Dandruff begins with small scales on the scalp, which are formed due to a pathological acceleration of skin cell renewal.

Dandruff is not a dangerous disease, but it brings discomfort and various social inconveniences. But the most interesting thing is that it is caused by a fungus, or rather pityrosporum ovale.

The principle of dandruff

Human skin performs a protective barrier function. The first to suffer from the negative influences of the external environment is the epidermis, which consists mostly of the stratum corneum and has a complex structure.

The stratum corneum has a unique structure, which is called brick and mortar (“cement and brick”), the role of “bricks” is given to horny cells, and intercellular lipids act as “cement”.

Thanks to a natural process, involuntary rejection of horn cells occurs from the skin surface every day. When changing items of clothing and while walking, hundreds of thousands of scales form around a person.

So, in one minute there are up to 20 thousand scales around a person. Over the course of a year, over 100 grams of scales are rejected from every square meter.

If the stratum corneum is damaged and the integrity of the skin barrier is compromised due to the action of internal and external factors, then an adaptive reaction appears, which manifests itself in the form of accelerated separation and an increase in the volume of stratum corneum cells.

In the normal cell development cycle, basal keratinocytes from the lower layer of the epidermis reach the stratum corneum in 25–30 days. During this period, keratinocytes dry out and become keratinized.

In the case of an accelerated process within 5-14 days, individual cells that have not had time to lose water stick together and peel off like yellow-white flakes or scales, called dandruff. It is the first sign of seborrhea.

Fungus and dandruff

In the 60s of the last century, scientists proved the importance of the role of a yeast-like fungus called Malassezia in the appearance of dandruff.

About 90% of the world's population have these fungi as part of the temporary or permanent microflora of the skin. In 1984, a group of scientists proved that it is the fungus Pityrosporum ovale that is the main causative agent of the process that results in dandruff.

First, good conditions arise on the scalp for the growth of the fungus Pityrosporum ovale, it multiplies and grows, accelerating the separation of epidermal cells that are not yet fully mature and not completely dehydrated. The cells stick together to form scales called dandruff.

Mycelium of the fungus pityrosporum ovale around the hair

Dandruff in its classic form is a collection of gray or white scales on the surface of the scalp. Sometimes it can turn into a severe form - seborrheic dermatitis.

This form of the disease is characterized by severe peeling and the appearance of hyperkeratotic plaques on the skin of the scalp.

With seborrheic dermatitis, the skin has a pronounced red color and itches much more. Drug treatment is required.

Mycelium of the fungus pityrosporum ovale

Dandruff may first appear during puberty, when the sebaceous glands begin to work most actively.

After puberty, dandruff can be a problem at different stages of life. There are many reasons for dandruff, but it is not contagious.

In addition, dandruff occurs due to the active formation of sebum, including that caused by diet or hormonal changes.

Seborrhea of ​​the scalp

Treatment of dandruff and its severe form - seborrheic dermatitis - is an activity that is relevant for many people. Modern cosmetics - lotions and shampoos - effectively combat dandruff.

The technologies used, which are presented in anti-dandruff medicinal products, can effectively combat these skin disorders.

Among the variety of topical antifungal drugs, you should choose those that accumulate in the affected layers of the skin, and those that have a keratoregulating and anti-inflammatory effect.

Anti-dandruff products

Anti-dandruff shampoos must contain one or more active ingredients:

• ichthyol,
• ciclopirox,
• ketoconazole,
• zinc pyrithione,
• clotrimazole,
• selenium disulfide,
• sulfur,
• tar,
• salicylic acid.

These substances have an active effect on the main algorithms for the formation of dandruff. The number of microbes that contribute to the appearance of dandruff is reduced by means such as selenium disilphide and climbazole.

If dandruff appears as a result of some physiological changes in the body, for example, against the background of puberty and post-puberty, or it is sporadic, then you need to use shampoos that are recommended for daily and constant use.

It is best if the shampoo contains zinc pyrithione. This substance does not dissolve in the air and remains on the surface of the skin after washing your hair. Zinc pyrithione dissolves over time when interacting with sebum and sweat glands, which creates an inhibition zone for fungi that form dandruff.

Treatment of dandruff with the use of special means lasts an average of 3-6 weeks.

If dandruff on the head appears constantly and is recurrent in nature, and the person is over 20 years old, then when choosing a medicinal shampoo, you need to take into account the nature of the dandruff.

The scales may accumulate densely and densely, be greasy and not fall off the skin surface. Dandruff can also be dry and easily detachable from the surface of the skin. A change in the normal state of the microbial biocenosis of the skin may be the result of a pathological process in the organs of the gastrointestinal tract.

In particular, dysbiosis, fermentopathy, and exacerbation of chronic gastrointestinal diseases can be distinguished. That is why it is important to conduct a high-quality clinical and laboratory study, which will be able to determine the main biochemical parameters. Sometimes it is necessary to perform a stool test for dysbacteriosis.

When treating dandruff, it is necessary to use drugs that improve lipolysis processes.

For example, the administration of methionine normalizes the synthesis of phospholipids from fats, and also reduces deposits of neutral fat in the liver, improves the synthesis of creatinine, adrenaline, and also activates the action of hormones and enzymes, such as vitamin B12, ascorbic and folic acids. Riboflavin has an effect on the redox process, due to the participation of the vitamin in fat, protein and carbohydrate metabolism.

If a person is malnourished, this is a factor in the appearance of dandruff and seborrhea. A deficiency in omega-3 fatty acids further increases the problem. however, with such a “diet” any type will flourish simply.

You need to eat foods that contain a large amount of omega-3 fatty acids 2 times a week. These are walnuts, flaxseed oil and, of course, fish, especially halibut, salmon and salmon. A moderate lack of zinc can be one of the reasons for weak immunity, and this also increases dermatitis. Meat contains a large amount of zinc, as do pecans, cashews, almonds, chick peas, cereals and some yogurts.

Dandruff also appears from a constant lack of vitamin B6. A medium-sized baked potato or banana provides 35% of the daily value of vitamin B6. A lack of vitamin B12 in the diet also leads to scalp problems; vitamin deficiency is especially common in vegetarians.

With correct diagnosis and an integrated approach to the treatment of dandruff, the problem of this type of dermatosis can be solved as quickly as possible.

Dandruff prevention and hair hygiene

You should wash your hair as often as necessary to feel clean. Therefore, if this feeling often disappears, you can wash your hair every day. The shampoo should be chosen taking into account the hair type, avoiding “family” options and “2 in 1” shampoos.

Cosmetics are applied only to the scalp, the hair shafts are washed with flowing foam. The shampoo should not be left on for longer than three minutes, unless otherwise stated in the instructions for use. The foam is thoroughly washed off with water; its temperature should be close to body temperature. After three minutes, the hair is rinsed with cool water.

After shampooing, it is important to apply a mask or conditioner to your hair. These cosmetics have a slightly acidic reaction, which means they neutralize the negative effects of shampoos. In addition, with the help of these agents, the lipid protective barrier is restored.

After washing your hair, it is best to apply not only balm, but also tonic. Serums, tonics and lotions are needed to carry out the process of restoring skin balance and normalizing the functioning of the sebaceous glands. Such cosmetics prevent the formation of dandruff and create additional nutrition for the hair follicles. More accurate and complete information can be obtained from the article - on our portal.

After washing your hair, you should not try to dry your hair by wiping it dry with a towel - this is harmful to both your hair and scalp. You should only lightly dab wet hair with a towel.

If you wash your hair every day, then once a week there is a so-called “fasting day”. The head is washed with egg yolk, which is well mixed in warm water. The hair is first thoroughly washed in running water, and then rinsed with water and lemon juice or table vinegar. This rinse has a balm-like effect.

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Pityriasis versicolor (syn.: versicolor, pityriasis versicolor, pityriasis furfuracea) is a fungal skin disease characterized by damage to the stratum corneum of the epidermis. The causative agent of this disease is the fungus Pityrosporum orbiculare or P. ovale. However, the question of whether both of these forms represent one organism at different stages of its development or are separate species has not been fully resolved. It is currently accepted that both micromorphological varieties P. orbiculare and P. ovale represent different stages in the life cycle of the fungus. Moreover, its oval shape - P. ovale - is more often found on the skin of the scalp, and its round shape - P. orbiculare - on the skin of the body. The correct taxonomic identification of the lipophilic yeasts causing this disease is still a matter of debate. Some scientists prefer the name Pityrosporum orbiculare, while others prefer Malassezia furfur. Thanks to molecular technologies, 10 species of the genus Malassezia have now been identified. Ogunbiyi A. O. and George A. O. (2005) identified the most common Malassezia species: M. furfur, M. symboidalis, M. obtusa, M. globosa, M. restricta, M. slooffiae and M. pachydermatis.

As a result of their analysis, it was established that the cause of pityriasis versicolor in humans is most often M. globosa. Hort W. et al. (2006), having examined 112 patients diagnosed with seborrheic dermatitis, atopic dermatitis, lichen versicolor and AIDS, found that these patients had various types of Malassezia fungi. According to the authors, M. globosa was the most pathogenic species and was more often recorded in HIV-positive patients and patients with lichen versicolor. In the group of patients with seborrheic dermatitis, along with M. globosa, M. sympodialis was isolated.

The issue of the contagiousness of the fungus has been discussed in the scientific literature for quite a long time. Previously, it was believed that transmission of infection occurs either through direct contact with a sick person or through contaminated underwear. This observation was based on the high prevalence of this disease among individuals in the same family. However, it has now been proven that lichen versicolor is not contagious, and a genetic predisposition to the development of keratomycosis has been established: known cases of familial disease are explained by similar skin type in family members who are related by blood.

The causative agent of lichen versicolor is isolated from 10-15% of the population, and 2 times more often in men. The disease mainly develops between the ages of 15 and 40 years. This mycosis is characterized by deterioration in the summer, cases of spontaneous recovery are possible. In some patients, the disease becomes chronic and prone to relapse. However, in most cases, P. orbiculare (ovale) exhibits its pathogenic properties only in adolescence. P. orbiculare (ovale) is a lipophilic fungus, so the intensity of skin colonization is related to the function of the sebaceous glands. In particular, in children under 5 years of age the fungus is not detected at all, while in 15-year-olds it is detected in 93% of cases. Further, with age, the percentage of detection of P. orbiculare decreases, which once again confirms the assumption of a relationship between the presence of the fungus and the functional activity of the sebaceous glands. The primary location of keratomycosis is the mouth of the pilosebaceous follicles; here the fungus multiplies, forming colonies in the form of yellowish-brown dots. Fungi concentrate around the sebaceous glands, using their secretions as a source of fatty acids necessary for their growth and development. Increased air humidity also contributes to the pathogenicity of the fungus, as evidenced by the high prevalence of lichen versicolor among the population of tropical and subtropical countries. Thus, the incidence rate in temperate climates is 2%, in tropical and subtropical climates - up to 40% of cases.

Being a yeast-like fungus, P. orbiculare has many of the qualities inherent in this group of fungi. In particular, the disease develops when a saprophytic form is transformed into a pathogenic one under special, favorable circumstances. The development of the disease is promoted by: increased sweating, seborrhea, decreased physiological peeling of the skin, decreased nutrition, and pathology of internal organs. Lichen versicolor is a unique marker of diabetes mellitus, tuberculosis, rheumatism, and AIDS. In these diseases it is found in 52-63% of patients. If pityriasis versicolor develops against the background of tuberculosis, lymphogranulomatosis and other diseases accompanied by sweating, there are no age restrictions and clinical signs of this dermatosis can be observed at any age. The literature described a case of lichen versicolor diagnosed in a three-month-old child with leukemia.

In recent decades, hematogenous infections caused by M. furfur have been observed; they are described in weakened and immunosuppressed patients, especially after organ transplantation, as well as in neonatal children receiving lipids through a central venous catheter.

The presence of cross-reacting antigens in P. orbiculare with fungi of the genus Candida provokes the development of allergic reactions of immediate, immunocomplex and delayed types. Studies conducted by various authors have proven that one of the main risk factors for the formation of complicated forms of atopic dermatitis at an early age in children is the predominance of fungi of the genus Malassezia. The addition of an associated fungal infection changes the clinical picture of atopic dermatitis, which is characterized by a more severe course, widespread process and resistance to traditional therapy. According to the observations of Mayser P. et al. (2000) in patients with P. orbiculare colonization on the scalp and neck, specific IgE antibodies were more often recorded than in patients with localization on the skin of the trunk. In addition, the author found that patients with Malassezia more often complained of diffuse hair thinning.

There is evidence to support the role of P. orbiculare in the development of seborrheic dermatitis. As a result of their vital activity, these fungi break down sebum triglycerides into free fatty acids, and these, in turn, are the direct cause of dermatitis on the surface of the skin, but this assumption still requires proof. In particular, an experimental model of seborrheic dermatitis was obtained by rubbing a P. orbiculare culture into the skin of subjects. Subsequently, regression of experimental dermatitis was noted under the influence of various antimycotic drugs, which confirmed the etiological role of P. orbiculare in seborrheic dermatitis. Moreover, if normally the microflora of the scalp contains 46% of this fungus, then with dandruff it consists of 74% of them, and with seborrheic dermatitis the number of fungi reaches 83%.

It must be remembered that seborrheic dermatitis associated with P. orbiculare (ovale) may be the single earliest manifestation of AIDS. According to foreign authors, from 30% to 80% of patients with HIV infection have seborrheic dermatitis, compared to healthy young people in whom this dermatosis was diagnosed only in 3-5% of cases. AIDS-associated seborrheic dermatitis is characterized by resistance to therapy and papular rashes resembling psoriasis.

Clinical picture of the disease. The onset of the disease is characterized by the appearance of yellowish dots confined to the mouth of the hair follicles. The primary morphological element is a pink-yellow spot, gradually changing to brown-yellow, on the surface of which there are pityriasis scales. The elements are characterized by peripheral growth and, subsequently, fusion into larger lesions with scalloped edges. With a long course of mycosis, the lesions can occupy large areas of the skin. Over time, the color of the lesions can vary from white to dark brown, this served as the basis for the second name for lichen - multi-colored. The surface of the rash is covered with pityriasis-like scales, which are hardly noticeable upon superficial examination, but when scratched, peeling easily occurs (Beignet's symptom). Since the favorite localization is confined to the “seborrheic zones,” the upper half of the body and the scalp are affected. Additional diagnostic criteria are, well known to doctors, the Balzer iodine test and a golden-yellow or brownish glow under a Wood's lamp, as well as detection of the pathogen by microscopic and cultural studies.

A feature of the clinical picture of pityriasis versicolor is the presence of pseudoleukoderma. Scientists have divided opinions about the causes of uneven skin coloring in this dermatosis. Some researchers believe that P. orbiculare (ovale) inhibits tyrosinase activity during the oxidation process, which leads to a decrease in melanin synthesis and is clinically manifested by the occurrence of true leukoderma. According to other authors, the loosened stratum corneum on the lesions prevents the penetration of ultraviolet rays into the depths of the epidermis. Therefore, after removing the scales during water procedures, the affected areas become lighter than the surrounding healthy skin.

As a rule, diagnosis is not difficult, but there are several points that the practitioner needs to pay attention to. Firstly, in individuals who received treatment and were irradiated with ultraviolet rays, the Balzer test will be negative. Secondly, identifying lesions on the scalp is of practical importance: if the doctor does not pay attention to this localization of keratomycosis, then there is a high probability of relapse. To diagnose lesions on the scalp, a Wood's lamp is used (the lesions have a greenish-yellow, yellowish-brown or brownish glow). Thirdly, pinkish-brown spots are barely noticeable on white skin, so they are often ignored when examined, but in the summer, if you have a tan, they become more noticeable. And the last nuance: in people without immune deficiency, isolated spots do not exceed, as is known, 1-1.5 cm in diameter, but with severe immunodeficiency they can reach 5 cm in diameter. In this case, not only a disseminated character is noted, but also rich pigmentation and infiltration of elements of multi-colored lichen. In patients with AIDS, lichen versicolor more often manifests itself as seborrheic dermatitis, less often as atopic dermatitis and multiple folliculitis in areas of the skin with symptoms of vasculitis and a necrotic component.

The atypical course of lichen versicolor has been described by various authors. The rarest manifestations of lichen versicolor include lesions on the skin of the soles. In the domestic literature, such localization is reported by V. M. Rukovishnikova (1999), who in her monograph refers to the observations of V. P. Zhirkova (1977) of a 16-year-old boy with hyperhidrosis, who, along with rashes of multi-colored lichen in typical places (chest , back, neck, face) there were foci of mycosis on the soles. A pronounced torpidity of the lesions of this unusual localization was noted. Even after four months of treatment, non-inflammatory brownish spots of irregular shape and outline remained on the heels and in the transitional fold from the toes to the sole.

Differential diagnosis of pityriasis versicolor is carried out with syphilis (with syphilitic roseola and leucoderma). The diagnosis of syphilis is confirmed by positive results of classical serological tests (CSR), Treponema pallidum immobilization test (TPI), and immunofluorescence test (RIF). In addition, roseola in secondary syphilis has a pinkish-livid tint, disappears with diascopy, does not peel off, does not fluoresce in the light of a fluorescent lamp, and the Balzer test is negative.

In syphilitic leukoderma there are no confluent hyperpigmented spots and micropolycyclic edges. Syphilitic roseola is characterized by a predominant localization on the trunk and upper extremities, which determines some similarity in the clinical picture, however, with syphilitic lesions there is no tendency to growth and fusion of elements. The roseola spot is of vascular origin, there is no peeling, it is not accompanied by subjective sensations, the Balzer test is negative.

Lichen versicolor should be distinguished from pink lichen of Zhiber, in which erythematous spots are acutely inflammatory, round or oval in shape, with a peculiar peeling in the center like “medallions”; there is a “maternal” plaque. The rashes are located symmetrically along Langer's lines. The edges of the central, flaky part of the plaque are surrounded by a collar of scales. Numerous secondary rashes are visible around the maternal plaque.

Pityrosporum folliculitis (Malassezia folliculitis) is an infection of the hair follicle caused by yeasts, the same ones that cause pityriasis versicolor. This disease is a separately located, sometimes itchy papulosquamous rash, localized mainly on the upper half of the body and shoulders. Pityrosporum folliculitis most often affects young and middle-aged people and women. Follicular occlusion appears initially, which is secondarily accompanied by increased growth of the fungus. Predisposing factors are diabetes mellitus, as well as taking broad-spectrum antibiotics or corticosteroids. The condition can appear on the forehead and mimic persistent acne. The clinical picture is represented by asymptomatic or slightly itchy dome-shaped follicular papules and pustules with a diameter of 2-4 mm. This dermatosis is more common in the tropics, where it manifests itself as follicular papules, pustules, nodules and cysts. A distinctive feature of Pityrosporum folliculitis is the absence of comedones, torpidity to therapy and localization in the forehead. According to Thomas P. Habiff (2006), very often patients with Pityrosporum folliculitis are mistaken for acne patients. According to the author, this disease should be suspected in young and middle-aged patients with follicular lesions located on the trunk and complaints of itching.

Treatment. Since this disease develops when the saprophytic form of the fungus is transformed into a pathogenic one under special, favorable circumstances, it is necessary, first of all, to identify the provoking factors. Lichen versicolor is a marker of diabetes mellitus, tuberculosis, rheumatism, and AIDS. Therefore, when examining a patient, it is necessary to conduct appropriate studies. Particular attention should be paid to persons who do not fall into the age category from 15 to 45 years. Often the development of a persistent clinical picture of pityriasis versicolor is caused by chemotherapy in cancer patients. As a rule, after completing the course of intensive treatment, such patients undergo spontaneous self-healing.

As mentioned above, pityriasis versicolor is characterized by damage to the surface layer of the epidermis - the stratum corneum. Therefore, treatment of keratomycosis should begin with external means. Medicines for the treatment of pityriasis versicolor can be divided into several groups:

Keratolytic agents;

Fungicidal preparations;

Products containing zinc pyrithioneate;

Combined means.

Therapy for lichen versicolor depends on the prevalence and location of the lesions. Previously, keratolytic agents were used in the treatment of this mycosis: 2-5% salicylic alcohol or an alcohol solution of resorcinol 2 times a day. Modern methods of therapy include fungicidal drugs from the azole group. It has been established that under the influence of antimycotic drugs, after 24 hours, dehydration and vacuolization of the cytoplasm in the fungal cell occurs, the cell wall clears, from which after 48 hours only a shadow remains. Therefore, specific antifungal treatment is often preferred over keratolytic drugs.

Considering the superficiality of skin lesions with keratomycosis, it is preferable to use fungicidal agents in the form of solutions (clotrimazole, bifonazole, ciclopirox, naftifine (Exoderil), terbinafine (Lamisil)) or econazole in powder form, sold under the trade name "Ifenek", which is applied to the affected areas of the skin and rub lightly. A more convenient form of using the drug is a spray (Lamisil, Thermikon). All antimycotic solutions for the treatment of pityriasis versicolor are prescribed 2 times a day for 1 week. Ketoconazole has higher activity against P. ovale, inhibiting its growth in concentrations 25-30 times lower than other antifungal drugs and several times lower than any systemic antimycotics. When topical forms of ketoconazole are applied to the skin, effective concentrations remain inside and on the surface of the epidermis for 72 hours after discontinuation of the drug, which is explained by the affinity of the drug for keratinized tissues.

Zinc pyrithione also has a direct antifungal effect. Today, the mechanism of therapeutic effects of zinc pyrithione is associated not only with cytostatic, but also with antifungal and antimicrobial effects. The effectiveness of drugs containing zinc pyrithione against yeast-like fungi has been studied by many authors. These drugs include Psorilom and Skin-cap, produced in two forms: spray and cream. In the future, these drugs can be used by patients as prophylactic agents at least once every 2 weeks. While inferior to ketoconazole, zinc pyrithione has superior antifungal activity to other drugs, including selenium sulfide and some imidazoles. In the last decade, zinc-based shampoos (Head and shoulders, Friederm zinc) have been widely used in the treatment of dandruff. Thus, the most effective drugs in the treatment of pityriasis versicolor are antifungal agents and zinc pyrithione.

When the scalp is affected by fungus, medicated shampoos containing fungicidal agents (Nizoral, Sebazol, Ducre Quelual DS, Ketoconazole) are used, which are prescribed daily with an exposure of 2-5 minutes for 7-10 days. Treatment with shampoos containing tar (Psoril) is effective in the presence of seborrheic dermatitis to eliminate such manifestations as infiltration, swelling, peeling, and erythema.

Combined preparations include shampoos: Node DS plus, which contains salicylic acid, climbazole, zinc pyrithione, and Keto plus based on ketoconazole and zinc pyrithione.

Systemic treatment is indicated for patients with advanced disease who do not respond to topical therapy or who experience frequent relapses. Intraconazole is prescribed at a dose of 200 mg 2 times a day for one day or 200 mg every day for 5 days. The drug is taken with food to improve absorption. Ketoconazole is taken in a dose of 400 mg once or 200 mg daily for 5 days at breakfast with fruit juice. Fluconazole is prescribed at a dose of 150 mg (2 capsules per week for 4 weeks or 2 capsules as an initial dose, repeated after 2 weeks). If the process resolves slowly, the course of systemic antimycotics can be repeated after 2 weeks. The patient is not recommended to take a bath for 12 hours after treatment, since abstaining from water procedures allows the medicine to accumulate in the skin. Some authors recommend changing clothes daily for one month to prevent relapses. Patients must accept that residual hypopigmentation, as a consequence of pseudoleukoderma, lasts for quite a long time.

In the treatment of Pityrosporum folliculitis, one should adhere to the same principles as in the treatment of pityriasis versicolor, but it is preferable to combine systemic ketoconazole (200 mg daily for 4 weeks) with external antifungal agents.

Literature

Skin Diseases: Diagnosis and Treatment / Thomas P. Habiff; lane from English; Under general ed. acad. RAMS, Prof. A. A. Kubanova. M.: MEDpress-inform, 2006. 672 p.

Skin and sexually transmitted diseases: Handbook / Ed. O. L. Ivanova. M.: Medicine, 1997. 352 p.

Mokronosova M.A., Pyzh V.V., Kashaeva O.V., Reznikov O.V. Therapeutic effect of activated zinc pyrithione in patients with atopic dermatitis / eczema syndrome with sensitization to yeast-like fungi // Russian Journal of Allergology. 2004, No. 3. P. 83-87.

Moshkalova I. A., Mikheev G. N., Sokolovsky E. V. et al. Blistering dermatoses. Psoriasis. Modern methods of treatment. St. Petersburg: Sotis, 1999. 133 p.

Potekaev N. N., Novikov A. G. Multi-colored lichen. A modern look at an old problem // Russian Journal of Skin and Venereal Diseases. 2004, No. 2. P. 42-45.

Rukovishnikova V. M. Mycoses of the feet. M.: MSD, 1999. 317 p.

Sukolin G.I. Seborrheic dermatitis: new in etiology and treatment // Russian Medical Journal. 1998; 6: 382-384.

Khabib O. N. Mycoses of smooth skin // Consilium Medicum, 2002, volume 2, no. 4.

Khaertdinova L. A. Medical and social aspects of atopic dermatitis in children complicated by secondary infection. Author's abstract. dis. ...cand. honey. Sci. 2006. 22 p.

Aljabre S. H. Intertriginous lesions in pityriasis versicolor // J Eur Acad Dermatol Venereol 2003? 17(b): 659-662.

Crespo-Erchiga V., Florencio V. D. Malassezia yeasts and pityriasis versicolor // Curr Opion Infect Dis. 2006; 19 (2): 139-147.

Christian Schnake S., Hector Gutierrez B., Marcos Saez G., Mario Becker C. Tinea versicolor. Pitiriasis versicolor en lactantes menores Rev // Chil. Pediatr. 1988, 59 (1); 50-52.

Darling M. J., Lambiase M. C., Young R. J. Tinea versicolor mimicking pityriasis rubra pilaris // Gutis. 2005; 75 (5):265-267.

Gemmer C. M., DeAngelis Y. M., Theelen B., Boekhout T., Dawson Jr. T. L. Differentiation of three biotypes of Malassezia species on human normal skin. correspondence with M. globosa, M. sympodialis and M. restricta // Mycopathologia. 1999; 145 (2): 69-74.

Hort W., Nilles M., Mayser P., Edward M., DeSimone R. Ph. Common Superficial Fungal Infections // US Pharmacist. 1999, 24 (4).

Mayser P., Gross A. IgE antibodies to Malassezia furfur, M. sympodialis and Pityrosporum orbiculare in patients with atopic dermatitis, seborrheic eczema or pityriasis versicolor, and identification of respective allergens // Acta Derm Venereol. 2000; 80 (5): 357-361.

Naseri M., Namazi M. R. Fast, noninvasive method for molecular detection and differentiation of Malassezia yeast species on human skin and application of the method to dandruff microbiology // J Clin Microbiol. 2002; 40 (9): 3350-3357.

Nematian J., Ravaghi M., Gholamrezanezhad A., Nematian E. Isolated scalp involvement with pityriasis versicolor alba (pityrias versicolor albus capitis) in a patient from a dry, temperate region // Dermatol Online J. 2003; 9 (3): 17.

Nenoff P., Haustein U. F. Effect of anti-seborrhea substances against Pityrosporum ovale in vitro // Hautarzt, 1994, v. 45 (7), p. 464-467.

Ogunbiyi A. O., George A. O. Pityriasis versicolor: Current concepts in Aetiology and Management // Niger Postgrad Med J. 2005; 12 (3): 183-188.

Parry M. E., Sharpe G. R. Seborrhoeic dermatitis is not caused by an altered immune response to Malassezia yeast // Br. J. Dermatol. 1998; 139: 254-263.

Schoepfer C., Carla H., Bezou M. J. // Arch. Pediatr. 1995. Vol. 2, No. 3. P. 245-248.

Silverberg N. B., Sidbury R., Mancini A. J. Childhood molluscum contagiosum: experience with cantharidin therapy in 300 patients // J Am Acad Dermatol. 2000; 43:503-507.

Shuster S. The aetology of dandruff and the mode of action of therapeutic agents // Br. J. Dermatol. 1984; 111: 235-242.

Tarazooie B., Kordbacheh P., Zaini F., Zomorodian K., Saadat F., Zeraati H., Hallaji Z., Rezaie S. Study of the distribution of Malassezia species in patients with pityriasis versicolor and healthy individuals in Tehran, Iran // BMC Dermatol. 2004; 4:5.

Thoma W., Kramer H. J., Mayser P. Pityriasis versicolor alba // J Eur Acad Dermatol Venereol. 2005; 19 (2): 147-152.

Wikler J. R., Nieboer C., Willemze R. Quantitative skin cultures of Pityrosporum yeasts in patients seropositive for the human immunodeficiency virus with and without seborrhoeic dermatitis // J. Am. Acad. Dermatol. 1992; 27: 37-39.

Yu. A. Gallyamova,Doctor of Medical Sciences, Associate Professor

GOU DPO RMAPO, Moscow

Seborrheic dermatitis (seborrheic eczema, seborrhea) - causes, symptoms, treatment, reviews. Diet for seborrheic dermatitis

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

What is seborrheic dermatitis?

Seborrheic dermatitis ( seborrhea, seborrheic eczema) is called inflammation of the skin in the areas where the sebaceous glands are located, which in most cases is chronic and tends to worsen in spring or autumn.

This disease can appear at any age, even in infancy. According to statistics, men are more likely to suffer from seborrhea. The prevalence of seborrheic dermatitis is about 2-5% among the world's population.

The most characteristic areas of localization of foci of seborrheic dermatitis are:

• nasolabial folds;
• eyebrows and brow ridges;
• area above the lip;
• cheekbones.

But any sebaceous glands can be involved in the pathological process, so sometimes foci of seborrheic dermatitis can occur in other areas of the face.

Dermatitis of the scalp

Seborrheic dermatitis of the scalp initially manifests itself in a dry form, which is accompanied by the appearance of dandruff. At the next stage of the disease, areas of redness appear on the scalp, which is accompanied by unpleasant sensations and itching.

When scratching, bleeding wounds can form on the scalp, which, when a secondary infection occurs, fester. The hair quickly becomes greasy, especially the root part, and the patient begins to notice that he has to wash his hair more often in order to keep his appearance neat.

Next, milky or yellow plaques appear on the areas of inflammation, which gradually grow. Plaque scales can be barely noticeable and stick together with sebum and the scalp. When such scales are scraped off, an inflamed area of ​​red skin is revealed on the head.

With the progression and long-term course of seborrheic dermatitis of the scalp, hair loss increases, and in some cases, areas of baldness of various sizes appear.

When the inflammatory process subsides, hair growth in these areas usually resumes.

Treatment of seborrheic dermatitis

Treatment of seborrheic dermatitis is carried out by a dermatologist and other specialists (gastroenterologist, endocrinologist, gynecologist, etc.).

Treatment of scalp dermatitis

Treatment of dermatitis of the scalp is carried out comprehensively:
1. A diet is prescribed (it is recommended to introduce foods rich in zinc, vitamins A, B, C and PP, and selenium into the diet).
2. It is recommended to use an antifungal drug (Nizorex, Mycozoral, Sebazol, Nizoral, Ketoconazole, Dermazol, etc.) in the form of a cream, gel or shampoo.
3. Antifungal antiseptics are prescribed (tar soap, zinc paste, quassia bitter extract, tea tree oil, etc.).
4. Traditional medicine recipes can be used.

Along with this treatment, therapy is carried out for the underlying disease, which contributes to the development of seborrhea. As far as possible, predisposing factors (stress, hypothermia, poor nutrition, etc.) are eliminated.

Shampoos for seborrheic dermatitis
The modern cosmetology and pharmacological industry produces a wide range of shampoos for the treatment of seborrheic dermatitis: Nizoral, Ketoconazole, Skin-cap, Squafan S, Sulsena, Cynovit, Kelual DS, Friederm Zinc, Danex, etc.

These tools help:

• reduce the number of fungi on the surface of the scalp and hair;
• reduce the amount of sebum produced;
• remove the formed scales;
• inhibit cell division and scale formation.

All of the above properties of good shampoos for seborrhea are guaranteed by the presence in their composition of active components that have antifungal, cytostatic, moisturizing and anti-inflammatory properties.

The main active components of antiseborrheic shampoos:

• ketoconazole 1-2% – has an antifungal effect, used 2 times a week, contraindicated until 12 years of age;
• ciclopirox 1-1.5% – has an antifungal effect, used 1-2 times a week;
• selenium sulfide – has a destructive effect on the fungus;
• zinc pyrithione – eliminates inflammation, affects fungus;
• medical tar – inhibits the growth of fungi and the formation of scales, eliminates inflammation and flaking of the scalp.

As a rule, medicated shampoos are prescribed for 2-4 weeks. The frequency of their use may vary depending on the severity of symptoms. In some cases, it is recommended to use two medicated shampoos (for example, one containing an antifungal drug, and the other with zinc).

Antiseborrheic shampoos should not contain substances that contribute to skin irritation. These include: parabens, aromatic fragrances, aggressive surfactants (SLESS, SLS), etc.

Treatment of facial skin dermatitis

Treatment of seborrheic dermatitis of the facial skin is also complex. In addition to eliminating the cause of dermatitis, therapy for this disease includes a number of general recommendations for normalizing nutrition and changing the facial skin care regimen.

Features of facial skin care:

• Do not use aggressive foams and soaps for washing.
• To cleanse the skin, use special gels or milks that contain components with antiseptic, antifungal and anti-inflammatory properties (for example, ketoconazole, tea tree oil, salicylic acid, zinc, selenium, lithium salts, witch hazel extract, quassia bitters, etc.) .
• Do not use lotions and tonics containing alcohol.
• The use of ointments and creams containing hormonal components is possible only under medical supervision.

Medical cosmetics
Therapeutic cosmetics for seborrheic dermatitis should be selected individually and used in courses that can be prescribed both for the treatment of the disease and for its prevention.

The most effective medicinal cosmetics are: Quasix gels and creams; Sebovalis line from Sesderma; cleansing gel Uriage DS Gel Nettoyant; Bioderma; Sensibio product line; Tsindol and Tsinocap.
Drug therapy
Treatment of seborrheic dermatitis can be carried out according to various schemes, using various pharmacological drugs.

Tablets:

• antibacterial drugs (Doxycycline, etc.);
• antihistamines (Citrine, Loratadine, Telfast, etc.);
• multivitamin and mineral complexes (Alphabet, Multitabs, Perfectil, Merz dragees, vitamin A, B 2 and C, nicotinic acid).

Medicinal ointments and creams:

• antifungal ointments (Nizoral, Mycospor, Bifisam, Ketodin, Lamisil, etc.);
• hormonal ointments (Elocom, etc.);
• immunostimulants (Tacolimus, Elidel, Protopic, Pimecrolimus).

The doctor may also prescribe medications to normalize the functioning of the digestive system and treat other concomitant diseases. When seborrheic dermatitis affects the skin of the eyelids and the development of blepharitis or conjunctivitis, rinsing the eyelids and eyes with antiseptic solutions and using antibacterial eye ointments and drops are used.

Physiotherapy
Physiotherapeutic treatment methods are also included in the complex therapy of seborrheic dermatitis. For this, patients are prescribed the following procedures:

• darsonval;
• UV irradiation;

Folk remedies for treating dermatitis

Traditional recipes used to treat seborrheic dermatitis are aimed at eliminating itching, inflammation and increasing general and local immunity. There are many recipes for internal and external use that significantly alleviate the course of the disease and improve the appearance of the skin.

Traditional recipes for the external treatment of skin seborrhea
St. John's wort decoction
Brew one tablespoon of dry St. John's wort herb in 200 ml of boiling water, let it brew. Wash your face with the resulting decoction or rinse the affected area of ​​skin with a napkin soaked in the decoction 2-3 times a day. The product helps get rid of inflammation and serves as a good preventive measure for secondary infections.

Oak bark decoction
20 g of dry bark is poured into 200 ml of water and kept in a water bath for about half an hour, filtered and used for rinsing or applying to lesions of seborrheic dermatitis. The product helps relieve itching and reduce inflammation.

Oil solution with calendula tincture for the treatment of oily seborrhea of ​​the face
Mix 10 teaspoons of calendula alcohol tincture with 1 teaspoon of castor oil. Rub the resulting mixture into the lesions of seborrheic dermatitis 1-2 times a day.

The same remedy can also be used to treat dry seborrhea - in such cases it is necessary to mix calendula tincture and castor oil in equal proportions.

Birch bud decoction
Pour 5-6 pieces of birch buds into 200 ml of hot water and boil over low heat for about 15 minutes, cool and strain. This decoction can be used for washing, applying, rinsing the scalp, preparing pieces of ice for wiping areas of dermatitis and performing medicinal baths (to prepare a bath, you need to add 2 cups of decoction to it).

Traditional recipes for the external treatment of seborrhea of ​​the scalp
Walnut shell tincture
Collect unripe nuts, extract the contents, dry the shells and grind them in a coffee grinder. 100 gr. pour the resulting raw material with a liter of vodka or 40% alcohol, close the container and leave in a dark, cool place for about 2 weeks. Rub the resulting tincture into the areas of seborrhea on the scalp.

Garlic and nettle mask
Grind the peeled garlic into a paste, add an equal amount of crushed nettle leaves, mix and apply to areas of seborrhea or baldness caused by it. Apply the mask for 20 minutes, then rinse with warm water or a decoction of birch buds, burdock leaves or chamomile infusion.

Oak bark decoction and honey to get rid of dandruff
Mix oak bark decoction and honey in equal proportions (if there is no allergic reaction to bee products). Rub the resulting mixture into the scalp an hour before washing your hair. After just 10 such procedures, the amount of dandruff will be significantly reduced and the itching will be reduced.

Ointment based on golden mustache juice and olive oil
Mix in a ceramic bowl a tablespoon of juice from golden mustache leaves, baby cream and olive oil, add 1 teaspoon of valerian alcohol tincture. Apply the resulting ointment to the scalp affected by dermatitis an hour or two before washing your hair. This product helps eliminate itching and inflammation, accelerates the healing process of scratches and nourishes the skin.

Kombucha infusion
To use this product, you need to infuse the kombucha solution for a month. The resulting solution is rubbed daily into the areas of the scalp affected by dermatitis.

Dry food mustard
Wash your hair with mustard powder (instead of shampoo) 2 times a month.

Traditional recipes for seborrheic dermatitis for internal use
Blackcurrant bark infusion
Pour one tablespoon of bark into 200 ml of boiling water and leave in a warm place for about 8 hours. Take the resulting infusion 1 tablespoon 5 times a day.

Infusion of soothing herbs and hawthorn and rose hips
Mix valerian roots, mint herb, hawthorn and rose hips in equal proportions. Pour 200 ml of boiling water over a tablespoon of the mixture and leave in a thermos overnight. Take the infusion 2 times a day, 100 ml.

It is best to discuss the duration of use of a particular prescription with your doctor.

Seborrheic dermatitis in children

Symptoms

Seborrheic dermatitis in infants
Dermatologists distinguish three degrees of severity of this disease:

• I (mild form)– rash and gneiss (crusts) are located on the scalp, sometimes behind the ears, on the forehead and cheeks, but the general condition of the child is not disturbed.
• II (medium-heavy)– the rash and gneiss spread to the body and limbs, the child becomes easily excitable; he may experience diarrhea and frequent regurgitation.
• III (severe)– 2/3 of the skin surface is covered with hyperemic, edematous areas of rash and gneiss. A secondary infection occurs, which causes weeping and suppuration; the child is lethargic or restless, eats poorly and does not gain weight; diarrhea is observed.

Seborrheic dermatitis in infants begins to manifest itself as early as 2 or 3 weeks of life. The child develops elements of a rash on the scalp and, in rare cases, on the forehead, in the folds behind the ears and on the cheeks. After a short period of time, gneiss appears on the rash areas, which is formed due to the accelerated desquamation of epithelial cells and their impregnation with sebum.

Such areas of rash and gneiss can also be localized in natural skin folds on the surface of the body. They are rarely accompanied by itching and present as a maculopapular rash that is covered with greasy scales. Typically, areas of seborrheic dermatitis in infants do not become wet.

If treatment is not started in a timely manner, these areas of gneiss can grow and spread to any part of the body, but most often they are localized specifically on the scalp or in the baby’s perineal area. When a secondary infection occurs, pyoderma may develop, accompanied by the release of exudate and painful sensations that provoke restless behavior in the child.

With nutritional correction and timely therapy, the disease responds well to treatment, and its symptoms disappear either at 6-8 weeks of life, or by 7-8 months of age (sometimes by 1 year).

Seborrheic dermatitis in children over one year of age
Seborrheic dermatitis in older children has symptoms similar to the manifestations of this disease in adults.

In areas of the skin with a large number of sebaceous glands (scalp, nose and nasolabial folds, forehead, cheeks, back and chest), a rash of papular-squamous nature appears. After a short period of time, the rash becomes covered with scales stuck together with fat. When the top layer is removed, areas of inflammation and redness are found on the skin. Foci of dermatitis may be subject to secondary infection with the subsequent development of pyoderma, otitis media, blepharitis and other infectious complications.

Like seborrhea in adults, this disease in older children can occur in liquid and thick form (i.e., dry and oily seborrheic dermatitis in children is distinguished). A characteristic feature of this disease in children is its chronic course with periods of exacerbation, which can be provoked by various predisposing factors (stress, exacerbations of chronic infections, immunodeficiency states, poor nutrition, etc.).

Treatment

Treatment of seborrheic dermatitis in children under one year of age
Seborrheic dermatitis in children under one year of age responds well to treatment and, in some cases, can disappear on its own by 6-8 weeks of the child’s life. To treat it, it is recommended to strictly follow the rules of hygiene and use products that help destroy fungi and prevent the addition of a secondary infection.

In the absence of an allergic reaction to medicinal herbs, daily baths and hair washing using decoctions of chamomile, sage and calendula are recommended. After this, mineral or olive oil is applied to the foci of seborrheic dermatitis, which helps to gently remove the crusts and has a beneficial effect on the baby’s skin.

After hygiene procedures, it is also recommended to apply Bioderma Sensibio D.S. cream to areas of the skin of the face, torso and limbs affected by seborrheic dermatitis.

If a secondary infection occurs, the doctor may prescribe the use of antibacterial solutions for the hygiene of affected areas and the application of antimicrobial ointments and creams.

In severe cases of seborrheic dermatitis in children under one year of age, the following may be prescribed: vitamin therapy, immunostimulants, antifungal and hormonal ointments, antibacterial drugs, and physiotherapeutic procedures.
dandelion, burdock, etc.);

correction of diet;

physiotherapeutic procedures (darsonval, UV, laser therapy, cryotherapy).

If necessary, consultations with specialists of a narrow profile (gastroenterologist, endocrinologist, gynecologist, etc.) can be prescribed. The duration of treatment and dosage of drugs are prescribed by the doctor individually.

Seborrhea and seborrheic dermatitis: symptoms, causes, treatment - video

Diet for seborrheic dermatitis

Successful treatment of seborrheic dermatitis in any form of this disease largely depends on the patient following a proper diet. This is explained by the fact that the consumption of certain foods promotes the growth of fungal flora and changes the chemical composition of sweat and sebum.

That is why from the diet should be excluded some products and dishes:

• alcoholic drinks;
• hot, smoked, spicy and marinated dishes;
• products containing quickly digestible carbohydrates (flour and confectionery products, sweet drinks, jam, rice, semolina, pasta);
• fatty and fried foods;
• allergenic foods (honey, nuts, citrus fruits, eggs, strawberries, etc.).

Eating other foods helps normalize digestion and metabolic processes and speeds up recovery from seborrheic dermatitis.

Useful products that must be included in the diet for seborrheic dermatitis:

• lean meats (veal, pork, white meat chicken, turkey, rabbit, lean fish);
• dairy products (natural fermented milk products, cottage cheese, low-fat cheeses, if tolerated well, you can drink whole milk);
• baked and boiled vegetables (pumpkin, zucchini, cabbage, asparagus and broccoli are especially useful);
• berries (gooseberries, cranberries, white cherries, red and black currants, watermelon, etc.);
• vegetable oils (sunflower and olive).

Patients with seborrheic dermatitis should pay close attention to sufficient consumption of drinking water.

In some cases, the doctor may recommend keeping a food diary, in which the patient will record their diet and reflect the severity of symptoms. Analysis of such a diary allows you to eliminate from the diet those foods that contributed to the exacerbation of symptoms and achieve a faster recovery.

Seborrheic dermatitis is an inflammation of areas of the skin where sebaceous glands are developed. Most often, the disease occurs in men, adolescents during puberty and infants. Seborrheic dermatitis affects 2–5% of the total population.

Seborrheic dermatitis in the photo

Seborrheic dermatitis of the scalp. Photo 1.

Photo of seborrheic dermatitis before treatment

Photo of seborrheic dermatitis after treatment.

Seborrheic dermatitis on the scalp and sebaceous glands

The secretion of the sebaceous glands is a mixture of lipids and is called sebum. It is necessary for the healthy functioning of the skin: moisturizing it, maintaining elasticity, creating an antimicrobial protective barrier.

The skin is covered unevenly with sebaceous glands; there can be from 4 to 380 ducts per 1 cm2. They lie in the middle layer of the skin - the dermis, between its papillary and reticular layers. The largest number of sebaceous glands are located in the so-called “seborrheic zones”: on the skin of the face and body (back, neck, scalp, pubis, chest, abdomen, shoulders, forearms, legs). There are no sebaceous glands on the skin of the soles and palms.

For the most part, the ducts of the sebaceous glands open at the mouths of the hair follicles. In smaller numbers, the excretory ducts open directly onto the surface of the epidermis - in the area of ​​the eyelids, borders of the lips, external auditory canal, nipple halos, and anus.

The size of the glands and the amount of lipid secretion depends on various factors: the functioning of the endocrine, nervous, reproductive systems of the body, age. In young children, the sebaceous glands secrete very little secretion. By adolescence, their work increases sharply, but as they grow older, their activity decreases. In adult men, sebum is constantly secreted in approximately the same amount; in women, this process is often associated with the menstrual cycle. In old age, the amount of secretion released decreases.

Seborrheic dermatitis. Varieties

Oily seborrhea is the most common type of disease. It is characterized by increased secretion of sebum and changes in skin microflora. With oily seborrhea, redness of the skin or small reddish papules with an oily sheen and clearly defined boundaries are observed. Oily seborrhea, in turn, is divided into thick and liquid, depending on changes in the composition of the skin secretion (see photo of seborrheic dermatitis).

With liquid seborrhea, the level of free fatty acids in sebum increases. The skin of the face becomes shiny, rough, with enlarged pores. Comedones and acne easily form on it. If liquid seborrhea affects the scalp, the hair looks very dirty and sticks together in strands.

With thick seborrhea, there is a decrease in the level of lower fatty acids and an increase in higher fatty acids in the sebum. An imbalance in the composition of skin secretions reduces its protective properties and provokes the proliferation of microorganisms. Externally, thick seborrhea can manifest itself as pustular rashes, dilation of the mouths of the ducts of the sebaceous glands, comedones, and the separation of large yellowish scales glued together.

Dry seborrhea - often observed in young children, as they produce an insufficient amount of skin secretion. In adults, the dry form of seborrheic dermatitis occurs less frequently. It is characterized by a decrease in sebum production, dryness, cracks and excessive flaking of the skin, a feeling of tightness that intensifies after contact with water. The hair on the head becomes thinner, brittle and split. In some cases, the scales layer on top of each other, forming crusts. Acne, pink and red spots appear on the skin.

Mixed seborrhea - characterized by the simultaneous appearance of dry seborrheic dermatitis on the scalp and oily seborrheic dermatitis on the face.

Seborrheic dermatitis. Symptoms

Seborrheic dermatitis can develop both in the head and torso. Seborrhea of ​​the scalp can manifest itself as inflammation of the scalp, eyebrows, eyelashes, hairline, nasolabial folds, external auditory canals and the area behind the ears. In men, it is often localized in the area of ​​beard and mustache growth.

Seborrheic rash can also affect the chest and natural folds of the body: armpits, groin, abdomen, mammary glands. Seborrhea of ​​the face and body manifests itself as red spots, accompanied by itching and peeling, a burning sensation and even the appearance of papules, merging into ring-shaped or garland-shaped plaques. The plaques have clear boundaries, the papules are covered with fatty yellowish scales. As the disease progresses, bright yellow crusts appear on the skin, inflammation grows over a large surface area of ​​the skin, and a bacterial infection occurs.

Seborrheic dermatitis of the scalp is characterized by the detachment of whitish scales, which can be mistaken for large dandruff. However, unlike dandruff, seborrhea is accompanied by itchy skin, and the lesions are clearly visible. Many patients associate dry scalp with the appearance of “dandruff”, so they wash their hair less often. Unfortunately, such tactics, instead of the desired result, only lead to the accumulation of seborrheic scales, the formation of dense crusts and pathological inflammation of the scalp and sebaceous glands. Refusal of treatment leads to thinning hair and baldness.

Seborrhea of ​​the scalp in infants usually appears at the age of 3 months. It consists of thick yellow crusts that can be easily removed with vegetable oil and does not bother children. However, the combination of skin rash with diarrhea and underweight in newborns requires urgent medical attention, as it may indicate the presence of such a serious disease as Leiner's erythroderma.

Seborrheic dermatitis. Causes

The main reason for the development of seborrhea is the effect on the skin of opportunistic yeast-like lipophilic fungi Malassezia furfur, which are present in varying quantities in most people. The oval form of the fungus (Pityrosporum ovale) is responsible for the development of inflammation of the scalp. Lesions on the skin of the body are caused by the round form of Malassezia furfur – Pityrosporum orbiculare. Fungi create colonies around the ducts of the sebaceous glands, feeding on lipid secretions and actively multiplying.

However, seborrheic dermatitis does not affect everyone. Thanks to the immune system, a healthy body inhibits the growth of fungi. If the body's metabolism is disrupted, Malassezia furfur begins to multiply uncontrollably, which breaks down sebum into free fatty acids, which causes inflammation.

The development of pathology can occur due to the following factors:

• puberty - due to hormonal changes in adolescents, the composition of sebum changes, and the sebaceous glands begin to work with greater intensity. In this case, the disease goes away on its own as the patient grows older;
• hereditary predisposition explaining the hyperfunction of the sebaceous glands;
• hormonal imbalance, in which there is an increase in the level of androgen and progesterone and a decrease in estrogen levels. Hormone-dependent seborrheic dermatitis is observed in women in menopause or with ovarian diseases, in men with testicular tumors, and in obesity;
• unhealthy diet with an abundance of spicy, salty and fatty foods;
• presence of bad habits (alcohol, tobacco smoking);
• infectious diseases, weakened immunity;
• stress and overwork;
• non-infectious diseases of the gastrointestinal tract, endocrine system and metabolism. Painful conditions are accompanied not only by increased work of the sebaceous glands, but also by excessive sweating and cardiac arrhythmia;
• psychological and mental diseases (for example, Itsenko-Cushing syndrome, schizophrenia, epilepsy, manic-depressive disorder), in which the functions of the pituitary gland and hypothalamus are disrupted.

But despite the extensive list of possible reasons, none of them are absolute. The exact reason contributing to the excessively active activity of Malassezia fungi has not yet been identified.

Seborrheic dermatitis. Diagnostics

To determine the presence of the disease, a dermatologist prescribes the following tests:

• examination of skin scales under a microscope to exclude other skin diseases (atopic dermatitis, psoriasis, microbial skin lesions, ringworm) and determine the causative fungus;
• blood test to determine hormonal status;
• skin biopsy if necessary.

Seborrheic dermatitis. Treatment and prevention

Since modern medicine currently cannot offer means to regulate the functioning of the sebaceous glands, treatment of seborrheic dermatitis is symptomatic.

In the acute period are prescribed antifungal drugs for internal use. The duration of treatment is determined by the doctor, but more often it lasts 1–2 weeks.

If the patient has seborrhea of ​​the scalp, shampoos with antimycotic components (ketoconazole, zinc pyriton, tar, naftalan oil) are prescribed. Special shampoos fight not only fungal infection, but also swelling, inflammation and itching.

Line of products Losterin

Designed for daily skin care in complex therapy of chronic skin diseases - psoriasis, eczema, atopic dermatitis.

Seborrheic dermatitis on the face requires close attention, as it is not only a medical problem, but also a serious cosmetic problem. During the entire treatment period, you must refrain from using cosmetics because they can cause irritation and an allergic reaction. Men suffering from seborrhea of ​​the facial skin are not recommended to shave with blades. Hair removal should be gentle - done once every 2-3 days with an electric razor. It is preferable to replace daily face washing with wiping the skin with special cleaning lotions designed specifically for people with skin diseases. Containing micellar water, lotions perform two functions - cleansing the epidermis and accelerating regenerative processes.

Therapy should be aimed at eliminating not only fungal activity, but also the inflammatory process, manifested by red spots and itching. For this purpose, gels and creams with sodium hyaluronate, zinc pyrithione, zinc-salicylic acid hyaluronate, and vitamin B5 are used.

After acute inflammation has passed, it is preferable to carry out therapy with products based on natural ingredients. Therapy is aimed at eliminating itching and flaking, as well as preventing the disease.

Therapeutic agents include vegetable oils (tea tree, flaxseed, olive, sunflower, almond), herbal decoctions, as well as tar and naftalan oil. In addition, patients are advised to use soap-free products for washing, as it disrupts the functioning of the sebaceous glands. For example, to treat seborrheic dermatitis on the head, you can use shampoo "Losterin" and for the body, choose shower gel of the same brand. These products do not contain soap, preservatives, dyes or fragrances. These preparations contain deresined naphthalan, burdock and Japanese Sophora root extract, and vegetable oils. Systemic use of these products reduces inflammation and flaking of the skin and relieves the symptoms of seborrheic dermatitis.

In some cases, hormonal medications may be prescribed. People with seborrheic dermatitis may benefit from following a special diet. It is not strict, but helps normalize metabolism. The diet is based on lean meat, fresh vegetables and dairy products. The patient is not recommended to consume fried, spicy, fatty, salty foods, carbohydrate foods, or alcoholic beverages during treatment.

Physiotherapy is also used in the treatment and prevention of seborrheic dermatitis. These include cryotherapy and cryomassage, magnetic and laser therapy of affected areas, darsonvalization (exposure to pulsed high-frequency currents) of the facial skin and scalp. In case of hormonal imbalance, inductothermy (exposure through a magnetic high-frequency field) of the adrenal glands can be used.

The environment also has a significant impact on the condition of the skin, especially in cases of seborrheic dermatitis. In hot and humid climates, the sebaceous glands produce more secretion, which creates better conditions for fungal growth. It is preferable to use dehumidifiers at home. Also, patients suffering from seborrheic dermatitis are not recommended to visit baths and saunas.

It is a chronic skin disease, usually manifesting itself in places where the sebaceous glands are localized. In most cases, seborrheic dermatitis affects the face, in particular the forehead, folds on the cheeks and nasolabial folds, chin, and scalp. Increased secretion of subcutaneous sebum and the harmful effects of microbes provoke skin inflammation and further development of pathology.

Note! Treatment of seborrheic dermatitis consists not only in the use of traditional and traditional medicine, but also in following the basic principles of proper nutrition.

What does seborrheic dermatitis look like?

The initial stage of the disease is characterized by inflammation of the skin, manifested in the form of redness and swelling in areas where the disease is localized, accompanied by burning and itching, and sometimes an increase in general body temperature. The development of pathology can be provoked by both mechanical damage to the skin and exposure to various types of irritants (chemical, temperature, animals, etc.).

Signs of the progression of the pathology are the appearance on the skin of bubbles (vesicles) filled with a transparent liquid substance. After the vesicles are opened, oozing forms in the affected areas.

Additional Information! Over the course of 7 days, the skin is able to secrete an average of up to 5 grams of sebum, which, together with sweat, forms a protective layer that protects the epidermis from premature drying and has antibacterial properties. It is for this reason that it is recommended to wash your hair no more than once every five days, since soap or other means for washing your hair destroys the protective water-fat layer, as a result of which the epidermis becomes more vulnerable and dries out much faster.

Causes of seborrheic dermatitis

Seborrhea occurs as a result of exposure to the fungus Pityrosporum, which is present on the skin of 90% of the population. The active growth of this infectious agent contributes to the development of pathology.

Based on their shape and location, there are 2 types of Pityrosporum:

• Pitysporum ovale (oval), its appearance is characteristic of the scalp;
• Pitysporum orbiculare (round), occurs on the epidermis of the trunk.

The most favorable soil for the development and growth of the yeast-like fungus Pityrosporum is the following factors:

• increased production of sebaceous secretions by the glands;
• general decrease in the patient's immunity.

In addition to Pityrosporum, there are many other factors, both external and internal, the presence of which predisposes to the manifestation of the disease.

What causes seborrheic dermatitis (internal factors):

• seborrhea can occur against the background of an endocrine disease;
• the presence of diseases of the nervous system can provoke the development of pathology;
• dermatitis, as a rule, affects patients with reduced immunity, as well as persons whose functional abilities of the immune system are impaired;
• epilepsy, infectious psychoses, encephalitis, schizophrenia and Parkinson's disease can also cause the disease, since these diseases are characterized by active work of the sebaceous glands, which is accompanied by increased secretion of sebaceous secretions;
• pathologies of the gastrointestinal tract (dysbacteriosis, gastritis, colitis, pancreatitis, ulcers, constipation, diarrhea, helminthic infestation).

External causes of seborrheic dermatitis:

1. genetic predisposition of the body to the manifestation of symptoms of the disease;
2. violation of diet, vitamin deficiency. Proper nutrition and vitamins for seborrheic dermatitis have a beneficial effect and provide a healing effect;
3. harmful effects of cold air flows, sudden changes in climatic conditions;
4. insufficient amount of zinc in the products consumed by the patient;
5. frequent exposure to stressful situations. Stress affects both directly and indirectly the functioning of the sebaceous glands. Overstrain of the nervous system activates their work, as a result of which the sebaceous secretion, which is the main source of vital activity of the yeast-like fungus Pityrosporum, is intensively produced;
6. abuse of detergents with chemical components, excessive use of personal hygiene products;
7. excessive use of hormonal drugs.

Note! Determining the cause of the development of pathology plays an important role during the fight against the disease, since its elimination in most cases leads to at least an improvement in the patient’s condition or to a complete cure of the disease.

Signs of seborrheic dermatitis and symptoms of the disease

Signs of the disease, such as redness of the skin and the appearance of vesicles, can appear behind the ear, in the mustache area, and on the chin. Most often, seborrhea appears on the scalp, in particular at the boundaries of hair growth, as well as on the eyebrows and eyelashes. If the location of the pathology is the torso, then, as a rule, the hairy area of ​​the chest is affected. Much less frequently, the disease affects the groin and axillary areas.

With seborrheic dermatitis, the symptoms are as follows:

• peeling of the epidermis, accompanied by the formation of scales. Over time, the inflamed areas begin to peel and itch, causing both physical and psychological discomfort to the patient. The cause of the burning sensation is the active activity of the infectious agent that provoked the onset of the disease;
• the appearance of rashes on the skin;
• inflammation of the skin, redness. At the initial stage of pathology development, red-pink spots with clear contours appear on the skin;
• hair thinning, partial loss.

The first stage of the disease is characterized by the appearance of crusts in areas of skin damage. Under the scaly crust, a layer of moist and red epidermis accumulates. The places of greatest peeling or the so-called seborrheic islands are nothing more than the epicenter of the disease, its focus. Most often, pathology develops in the eyes, eyebrows, lips and nose. The most vulnerable places in men are the chest, in particular the area under the hairline, and the head. It should be noted that the manifestations of the disease on the scalp have a rather unaesthetic appearance and cause increased discomfort.

The progression of the disease is associated with a continuous burning sensation in the places where it is localized. However, you should refrain from scratching the skin as this may only make the situation worse. As a result of such exposure, wounds appear on the skin.

Additional Information! If seborrhea manifests itself in the eye area, it is usually accompanied by the development of blepharitis, as a result of which the eyelids become inflamed and swelling appears. The crusts that appear eventually fall off and scars remain in their place.

Dermatitis in the ear area is especially dangerous. As a rule, the pathology spreads here from the scalp. First, the folds behind the ear become covered with red spots, then they become crusty. The disease can penetrate into the auricle and even reach the inner lining of the ear canal.

Note! In men who prefer to wear a beard, seborrhea appears more often, since the number of places where the disease is localized increases due to the areas under the hair on the chin and cheekbones.

Seborrhea in adults: types and forms of pathology

The disease affects patients of different age categories, both children, adolescents and adults. There are three types of pathology:

1. Dry seborrheic dermatitis. Typically, this type of seborrhea occurs in adolescent children whose puberty has not yet begun. The main signs of the disease include increased dryness of the skin and cracking;
2. Oily dermatitis. This type of disease typically occurs in liquid or thick form. The liquid form, characterized by increased sebum secretion in the area of ​​the nose and scalp, most often appears in teenage girls aged 14 years and older. Men and boys who have not reached the age of 20, as a rule, suffer from symptoms of a thick form of oily seborrheic dermatitis, which is characterized by the formation of acne and pimples;
3. Mixed. The mixed type of the disease, manifesting itself in several places, affects predominantly male patients. The main difference between this type is the presence of foci of both dry seborrheic dermatitis and oily seborrheic dermatitis on the patient’s skin. Thus, the scalp may be susceptible to the oily type of seborrhea, and the skin of the face may be dry.

Important! Regardless of the location of the disease and its type, the pathology requires treatment. Neglect of recommendations and nutritionists, as well as negligent attitude towards skin condition leads to complications and deterioration of health in general. In addition to the fact that the disease has an unaesthetic expression, if left untreated, it tends to develop and spread to other areas of the skin.

Treating seborrheic dermatitis with diet

• fried, fatty foods;
• smoked meats, pickles, vegetables prepared by pickling;
• fast food, semi-finished products;
• citrus fruits, mushrooms, fish roe.

Seborrheic dermatitis of the facial skin: symptoms and treatment of the disease

Diagnosing dermatitis on the skin of the face is not difficult. Signs of the disease are immediately noticeable because they have a pronounced character. Note! Treatment of a disease on the face is required not only to reduce symptoms, but also to prevent the pathology from spreading to other areas of the skin, for example, to the epidermis of the auricle or to the head.

The teenage period is one during which the risk of developing the disease is especially high, so parents should pay special attention to the skin condition of children of this age. The pathology is classified as skin infections, which manifest themselves quite painfully. The chemical composition of the sebaceous secretion changes and it can no longer be described as healthy.

The most common cause of seborrheic dermatitis on the face is:

• poor nutrition, irregularity;
• harmful effects of infection;
• excessive amounts of fat;
• gastrointestinal dysfunction, intestinal problems;
• thyroid diseases;
• lack of vitamins, reduced immunity.

Seborrhea of ​​the facial skin is a disease that requires mandatory treatment. According to the recommendations of dermatologists, the optimal period to combat the disease is summer, since it is at this time that the state of the immune system is most favorable for overcoming the disease.

Seborrhea (dermatitis) of the scalp

The head, namely the part of it that is under the hairline, is most often susceptible to seborrhea.

Additional Information! According to statistics, about 5% of the total world population suffers from seborrheic dermatitis on the head. The disease manifests itself in both adolescents and members of the older generation. Significantly less often, symptoms of pathology develop in infants, as well as children of preschool and primary school age, however, there are exceptions here. The risk of disease manifestation is inextricably linked with the formation of sebaceous secretion and its secretion, which is individual for each patient.

One of the fundamental causes of dermatitis on the head is dysfunction of the immune system. As a result of decreased immunity, pathogens that persist in the form of spores turn into pathogens, and their number is constantly increasing. The skin in the foci of the disease begins to peel off, and the sebaceous secretion is released in triple volume.

Seborrhea, how to treat ailment on the head:

• to prevent the development of the disease, the nutritionist prescribes a special diet for the patient, which involves eliminating junk food and introducing healthy foods into the patient’s daily diet;
• the use of external agents, such as shampoos with beneficial extracts and medicinal ointments, helps reduce the symptoms of the disease;
• the use of antifungal drugs, healing compresses and ointments, vegetable oils helps to destroy excess sebaceous secretions;
• Vitamins for seborrheic dermatitis in the den have a healing effect on the affected skin and on the entire body as a whole.

What treatment is required for seborrheic dermatitis of the skin?

Timely traditional treatment of seborrheic dermatitis and treatment with traditional medicine, as a rule, helps reduce the symptoms of the disease and achieve a significant improvement in the patient’s condition.

Traditional treatment for seborrheic dermatitis of the skin

Seborrheic dermatitis, how to treat:

1. tar-based shampoos. The product is quite effective in treating fungal deposits in case of infection of the scalp. Tar shampoos have both antifungal and anti-inflammatory properties, destroy most opportunistic bacteria;
2. salicylic acid (seborrheic dermatitis), which contains tar, zinc and other useful elements, allows you to achieve significant remission. In case of exacerbation of the disease, dermatologists recommend using the product almost daily;
3. preparations based on salicylic acid containing selenium and tar, for example, “Selenium-active”;
4. Treatment of the oily form of the pathology requires the use of combined detergents that have an antifungal and drying effect. In addition, shampoos of this kind relieve inflammation, help get rid of burning and itching;
5. medicated pastes, which are recommended to be applied after washing your hair (“Sulsena”);
6. antifungal and hormonal medications;
7. medicinal creams that have an immunostimulating effect (Protopic, Elidel).

Folk remedies for seborrheic dermatitis

Important! Independent use of healing drugs can provoke the development of pathology. To cure the disease, you need to follow the advice and recommendations of your doctor and adhere to a therapeutic diet.

Seborrheic dermatitis, how to cure it (folk recipes):

1. decoctions of medicinal herbs help dry the skin and relieve inflammation;
2. using tea tree oil you can destroy the fungus in affected areas;
3. Lemon juice will relieve burning and itching.

Treatment for seborrheic dermatitis is treatment not only with traditional remedies, but also with folk remedies. However, remember that questions such as how to treat seborrhea and how are within the competence of a dermatologist, so before using this or that remedy, you should consult with a specialist.

Important! To prevent the development of the disease, there is no need to overuse soap and other detergents. Men are advised to get rid of hair on the chin and mustache area, since hair is a favorable environment for the growth and development of pathogens.

Treatment of dermatitis involves a whole range of measures aimed at overcoming the disease. Both traditional methods and remedies, in particular medications, shampoos and ointments, as well as folk ones (decoctions, compresses, oils) help to get rid of the symptoms of the disease. In addition, the use of ultraviolet irradiation helps achieve remission. The patient also needs to pay special attention to clothing for daily use; it should be made from natural fabrics (cotton, linen) that do not cause irritation.

Video about seborrheic dermatitis