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Forum Name: Dermatology Topics

Question: Dandruff and seborrhea dermatitis


 excessworry - Tue Mar 18, 2008 9:44 pm

Dear Doctor,

I am a 31 year old male of asian enthnic. I have had oily skin on my scalp and dandruff like flakes for over 10 years (as far as I can remember). My scalp sometimes gets reddish, itches especially on the sides of my scalp above my ears and on the back area above my spine. I am losing my hair, which started since my late teenage years. Both my father and mother are also losing hair.
On my face I also have oily skin, especially on my T zone, nose and cheeks area. But starting early last year, my eyebrow area and the side of my nose starts to get reddish and itchy. Then I noticed these areas starts to shed skin like dandruff. My doctor said I have Seborrhea dermatitis. My question is:-
1.Why do I get it on my face now?
2.Is this condition the same with what I have on my scalp?
3.Is it a common skin disorder? I am worried as I read it is associated with HIV.
4.My doctor gave me a shampoo which has worked very well on my scalp. But for my face, not so. What should I use as a facial cleanser?

Thank you kind doctor.
 Alexandra C, RN - Fri Mar 21, 2008 10:45 am

Hello excessworry,

Seborrheic dermatitis is a common skin condition and does not cause serious harm, though it can certainly be unsightly and annoying. Many people have symptoms on their faces and bodies, it is not limited to the scalp. The areas most affected are those where the sebaceous (oil) glands are more prominent, like the sides of the nose, eyebrows, eyelid creases,etc. The cause of seborrheic dermatitis is unknown, however it occurs more often in people with oily skin, and a type of yeast probably plays an important role. While seborrheic dermatitis is frequently seen in those who have immune deficiencies related to HIV infection or other diseases, many people who are perfectly healthy develop seborrheic dermatitis. If you are concerned that you may be at risk for HIV, please consult with your doctor, and get tested.

The most important thing for treating your face is to keep it clean. I suggest using a mild facial cleanser once/twice daily, to remove excess oil and flaking. You should avoid acne products that are meant to dry the skin out, because your skin may respond to the drying effect by producing even more oil, which will make the problem worse. Some people use over-the-counter dandruff shampoos on their faces with good results, just avoid getting these in your eyes. I'd recommend trying one with zinc pyrithione as the active ingredient. You can also try a 1% hydrocortisone cream, applied once or twice daily to the problem areas until you see some improvement.

If you don't see any improvement after a few weeks of using over-the-counter treatments, consult with your doctor again. There are other treatments which are available by prescription only. I hope this helps!

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