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| Dandruff (seborrheic dermatitis)
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This
information is not meant to replace your physician and is simply
provided as a free educational service to our visitors. If you feel
that you have a skin problem, please consult with your physician.
Seborrheic dermatitis is a common chronic skin condition affecting the
scalp and areas of skin where oil glands are abundant. In its mildest
variety, called "dandruff", it affects the scalp and shows mainly
shedding of scales with itching. More severe varieties include a
troublesome oiliness of the hair and scalp, sores, greasy scales,
crusts, and pimples in the scalp. Other areas of the skin can be and
are often affected. Here we see the condition on areas of the forehead
near the hairline, the eyebrows and the eyelid margins, the sides of
the nose, in and around the ears, the central chest, belly button, and
genitals.
The cause of seborrheic dermatitis is not well understood. It is not
contagious nor due to any infectious agents. There is some relationship
between this condition and a skin disease called psoriasis. In fact,
some individuals with severe cases of seborrheic dermatitis are later
found to have psoriasis. The production of flakes of skin which shed
from the scalp is a normal condition, as is the production of oil from
the oil glands. For some reason, the over production of either or both
of these materials is found in most cases of this condition.
Whenever there is a lot of oil and scale on the skin or scalp, the
bacteria and yeasts which are normally present on skin surface have
more nourishment and thrive. In the same way that when a horse eats hay
changes the hay and produces a waste product, surface organisms produce
changes in the oil as they "eat" it and the flakes of skin. These waste
products are an irritant to the skin and it become itchy, red and
inflamed. The skin tries to get rid of this irritant in two ways: it
makes more oil as if attempting to "wash away" the irritation and it
increases the rate of skin production attempting to "shed off' the
irritant. This adds more nourishment for the bacteria and yeasts and
actually makes the condition worse. Unless you do something to decrease
this oil and scale production or to remove them, the bacteria and
yeasts from the area the condition will persist.
Hormones also play a role in this condition. Since the amount of oil
flow is controlled by changes in certain hormones, any circumstance
that affects these hormones can make seborrheic dermatitis worse. Such
things as nervousness, stress, normal control pills and aging changes
are factors here.
Unfortunately, there is no way to totally stop the condition forever.
The treatment of this condition is directed at the control of
troublesome symptoms. As long as the treatment program is followed,
most patients achieve improvement and control. The cornerstone of scalp
treatment is frequent washing with shampoos to mechanically remove
scale and oil, bacteria and yeasts. The medications in shampoos also
put chemicals on the scalp to slow the growth rate of bacteria and
yeasts as well as to loosen scales and slow down their rate or
formation. Because certain hair styles may be difficult to maintain
with the frequency of washing needed to keep the condition under the
best control, when an individual decides that cosmetic needs are more
important than the treatment recommendations, they should recognize
that they will get less than ideal treatment results. The use of most
cosmetics, hair dressings, sprays, scalp oils, conditioners, dyes or
rinses for the scalp may cause more problems to diseased scalp than
help. It is recognized that people will use these items - but
recommended that anything that is greasy or will occlude the scalp be
avoided
TREATMENT IS FOR CONTROL, NOT FOR CURE. AS THE CONDITION ALLOWS,
TREATMENT CAN BE REDUCED TO THE LEAST AMOUNT OF MEDICATIONS AND
SHAMPOOS THAT KEEPS YOU COMFORTABLE. BUT WHEN SYMPTOMS ONCE MORE
INCREASE, YOU WILL HAVE TO RESUME MORE INTENSIVE TREATMENT.
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