion – sebum, which can have an allergic, hormonal or genetically determined etiology .
, , , , , ,
Also Check: How To Get Psoriasis Under Control
So How Do You Tell The Difference Between Psoriasis And Seborrheic Dermatitis
- Seborrheic dermatitis plaques are covered with yellower and oilier scales than psoriasis-type plaques
- Itching is less common in seborrheic dermatitis than psoriasis, although it can be severe in some patients. When patients have psoriasis on their body and seborrheic dermatitis on their face, it is referred to as sebo-psoriasis.
Diagnostics Of The Seborrheic Psoriasis
As already noted, the diagnosis of seborrheic psoriasis causes certain difficulties, especially in cases where the manifestation of psoriasis does not start with plaques on the elbows, but with the appearance of papulo-squamous eruptions on the head.
To diagnose seborrhoeic psoriasis, instrumental diagnostics – dermatoscopy, as well as laboratory examination of flakes and a sample of plaque tissue or spots are performed.
You May Like: Does Psoriasis Flare Up In Heat
How Do You Treat Psoriasis On Your Face
Because the skin on your face is more sensitive than other parts of your body, the treatment will most likely start out conservative. Your treatment plan will also depend on how severe your symptoms are and if you are experiencing psoriasis sores or plaques on other areas of the body.
Your healthcare provider will recommend using a quality moisturizer on your face, as dryness is a trigger for psoriasis symptoms. Other possible treatments include steroid creams, vitamin ointment, light therapy, and immune therapies.