Therapeutic Update on Seborrheic Dermatitis

I. Stefanaki, MD; A. Katsambas, MD


Skin Therapy Letter. 2010;15(5):1-4. 

In This Article

Abstract and Introduction


Seborrheic dermatitis is a recurrent, usually mild, skin disorder with typical clinical manifestations. As it most frequently involves exposed areas, such as the face and scalp, patients seek advice from a dermatologist in order to control their disease. This article will review the available treatments for this common dermatologic problem.


Seborrheic dermatitis is a chronic mild skin disorder that characteristically presents as sharply demarcated red patches and plaques with greasy scales in areas with increased density of sebaceous glands, namely the scalp, face, upper trunk, and flexures. It affects approximately 3–5% of the population, with a predilection in men.[1] An even higher incidence can be found amongst patients with HIV infection, Parkinson's disease, and several other medical conditions.[1] There is still debate as to whether infantile seborrheic dermatitis represents a distinct dermatitis.

The pathogenesis of the disease remains controversial. The role of Malassezia spp. carriage is not clear. However, the number of yeasts decreases with antimycotic treatment, resulting in clinical improvement, and increases in periods of exacerbation.[2] Despite its name, sebum excretion in patients with seborrheic dermatitis is not significantly increased when compared with controls. Malassezia metabolism alters sebum composition by consuming saturated fatty acids and releasing unsaturated fatty acids, which in turn promotes inflammation in susceptible individuals.[3] It has also been proposed that Malassezia spp. induce cytokine production by keratinocytes,[4] while studies on cellular immunity show contradictory results.[5,6]

Patients should be informed that all available therapeutic modalities alleviate symptoms temporarily until the next relapse, which is typically followed by variable periods of remission. Affected individuals should avoid causing compounding irritation to active lesions, i.e., through the mechanical removal of scales and the use of potent keratolytic preparations. Daily cleansing of the skin and the use of emollients are beneficial.


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