Seborrheic dermatitis
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Seborrheic dandruff is a chronic, recurrent dermatosis of the scalp, classified within the spectrum of seborrheic dermatitis. It is characterized by excessive scaling of the epidermis, often with a fine or greasy appearance, and may be accompanied by itching and erythema. The pathogenesis of the condition is multifactorial, involving dysfunctions of the sebaceous glands, changes in the skin microbiome composition, and the individual's inflammatory response. Seborrheic dandruff is not an infectious disease, but it shows a clear tendency to recur and worsen under certain conditions (stress, hormonal changes, season). It requires systematic management that targets not only the symptoms but also the underlying mechanisms.
Seborrheic dermatitis – causes
The development of seborrheic dermatitis results from the overlap of several biological processes, rather than a single causative factor. Key aspects include:
1. Excessive activity of sebaceous glands
- increased sebum production,
- changes in the composition of the skin's surface lipids,
- creating an environment conducive to microbiological disturbances.
2. Disturbances in the scalp microbiome
- dominance of lipophilic yeasts from the genus Malassezia,
- metabolism of sebum lipids into free fatty acids,
- induction of a local inflammatory reaction.
3. Individual immune response
- skin hypersensitivity to yeast metabolites,
- intensified inflammatory response of the epidermis,
- accelerated keratinization cycle (shortening the time from keratinocyte division to shedding).
4. Predisposing factors
- psychological stress and chronic fatigue,
- hormonal disturbances (particularly androgenic),
- neurological and internal diseases,
- improper scalp care (aggressive detergents, frequent overheating).
It is worth emphasizing: sebum itself is not the problem – the problem lies in its amount, composition, and the skin's reaction to its breakdown products.
Seborrheic dermatitis – symptoms
The clinical presentation of seborrheic dandruff can vary, but there are characteristic features that allow it to be distinguished from dry dandruff or scalp psoriasis.
Most common symptoms:
- yellowish or whitish scales of a greasy nature,
- adherence of scales to the skin and hair,
- itching of varying intensity,
- scalp erythema (often subtle, but chronic),
- rapid hair greasiness.
Accompanying symptoms:
- sensation of burning or tightening of the skin,
- hypersensitivity to touch and cosmetics,
- periodic exacerbations and remissions.
Location of lesions:
- hairy scalp (parietal, temporal areas),
- hairline,
- eyebrows, nasolabial folds, behind-the-ear area (as part of seborrheic dermatitis).
If the lesions are thick, silvery, clearly demarcated or involve other areas of the body, differential diagnosis should consider other dermatoses.
Seborrheic Dermatitis - How to Treat
Treatment of seborrheic dermatitis should be multi-stage and long-term because the condition is chronic and recurrent. The approach includes both home therapy and specialized treatment.
Basic Management
- regular cleansing of the scalp with regulating agents,
- normalization of the skin's keratinization process,
- limiting the colonization of lipophilic microorganisms,
- reducing inflammation.
Supportive Care
- avoiding aggressive detergents and alcohol,
- using products with physiological pH,
- limiting irritating factors (high temperature, friction),
- maintaining regularity – "ad-hoc" treatment is ineffective.
Chronic Treatment and Prevention of Relapses
- maintenance therapies even during remission periods,
- rotation of methods to prevent skin adaptation,
- individualization of treatment depending on skin reactivity.
Honestly, it must be said: there is no definitive cure, but there are methods that allow effective control of the disease and extend asymptomatic periods.
Treatments for seborrheic dandruff
In cases of recurrent or resistant seborrheic dermatitis, specialized treatments are playing an increasingly important role, as they work more deeply than standard home care.
Most commonly used procedures:
Scalp cleansing
- removing excess sebum and corneocyte deposits,
- improving the penetration of active substances,
- normalizing the skin's microenvironment.
Therapies regulating sebaceous gland activity
- impact on the cellular metabolism of the skin,
- reducing excess sebum production,
- improving the epidermal barrier function.
Anti-inflammatory and regenerative treatments
- reducing erythema and itching,
- modulating inflammatory response,
- supporting the skin's repair processes.
Therapies supporting microcirculation
- improving tissue oxygenation,
- normalizing cellular renewal,
- benefiting the condition of hair follicles.
These treatments do not replace dermatological treatment, but serve as an important complement, especially for patients prone to frequent relapses or with sensitive scalps.
