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 torso. 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 during 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.

With 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 torso 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 there is dehydration and vacuolization of the cytoplasm in the fungal cell, clearing of the cell wall, 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 the form of a powder, 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 manifestations such 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

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

GOU DPO RMAPO, Moscow

Pityriasis versicolor (synonym: pityriasis versicolor) is a fungal infection of the superficial stratum corneum of the skin (epidermis) in humans.
Latin name: Pityriasis versicolor
ICD10 code: B36.0
Other synonyms: yellow lichen, multicolored lichen, sun fungus, sun or beach lichen.

Treatment for pityriasis versicolor is with a dermatologist.

Reasons

The only cause of pityriasis versicolor in humans is the yeast-like fungus Pityrosporum (that is, it is similar to yeast fungi).
This pathogen has three forms: Malassezia furfur (mycelial form), Pityrosporum orbiculare (round form) and Pityrosporum ovale (oval form of the fungus). Normally, a person may have Pityrosporum orbiculare and Pityrosporum ovale in their skin, but they do not cause lichen. Once these forms of the fungus transform into the Malassezia furfur form, the person develops tinea versicolor.

Mostly young people, often men, are affected in countries with hot and humid climates. Children and old people rarely get sick.
If pityriasis versicolor appears in a child or an elderly person, you should look for the underlying disease or predisposing factor that led to the development of a fungal infection on the skin.

The disease is chronic and relapses occur frequently.

Contagiousness (that is, infectiousness) is low. That is, the fungus, of course, is transmitted from person to person. But you are unlikely to be able to become infected with pityriasis versicolor from a patient. After all, with a 90% probability, every person on Earth has this pathogen.

In addition to the main cause, there are predisposing factors that contribute to the development of fungus in human skin:

• diabetes mellitus and other endocrine diseases,
• HIV and immunodeficiency as a result of treatment for blood cancer,
• increased sweating of the human body,
• stress,
• hereditary predisposition, special composition of sweat and excess sebum,
• diseases of the gastrointestinal tract,
• in general - a decrease in immunity, which is designed to fight the fungus.

Symptoms

On the head

If pityriasis versicolor is located on the scalp, it is called seborrhea, or dandruff.

The symptoms are exactly the same - spots, itchy scalp, flaking. At the same time, it is peeling that most often worries patients.
How to treat pityriasis versicolor on the head and other hairy areas of the body - and in the same way as on other parts of the body. Just choose not a cream or ointment, but a spray or solution for external skin treatment plus shampoo with an antifungal agent.

Diagnostics

The diagnosis of pityriasis versicolor in a person is made on the basis of:

1) Main symptoms: spots on the skin of different colors, merging into conglomerates.

2) Pityriasis-like peeling of spots.

3) Spots without inflammation.

4) Diagnostics under a microscope is the main instrumental method for diagnosing lichen versicolor. Scrape off exfoliated skin particles from the surface of the spots, treat with potassium alkali and look under a microscope. Both the mushrooms themselves and their mycelium are visible.

5) Examination of the skin under a Wood's lamp. Wood's lamp is an ultraviolet fluorescent lamp with a magnifying glass for examining the skin.
Pityriasis versicolor spots under a Wood's lamp give a yellow-greenish or reddish-brown glow different from the surrounding skin. Moreover, lichen spots of different colors also give a different glow under a Wood’s lamp.

What does pityriasis versicolor look like under a Wood's lamp?

6) Iodine test, or Balzer test, is an important diagnostic symptom. It can be done at home and if not diagnosed, then suspect the diagnosis of versicolor versicolor yourself.
Take iodine tincture, lubricate the spots and surrounding healthy skin. After a few seconds, wipe so that there are no drops of iodine on the skin. Healthy skin becomes yellowish, and pityriasis versicolor spots overabsorb iodine and turn brown.

7) Beignet's sign, or floury peeling. When skin lesions are scraped, for example with a glass slide or scalpel, fine flour-like peeling appears.

Beignet's sign - floury peeling

Differential diagnosis is carried out:

• With Becker's nevus in the stage when there is no hair growth yet.
• Zhiber's rosacea is also in the initial stage.

Treatment

Treatment of pityriasis versicolor has only cosmetic indications, since there is no inflammation or damage to other organs in this disease. Such patients are not contagious, since the fungus is present in almost all people, it’s just a matter of immunity.

How to treat pityriasis versicolor:

1) Correction of the underlying disease (if any) that led to the appearance of pityriasis versicolor. We must not forget about this direction. It is imperative to get rid of the provoking factor.

2) Local skin treatment.

Always done.
Creams, ointments, shampoos, sprays and solutions with antifungal (antimycotic) agents are used.

Exactly the same treatment regimen when using the following local antifungal agents:

• clotrimazole (cream or solution),
• miconazole (cream),
• terbinafine (Lamisil) – cream,
• fungoterbin (spray or gel),
• oxiconazole (cream),
• termikon (spray or cream).

If lichen versicolor affects areas with hair growth (on the head, groin, labia or penis), it is better to use sprays or solutions of the above-mentioned drugs rather than ointments or creams.

3) General treatment.

Mandatory:

• for widespread lesions over large areas of skin,
• with weakened immunity,
• if local treatment is ineffective after 2 weeks.

But a number of dermatologists advise always using systemic antifungal drugs simultaneously with creams or ointments. The effectiveness of this treatment is higher due to its effect on fungi in the hair follicles.

Attention: general treatment without local treatment is ineffective!

Antifungal drugs are prescribed in tablets or capsules that must be taken orally.

• Fluconazole (150 mg capsules). How to take: 2 capsules 1 time per week for a course of 2 weeks. That is, we took 2 capsules on Monday, and a week later - 2 more capsules. Fast, cheap and effective.
• Itraconazole – 200 mg once a day – for 1 week.
• Ketoconazole - 200 mg once a day - for 3-4 weeks.

Approximate treatment plan for pityriasis versicolor

1. Fluconazole – 2 capsules 1 time per week – course 2 weeks.
2. Nizoral shampoo - wash your hair and body every evening for the first week. And every other day - 2 and 3 weeks.
3. Instead of Nizoral, you can use Thermikon spray for the body - apply once a day to the affected areas for 3 weeks.
4. Salicylic acid – lubricate the affected areas once a day in the morning.
5. Taking multivitamins (Complivit, Selmevit and others).
6. A set of activities to improve immunity.

Treatment of pityriasis versicolor during pregnancy

Peculiarities:

• You should not take any antifungal agents orally, as they may have a negative effect on the fetus.
• Externally, locally, it is best to use Nizoral shampoo. And only in cases where the benefit to the mother’s body outweighs the risk to the fetus. Treatment should be agreed with your gynecologist.
• In most cases, it is better to wait until childbirth and then carry out a full course of treatment.
• Remember: the pathogen has no effect on the fetus and does not affect childbirth.

When breastfeeding

• Do not take medications internally.
• Do not apply ointments or creams to your breasts.

How to evaluate the effectiveness of treatment?

1. The first symptom should disappear - peeling on the spots.
2. The spots should go away, at least the pink and brown ones. White spots may persist for some time until the skin evenly tans in the sun.
3. There should be no mushrooms or threads of fungal mycelium in the skin scrapings.

Prevention

Remember: just because the stains are gone, it doesn't mean they won't come back. The disease is chronic and cannot be cured forever. Therefore, prevention is mandatory!

• Taking ketoconazole – 400 mg once a month – every month. Or taking another antifungal drug.
• In the month of May, before the summer period begins: Nizoral shampoo - wash once a day - 3 days in a row.
• Wash clothes at 95% for the entire treatment period.
• Iron clothes with a hot iron for the entire treatment period.
• Do not wear synthetic clothing - it does not absorb sweat.
• In case of excessive sweating: use antiperspirants and change clothes frequently!
• Treatment of all diseases and correction of conditions that led to the appearance of pityriasis versicolor.
• Strengthening the immune system using different methods is a must!!!
• Is it possible to go to the solarium and sunbathe? During treatment - not allowed. After treatment, you can and even need to lightly sunbathe in the sun, since sunlight kills the pathogen - the fungus.

Folliculitis in dermatology is a skin disease characterized by inflammation in the hair follicles. There are two forms of this disease: superficial and deep folliculitis. In the first case, the inflammation affects only the mouth of the follicle, in the second, the process affects deeper tissues.

Reasons for development

Various infectious agents can lead to the development of folliculitis. Thus, pityrosporum folliculitis is caused by fungi belonging to the genus Pityrosporum. This disease is widespread in countries located in the subtropical and tropical zones.

A little about the pathogen

The fungus Pityrosporum is the causative agent of the disease.

Pityrosporum folliculitis is caused by a fungal infection. The causative agent of the disease is the fungus Pityrosporum, which exists in two forms - with round (orbiculare) or oval (oval) shaped cells. Currently, most scientists believe that both of these forms represent a single organism at different stages of development, however, the final point in the discussion has not yet been set.

It has been noticed that round-shaped pityrosporum fungus is more often detected on the skin of the body, and oval cells mainly affect the skin on the head and, as a result, can develop.

The presence of fungi of the genus pityrosporum on the skin in itself is not the cause of the disease, but in the presence of predisposing factors, folliculitis or folliculitis may develop.

Provoking factors

Most often, a fungal infection enters the hair follicles due to minor damage to the skin or as a result of hair removal procedures. Often the cause of the development of folliculitis is.

In addition, the cause of fungal folliculitis can be a decrease in general or local immunity caused by one of the following factors:

• Long-term infectious diseases and treatment with antibiotics;
• Metabolic disorders and, above all, diabetes;
• Diseases associated with liver dysfunction;
• Adverse effects on the skin, including the effects of chemicals, etc.
• Illiterate use of external medications containing glucocorticosteroids and, as a consequence.

Clinical picture

Folliculitis caused by pityrosporum is characterized by the appearance of a monomorphic (monotonous) rash in the form of pustules and papules located at the mouths of the hair follicles.

Most often, this type of folliculitis affects the skin of the upper body - forearms, shoulders, back and neck. Rarely, rashes appear on the face.

With the superficial form of folliculitis, pustules (pustules) the size of a millet grain are formed. Pustules, as a rule, have the shape of a cone, from the upper part of which a hair emerges.

An abscess with folliculitis may be surrounded by a rim of hyperemic skin, there is no pain, but patients may be bothered by severe itching. Therefore, in the area of ​​rashes with folliculitis caused by pityrosporum, excoriations are usually observed - superficial damage to the skin caused by scratching.

After a few days, the pustules open, the pus comes out with the formation of a crust. After which the inflammation goes away and the skin takes on a healthy appearance.

With the deep form of folliculitis, large painful nodules form. The size of one such nodule can reach 10 cm. The center of the nodule is also a hair, around which the abscess is located. The number of inflamed follicles may vary. As a rule, with the superficial form of folliculitis, the rashes are multiple.

Possible complications

In most cases, pityrosporum folliculitis has an uncomplicated course, especially if treatment measures are taken in a timely manner. However, quite severe consequences can also occur. In particular, against the background of folliculitis, the following can form:

• – acute purulent inflammation of the follicle with the process spreading to surrounding tissues.
• Carbuncle. This name is purulent inflammation of the tissues around a group of follicles. Carbuncle is a complication.

• Abscess. This is an inflammation of tissue with the formation of purulent cavities

Diagnostic methods

The main task in diagnosing pityrosporum folliculitis is the need to differentiate this disease from other forms of folliculitis and inflammation of the follicles of a non-infectious nature.

To make a diagnosis:

• Examination of affected follicles;
• Identification of the pathogen that provoked the development;
• Rule out disease and HIV;
• Examination of the patient to identify diseases that could provoke the development of pityrosporum folliculitis.

Treatment

Folliculitis is treated on an outpatient basis. It is necessary to open existing pustules and remove pus from them. This treatment of folliculitis is carried out in a clinic using antiseptic agents.

For treatment, a cream such as Clotrimazole is used.

In the future, the patient is prescribed antifungal drugs. For the superficial form of folliculitis, only external agents are used - ointments or emulsions. To treat pityrosporum folliculitis, as a rule, creams such as Clotrimazole, Terbizil, Exoderil, etc. are used. Modern antifungal agents are applied to the skin twice a day. The patient will need to complete the course of treatment, even if the clinical symptoms of folliculitis disappear earlier. Otherwise, a relapse is possible.

If folliculitis has a stable course, or the process has entered the stage of deep inflammation, it is necessary to use systemic drugs in addition to external treatment.

For folliculitis caused by pityrosporum, systemic antifungal agents are prescribed, as well as drugs to strengthen the immune system. As a rule, to treat this form of folliculitis, drugs such as fluconazole, itracanozole, terbinafine, etc. are used. As for this, it is also used in the treatment of thrush.

The patient should know that during the treatment of folliculitis, one should not squeeze the inflamed skin or try to squeeze out the pustules on their own. The fact is that when the abscess is compressed, the risk of infection penetrating into the deeper parts of the follicle increases, this can provoke the development of complications.

Physiotherapy is also used to treat folliculitis caused by pityrosporum fungi. In particular, the Ural Federal District has proven itself well. Patients are prescribed 6-10 procedures, which should be performed daily or every other day. Irradiation of skin affected by folliculitis is carried out in a suberythemal (not causing redness of the skin) dose.

If pityrosporum folliculitis develops against the background of some disease, it is necessary to undergo a course of treatment aimed at correcting the health condition.

When treating fungal folliculitis, it is recommended to follow a diet. The amount of sugar and sweets in the diet should be sharply limited, since carbohydrates, especially “fast” carbohydrates, are an excellent breeding ground for fungi.

Treatment with traditional methods

Folk remedies can also help in the treatment of fungal folliculitis. Many recipes are quite effective and help to cope with the disease faster.

1. A healing decoction for the treatment of folliculitis can be prepared from viburnum and rose hips. For two glasses of water you need to take 100 grams of fresh or 50 grams of dry viburnum and rose hips. You need to pour boiling water over the berries and let the broth brew for 24 hours. Strain the broth and stir a spoonful of honey into it. Soak a clean napkin in the broth and apply it to the inflamed skin with folliculitis. Treatment is carried out three times a day, the procedure time is 20 minutes.
2. Common sorrel can help in the fight against fungal follicles. It is necessary to thoroughly wash the sorrel leaves and grind them to a paste. Add a little sour cream to the sorrel and use the prepared mixture as an ointment to treat folliculitis.
3. An ointment for the treatment of folliculitis can also be prepared from St. John's wort. Grind the leaves and stems of the fresh plant into a paste. Mix with softened butter and birch tar (take all components of the ointment in equal quantities). Use ointment to apply to the skin for folliculitis. Keep the compress for at least 40 minutes. In winter, to treat folliculitis, you can prepare an ointment from dry St. John's wort. The raw materials are ground into powder and mixed with petroleum jelly in a ratio of 1 part herb to 4 parts petroleum jelly. Lubricate the affected skin with pityrosporum folliculitis three times a day.

Prognosis and prevention

The prognosis for pityrosporum folliculitis is almost always favorable. If the disease causes deep damage to the follicles, then spots of hyperpigmentation may remain in place of the healed foci of inflammation. If left untreated or improperly treated, folliculitis can provoke the development of serious complications, the treatment of which will require surgical intervention.

Prevention of the development of all forms of folliculitis involves maintaining skin and hair hygiene. In addition, it is necessary to undergo regular medical examinations, tests and monitor your general health. Fighting sweating will help prevent the development of fungal folliculitis. In addition, you should not use products containing corticosteroids and antibiotics without a doctor's orders. Self-medication with the use of these drugs can lead to a decrease in the protective functions of the skin and the development of folliculitis.

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, 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 pickled 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 a chronic skin disease caused by the fungus Pityrosporum ovale. The pathological process occurs in those areas of the skin that contain large quantities of sebaceous glands. The disease is characterized by a relapsing course. Seborrheic dermatitis worsens in winter, and symptoms often disappear in summer.

What happens to the sebaceous glands?

The sebaceous glands are scattered unevenly throughout the body. Thus, the skin of the face, as well as the scalp, chest, and interscapular area contains a large number of glands. And the skin of the feet and palms does not contain them at all.

The function of these glands is to produce sebum. The sebaceous secretion lubricates the skin and hair, thereby softening it and protecting it from adverse external factors.

The fungus Pityrosporum ovale is a facultative inhabitant of the skin, concentrating near the ducts of the sebaceous glands. When, under the influence of certain factors, the protective properties of the skin are reduced, this leads to increased proliferation of the fungus. Pityrosporum ovale breaks down sebum into free fatty acids, which it then uses to maintain its own vital functions.

But the peculiarity is that free fatty acids have an irritating effect on the skin. This is how an inflammatory reaction is formed. In addition, qualitative and quantitative changes in sebum production play a role in the pathogenesis of the disease.

Causes provoking the development of the disease

The fungus Pityrosporum ovale lives on everyone's skin, but only some people develop seborrheic dermatitis. Why is this happening? Many factors can activate the growth of the fungus and trigger the disease, such as:

Symptoms of the disease

Most often, seborrheic dermatitis is observed on the face, scalp, eyebrows and eyelashes. The behind-the-ear area, chest, and interscapular area are slightly less likely to be affected by the disease. Skin folds are even less commonly affected.

The following types of seborrheic dermatitis are distinguished:

1. Seborrheic dermatitis of the face;
2. Seborrheic dermatitis of the trunk and skin folds;

• Dry type;
• Fat type:
• Inflammatory type.

1. Generalized seborrheic dermatitis.

Seborrheic dermatitis of the face

Areas of redness with clear edges appear in the area of ​​the forehead, nose, nasolabial triangle, and chin. The skin peels and itches. Gradually, the spots begin to become covered with yellowish scales, which are formed as a result of the impregnation of skin cells with sebaceous secretions. At the initial stage, small, whitish scales are noted. But with excessive peeling, the scales become larger and yellower. They can merge with one another, thereby forming large surfaces. Wetting of the scales occurs during infection.

Seborrheic dermatitis, complicated by a bacterial infection, is characterized by a polymorphic rash. Along with redness and peeling, papules and vesicles appear, usually located in the center of the plaque. In males, pustules may appear in the mustache and beard area.

Sebum can clog the ducts of the sebaceous glands. As a result, the contents of the duct stagnate and soon become infected. This is how acne occurs.

The pathological process may also affect the eyelids. In this case, seborrheic blepharitis develops, which is characterized by redness, swelling of the eyelids, and the appearance of cracks. There are scales along the edges of the eyelashes, which is why a person’s eyes often stick together in the morning.

Seborrheic dermatitis of the trunk

Foci of seborrheic dermatitis form on the chest and in the interscapular area. The rashes are mainly pink or yellowish papules covered with scales. As a result of their fusion, large seborrheic plaques are formed. They gradually increase in size, have clear outlines, while the skin in the center of the plaque can take on a natural, healthy appearance, and papules are observed along the periphery. Thus, the plaques can take on a ring-like shape. When a bacterial infection occurs, acne may appear on the skin. These formations often become inflamed and painful.

In large skin folds (axillary, inguinal, under the mammary glands), clearly defined scaly erythema or pink or even dark red plaques appear. Cracks and crusts may form on the surface of the seborrheic lesion.

Seborrheic dermatitis of the scalp

The main symptom of this form of the disease is the appearance of dandruff. Skin cells are constantly renewed. The natural exfoliation cycle of epidermal cells lasts an average of a month. But with high fungal activity, this cycle is shortened to literally one week, while the exfoliated cells do not have time to go through the dehydration stage.

This leads to the appearance of a large number of scales (dandruff) covering the head, which are visible to the naked eye.

Dry type of dermatitis

Dandruff appears in patches with a predominant localization in the occipital-parietal region. Occasionally spreads over the entire head. The boundaries of the lesion are unclear. For this type of seborrheic dermatitis, hypersecretion of the sebaceous glands is not typical. Therefore, the scales are small, loose, and grayish-white in color. When you rub your head, copious dandruff easily falls onto your shoulders and clothes. The hair is also dry.

Oily type of dermatitis

This type of disease occurs with increased production of sebaceous secretions. The scales have a greasy, waxy appearance, stick together, and are yellow in color. The scales are more tightly attached to the scalp than in the dry type of dermatitis. When you rub your head, dandruff comes off in small, large flakes. Hair quickly becomes oily and looks greasy and sticky. Foci of redness are observed on the surface of the skin. Due to itchy skin, a person may scratch their head. As a result, excoriations occur on the scalp.

Inflammatory type

This type of dermatitis is characterized by scaly erythema with clear edges on the scalp. Seborrheic plaques can merge into entire lesions covering the entire scalp. On the surface of the plaques there are whitish or yellow scales. A characteristic sign of “seborrheic crown” is also observed. These are clearly demarcated rashes that occur at the border of the forehead and scalp. With the inflammatory type of dermatitis, a person is bothered by severe itching of the head.

In some people, purulent yellowish-gray crusts that have an unpleasant odor appear on the surface of seborrheic lesions. It is typical that after removing the crusts, a wet surface is observed.

Dermatitis often spreads to the neck, ear and behind-the-ear areas, and forehead. Deep, painful cracks form in the folds behind the ears. In rare cases, there is an increase in local lymph nodes.

Generalized seborrheic dermatitis

Increasing and merging seborrheic lesions can lead to the development of secondary erythroderma. The skin becomes pink, sometimes with a yellow or brown tint, becomes swollen, and cracks, weeping, and peeling appear on its surface.

Often, candidal and pyococcal flora are additionally involved in the pathological process. In such cases, a person’s temperature rises, itching appears, and general health worsens.

A generalized form of seborrheic dermatitis often develops with HIV infection.

Treatment

The fight against seborrheic dermatitis should begin with identifying the cause that caused the disease. If the cause can be found, it is necessary to begin eliminating it.

Drug treatment

Etiotropic treatment consists of prescribing external antimycotic drugs that act on Pityrosporum ovale. These drugs include:

To treat smooth skin, these medications are prescribed in the form of ointments, gels, and creams. In cases where seborrheic dermatitis is complicated by pyogenic flora, creams containing an antibiotic are prescribed (for example, Baneocin, Fucidin). For the inflammatory type of the disease, ointments, emulsions, and creams containing glucocorticosteroids (Elocom, Lokoid) are prescribed. In addition, for seborrheic dermatitis, keratolytics are used in low concentrations (resorcinol, salicylic acid).

For dermatitis of the scalp, the above listed products are prescribed in the form of shampoos. They must be used twice or thrice a week. The entire course of treatment can last 8-9 weeks.

Please note: After applying the antifungal shampoo, you should wait five to ten minutes. So, the active substances of the shampoo will have time to produce a positive effect. And only after the specified period of time can you wash the product off your head.

If you have a dry type of disease, you should avoid products that dry out the skin. Alkaline shampoos, soaps, and alcohol-containing products have a similar effect.

The most suitable shampoos for treating dry dermatitis are:

• Zinc-containing (“Friderm-zinc”);
• Sulfur-containing ones (“Selezhel”, “Sulsena”).

The most suitable shampoos:

• Azole-containing ones (“Nizoral”, “Sebozol”);
• Containing tar (“Friderm-tar”);
• Containing ichthyol (“Kertiol”);
• Sulfur-containing (“Sulsena”).

After achieving remission, you should wash your hair with an antifungal shampoo once every one to two weeks. The rest of the time, a mild shampoo with a neutral ph will do.

For severe, generalized seborrheic dermatitis, antifungal drugs (ketoconazole) and steroids (prednisolone) may be prescribed in tablets. In cases of secondary infection, broad-spectrum antibiotics are indicated.

Treatment of seborrheic dermatitis with folk remedies

As auxiliary methods, you can use traditional medicine recipes that can reduce the manifestations of the disease and eliminate itching. For this purpose, you can prepare a decoction of herbs.

To prepare a decoction of sage, grind a tablespoon of the herb and then pour a glass of boiling water. When the broth has cooled a little, you need to add a tablespoon of honey and then strain the infusion. The resulting product should be wiped over the skin. This method is suitable for caring for skin with dry seborrheic dermatitis.

To combat oily seborrheic dermatitis, you can use a tincture with St. John's wort. Pour two glasses of alcohol into the prepared container and add three tablespoons of crushed St. John's wort. The dishes must be covered with a lid and placed in a dark place for at least seven days. Before direct use, the tincture must be diluted with water in a 1:1 ratio. The resulting product is applied to the affected skin in the morning. You should not overuse this tincture, since its long-term use can cause dry skin.

Grigorova Valeria, medical observer

Seborrheic dermatitis - on the face and head

Seborrheic dermatitis is a chronic skin disease manifested by focal redness and peeling. It affects 2-5% of the total population. Men get sick more often than women.

This dermatitis affects areas of the skin rich in sebaceous glands, most often: the central area of ​​the face and the scalp. In this article we will look at treatment methods, causes, as well as photos of this disease.

Causes of seborrheic dermatitis

Why does seborrheic dermatitis occur and what is it? The fungus Pityrosporum ovale (the same one that causes dandruff) plays a significant role in the pathogenesis of this disease. This yeast-like fungus is a normal member of the skin microflora in most people.

The human body can control the growth of fungi. However, due to weakened immune defenses, frequent stressful situations, endocrine disorders, and nervous diseases, this natural ability is lost. Yeast-like fungi begin to grow and multiply.

There are a number of reasons why seborrheic dermatitis may occur:

• decreased immunity;
• hormonal imbalances;
• constant stressful situations;
• predisposition to this disease due to corresponding heredity.

With a decrease in general immunity, the body’s protective functions also decrease, which contributes to the proliferation of various opportunistic infections. Seborrheic dermatitis can also occur in cases of artificial immune suppression. We will look at how to treat this disease below.

Classification

Depending on the symptoms, there are several types of seborrhea.

1. The dry type of seborrhea appears in adolescents, with the skin cracking and becoming very dry.
2. With the oily type, a large amount of iron begins to be released, so the hair constantly looks unwashed; most often this type occurs in young girls.
3. Mixed, when the seborrhea on the head is dry, and in other areas it is oily.

Depending on the underlying cause, seborrheic dermatitis can be of two types.

1. Congenital - due to the original structural feature of the sebaceous glands, which is determined at the level of genes and heredity.
2. Acquired - is a consequence of any internal processes in the body, as a result of which the produced sebum changes its composition or quantity.

To know how to effectively cure dermatitis, you need to determine its nature.

Seborrheic dermatitis on the face

Seborrheic dermatitis on the face is becoming more common. It is easy to identify because a cluster of peeling forms on the face, with a strong itching sensation. When the case is particularly serious, the skin deteriorates not only on the face, but also on the areas behind the ears.

If you do not start fighting the disease in time, the peeling may intensify, the surfaces of the scales begin to become oily, they thicken, turn yellow, this is a warning about re-infection.

Corticosteroids are used externally to treat this type of seborrheic dermatitis. You need to consult a doctor to try to avoid skin atrophy.

Seborrheic dermatitis of the scalp

What causes dermatitis on the head? Dermatologists consider it an inflammatory disease of the epidermis. Its treatment should be based on antifungal therapy, since the disease is caused by opportunistic fungi Pityrosporum Ovale, which are present on the skin of all healthy people.

Usually they do not manifest themselves in any way, but when conditions favorable to them appear, they begin to actively reproduce. These microorganisms live in sebum, so seborrheic dermatitis develops only in those areas of the skin where there are sebaceous glands.

The following ointments and creams can be used to treat advanced seborrhea: Hydrocortisone butyrate, Dexamethasone, Afloderm, Triderm, Skin-Cap, Silcaren.

Symptoms

Symptoms of seborrheic dermatitis appear gradually. The first signal of the onset of the disease may be redness and itching of the skin.

As a rule, it initially occurs in the face, ears and folds of the skin. Flakes from peeling skin will have a yellowish, white or grayish tint. All these signs can be accompanied by hair loss. Skin damage is gradual, the disease progresses at a slow pace, so it is not always possible to recognize it immediately.

When the process is localized on the head, symptoms manifest as small flaky itchy spots, sometimes bright pink in color and white horny scales with a diameter of about two millimeters. The cause of the active appearance of dandruff may be the lack of timely necessary treatment measures.

If the disease manifests itself on the face, it makes itself felt in the form of white or yellow scales on typical local areas that have many sebaceous glands:

• brow and eyebrows;
• wings of the nose;
• middle part of the forehead;
• mustache zone;
• ears.

The affected areas may itch and be accompanied by a burning sensation, the skin becomes sensitive and painful, acne and comedones are possible.

It is known that today there are no drugs that normalize the functioning of the sebaceous glands, so the problem of treating seborrheic dermatitis should be aimed at correcting the manifestations of individual symptoms.

Manifestations in children

Seborrheic dermatitis in children is diagnosed before 6 months and by the time breastfeeding is completely or partially stopped, its symptoms gradually fade away.

In adulthood, the occurrence of seborrheic dermatitis is in no way related to its appearance in infancy. The main cause of seborrheic dermatitis in infants is the increased content of hormones in mother's milk.

Seborrheic dermatitis: photo

You can see what this disease looks like on the face and scalp in the photos presented.

Treatment of seborrheic dermatitis

Once you are diagnosed with seborrheic dermatitis, treatment requires a multi-pronged approach and a long period of time. Therapy is carried out both locally using shampoos and ointments, and internally using injections and tablets.

For seborrheic dermatitis, certain medications may be prescribed for treatment:

• antihistamines and hyposensitizers;
• antifungal;
• glucocorticoid;
• keratolytic agents (zinc preparations, salicylic acid);
• antibacterial medications.

For example, when the process is localized on the scalp, preference is given first to specific antifungal treatment. In this case, shampoos containing antifungal components such as ketoconazole or ciclopirox, as well as zinc pyrithione and tar are used

Treatment of seborrheic dermatitis on the face is carried out with gentle means. The most suitable product is a cleansing lotion. When a skin disease occurs on the face, the first step is to reduce inflammation. Antifungal creams (for example, Lamisil) and zinc talkers (Tsindol) help well with this. These products should be used 2 times a day.

Reviews on how to treat seborrheic dermatitis are very varied. Treatment is so individual that listening to them is useless. Each patient will have unique causes, symptoms and treatment accordingly.

For external use, certain ointments are used:

• Hydrocortisone butyrate 0.1 percent;
• Dexamethasone 0.05 percent;
• Alclomethasone;
• Triderm;
• Skin cap;
• Silkaren;
• Lotion Belosalik;
• Emulsion Advantan;
• Salicylic ointment.

Shampoos

When dermatitis is localized on the head, treatment involves the use of special shampoos, here are the main ones:

Diet

Proper nutrition for seborrheic dermatitis is the key to recovery. It is recommended to systematically introduce boiled meat, vegetables, fermented milk products, fruits, as well as foods enriched with vitamins A, B, C, zinc and selenium into the diet.

The diet for seborrheic dermatitis excludes chocolate, honey, sweets, sugar, candy, jam, spicy and spicy foods. If the patient is concerned about constipation, then laxatives are prescribed.

An anthelmintic drug, levamisole, which has an immunological effect, is recommended for use once. The diet for seborrheic dermatitis should be low-calorie and exclude drinks that increase sebum secretion.

Seborrheic dermatitis (seborrhea)

Causes of seborrheic dermatitis

Seborrheic dermatitis- inflammation of the skin as a result of increased secretion of qualitatively changed sebum and the active influence of microbial agents - Pitirosporum orbiculare and Pityrosporum ovale - opportunistic fungi from the genus Malassezia. Skin densely populated with sebaceous glands is susceptible to such damage, namely, the face (forehead, chin, nose, nasobuccal folds), scalp skin, chest (midline area), back (interscapular area), and ear area.

With seborrheic dermatitis, skin damage is gradual, slowly progressing and is accompanied by itching, often intense. In seborrheic areas, against a background of red spots, plaques with fairly clear boundaries appear, formed as a result of the fusion of small yellowish-pink nodules covered with fatty scales. The process of skin lesions is often symmetrical in nature and due to peripheral growth and resolution in the center, plaques can acquire garland-like and ring-shaped shapes.

The photo shows the symptoms of seborrheic dermatitis of the face

The pathological process located in the folds (behind the ear, under the mammary glands, in the groin) is often accompanied by weeping, the appearance of sticky crusts and cracks.

The photo shows the symptoms of seborrheic dermatitis (naso-cheek folds)

When the skin of the scalp is affected, uneven peeling or the formation of dense crusts is noted. Often, upon examination, you can see yellow or white scales attached to the hair shaft, as well as dandruff. The hair usually becomes thinner and thinner, which ultimately leads to diffuse alopecia (baldness).

The photo shows the symptoms of seborrheic dermatitis of the scalp

With a prolonged course of the process, in severe cases, seborrheic dermatitis can progress. In this case, the peeling becomes significant, the scales thicken. Often a secondary infection occurs in the form of honey-yellow crusts. Redness of the skin and peeling can increase in size, up to erythroderma - redness of large areas of the skin. This condition requires mandatory medical monitoring and additional examination.

The photo shows the symptoms of seborrheic dermatitis of the body: erythroderma

In newborns, when seborrheic erythroderma is combined with diarrhea and delayed weight gain, a rather serious skin lesion is diagnosed - Leiner's desquamative erythroderma. This condition is classified as severe and requires urgent medical intervention.

The photo shows the symptoms of seborrheic dermatitis in a child: milk scab

Examination for seborrheic dermatitis

When diagnosing seborrheic dermatitis, it is necessary to exclude skin diseases such as atopic dermatitis, eczematitis, psoriasis, fungal diseases (ringworm) and microbial skin lesions. To do this, it is necessary to conduct a microscopic and mycological examination of skin flakes for pathogenic fungi. Sometimes they resort to a diagnostic biopsy, in which, in combination with numerous signs, neutrophil cells will be recorded in the crusts and scales, as well as in the mouths of the hair follicles. For seborrheic dermatitis that occurs torpidly, additional research into the patient’s hormonal status is necessary.

Treatment of seborrheic dermatitis

It is known that today there are no drugs that normalize the functioning of the sebaceous glands, so the problem of treating seborrheic dermatitis should be aimed at correcting the manifestations of individual symptoms. For example, when the process is localized on the scalp, preference is given first to specific antifungal treatment. In this case, shampoos containing antifungal components such as ketoconazole or ciclopirox, as well as zinc pyrithione and tar are used.

Other shampoos with zinc pyrithione are also used in the treatment of seborrheic dermatitis.

During the acute period, it is possible to use these shampoos daily until the symptoms subside. If the effectiveness of one of the shampoos decreases, it is possible to alternate it with another. In the absence of complete stabilization of the process, the dermatologist additionally prescribes products containing selenium sulfide, tar and salicylic acid. The combination of antifungal shampoos and components that have a drying effect reduces infiltration, swelling, redness and helps to achieve faster recovery of the scalp. 1-2% Sulsena paste has proven itself well as a therapeutic and prophylactic agent for seborrheic dermatitis of the scalp. After using the medicated shampoo, a small amount of 2% paste (about 5 ml) is rubbed into the roots of the hair in a circular motion, and the resulting emulsion is kept on the scalp for 30 minutes and then washed off with warm water.

This treatment is usually carried out once a week for 3 months. Maintenance therapy in a similar mode is carried out with 1% paste. Shampoos “Head and shoulders”, “Friderm-zinc” and “Friderm-tar” have a good effect in the treatment of seborrheic dermatitis of the scalp.

In cases resistant to the treatment described above, the dermatologist may prescribe combination products containing antifungal and hormonal components. Such drugs are not allowed to be used independently, as they have numerous contraindications and side effects.

If the facial skin is affected by the inflammatory seborrheic process, appropriate facial skin care is prescribed. It is necessary to use products that do not cause irritation to the skin. In this area, Bioderma cosmetics, the Sensibo line, have proven themselves well. The most preferred facial skin care without contact with water is cleansing lotions.

Treatment of affected skin should primarily be aimed at reducing inflammation. For this purpose, various talkers containing zinc are used. Using the Tsindol mash 2 times a day stabilizes skin inflammation in a short time. Using the antifungal cream "Lamisil" 2 times a day on the affected skin of the face reduces the aggression of opportunistic fungi from the genus Malassezia at the mouth of the hair follicles and thereby causes an exfoliating and anti-inflammatory effect. Creams containing zinc pyrithione have proven themselves in the treatment of seborrheic dermatitis of the face.

Recently, external immunomodulators, which also have anti-inflammatory and antifungal activity, have been increasingly used in dermatology. These are Elidel and Protopic creams, which can be used at a certain stage in the treatment of seborrheic dermatitis, under the supervision of a doctor.

When seborrheic dermatitis affects the skin of the chest and back, all of the above remedies are used. These include shampoos, the foam of which is applied to the body when washing, and antifungal creams, talkers and immunomodulators for external use.

When folds are affected by the seborrheic process, the use of Castellani liquid is considered an effective remedy.

Folk remedies for treating seborrheic dermatitis

Among the numerous folk remedies for the treatment of seborrheic dermatitis, we have recently increasingly heard about the use of tea tree oil. Tea tree oil has gained this authority due to its antifungal effect. Unfortunately, the anti-inflammatory qualities of this remedy are not numerous, so tea tree oil cannot be the drug of choice in the treatment of seborrheic dermatitis. Herbal decoctions used in the form of lotions and wet-dry dressings during an active inflammatory process have a good drying effect. To prevent skin injury due to itching, it is possible to use diluted lemon juice in the form of rubbing the itchy areas of the skin.

To achieve a longer period of remission, daily hygienic skin care is necessary, while avoiding the use of soaps and cleansers that irritate the skin. Since the exacerbation of the process is caused by irregular hygienic care of the facial skin, growing a beard and mustache is an aggravating factor in the development of the pathological process. When choosing underwear, it is necessary to take into account that soft cotton clothing significantly reduces skin irritation. Ultraviolet irradiation in suberythemal doses in the treatment of seborrheic dermatitis helps to achieve a longer remission effect.

Consultation with a doctor on the topic “seborrheic dermatitis”:

1. Why does my husband's seborrheic dermatitis constantly worsen under stress?
It is known that with functional and organic disorders of the nervous system, the body is not able to keep opportunistic fungi from the genus Malassezia in a saprophytic state. The active form of these fungi increases significantly and they begin to exhibit their pathogenic qualities. This occurs due to the action of free fatty acids, which actively increase during the action of lipolytic enzymes of fungi on sebum, which provokes skin inflammation.

2. Is it true that seborrheic dermatitis occurs more often in men than in women??
Indeed, this is so and this phenomenon is explained by the influence of androgens on the activity of the sebaceous glands. Most likely, this is due to the presence of special receptors on the surface of sebaceous gland cells - sebocytes - for sex hormones, which causes changes in the secretion of sebum and disruption of the barrier properties of the skin.

3. Does seborrheic dermatitis occur in children?
In children, seborrheic dermatitis appears as thick yellow plaques, often greasy and flaky. This is the so-called milk scab. They usually appear at the age of 3 months. Such rashes do not itch or cause discomfort to babies and can be removed painlessly with the help of vegetable oils.

4. Are dandruff and seborrheic dermatitis the same thing?
No. Seborrheic dermatitis, unlike dandruff, is characterized by an inflammatory reaction of the skin and the presence of lesions.

5. A year ago I had eczema on my hands. Recently a plaque appeared on my chest. The dermatologist diagnosed seborrheic dermatitis. I asked him if it could be eczema again. He replied no. How can this be confirmed?
Dermatologists have their own diagnostic techniques. For example, when scraping a plaque caused by an eczematid process, point erosions will be detected.

6. Can one person have both seborrheic dermatitis and psoriasis at the same time? And how can you tell them apart?
Yes, this combination often occurs. The difference between plaques in these skin pathologies is revealed by diagnostic scraping of the scales with a scalpel. With psoriasis, the symptoms of the psoriatic triad are clearly visible: increased silvery peeling (symptom of “stearin stain”), a shiny surface is exposed under the scale (symptom of “terminal film”), droplets of blood appearing at the end of scraping of the plaque (symptom of “blood dew”).

Seborrheic dermatitis, photo on the face and scalp, treatment, ointments and preparations

This is the name given to inflammatory processes of the skin in the area of ​​the sebaceous glands. Seborrheic dermatitis is prone to chronicity and exacerbation in the spring-autumn season. It manifests itself as inflammatory areas in places of increased secretion of sebum (sebum) in people of any age.

In addition to its antioxidant and protective functions, sebum is an excellent breeding ground for many microorganisms that provoke inflammatory reactions on human skin. And the localization of the seborrheic process is precisely in the locations of the glands that abundantly secrete fatty secretions: on the surface of the chest and back, in certain areas of the face, and the scalp.

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Reasons for development

The main cause of the development of seborrheic dermatitis is fungi (Pityrosporum ovale and Pityrosporum orbicuiare) that affect the areas of the head under the hair and provoke pathological processes on the skin of the body.

Seborrheic dermatitis photo on the face

In turn, increased secretion of sebum (sebum fat) can be provoked by various internal pathological processes - endocrine, nervous, neuropsychiatric, immune and neurodegenerative pathologies. And also, the influence of various external factors - cold, excessive sweating, poor diet, vitamin deficiency, stress or alkaline detergents.

• In many cases, once the main provoking factors and causes of seborrheic dermatitis are eliminated, no special treatment is required.

Classification of seborrheic dermatitis

dry form of seborrheic dermatitis photo

According to the medical classification, there are three forms of the disease:

1. Fat, including the manifestation of pathology with liquid and thick secretion (according to the consistency of sebum). Seborrhea, with the release of a fatty liquid secretion in the area of ​​the nose and head under the hair, is observed more often in teenage girls. And the oily, thick secretion manifests itself as acne and pimples in guys under 20 years of age.
2. Dry a type that manifests itself during puberty (adolescence). It is characterized by reduced sebum secretion, manifested by pathological cracking of dry skin.
3. WITH mixed, caused by the simultaneous manifestation of fatty and dry lesions in different parts of the body. Usually characteristic of men.

According to the nature of the clinical signs of seborrhea, it can manifest itself:

• Seborrheic eczematide, the mildest type, is accompanied by slight peeling and a slight inflammatory reaction on the skin surface of the nose, in the folds behind the ears and under the hair on the head.
• A spotted type of seborrhea with constant exacerbation and prolonged clinical symptoms, turning into a chronic process.
• Perinasal erythema is a type of eczematid that manifests itself mainly in females.

Seborrheic dermatitis on the face

Patients with immune and endocrine pathologies, mostly men, typically develop seborrhea on the face, manifesting itself as dry or oily seborrhea. The dry variety is caused by special crusty formations that are difficult to treat with simple skin care products.

With the oily form of seborrhea, the skin becomes oily and shiny, and acquires a gray tint. The relief of the affected areas resembles the peel of an orange; blackheads with a black head appear, which are prone to inflammation.

The addition of an infection contributes to the development of furunculosis and widespread localization of acne.

development of peeling on the face (photo)

Distinctive signs of seborrheic pathology are manifested by characteristic rashes of pink, clearly defined papules, reaching large sizes (up to 20 mm), followed by peeling of the skin areas located under them. There is a discomfort and itchy symptoms of the inflamed areas.

Lack of timely treatment of seborrheic dermatitis on the face can result in:

• progression of rashes;
• proliferation and fusion of inflamed foci;
• the addition of infection and the development of purulent processes.

oily form of sebrorheal dermatitis on the face (photo 4)

Localization of the pathological process near the eyes and ear canal can provoke acute inflammatory processes of the edges of the eyelids (blepharitis) and their inner surface - the conjunctiva, and various ENT diseases.

The processes of seborrheic dermatitis can develop on any part of the face where the sebaceous glands lie. The most vulnerable areas are the skin on the wings of the nose, nasolabial triangle, cheekbones, eyebrows and superciliary folds.

Seborrheic dermatitis of the scalp

seborrheic dermatitis photo on the head

seborrheic dermatitis photo in adults

The initial symptoms of seborrheic dermatitis of the scalp are caused by the release of dry sebum, manifested by the formation of abundant dandruff, followed by the formation of inflamed, itchy lesions on the scalp.

• Scratching causes the formation of bleeding wounds and suppuration due to infection.

Hair at the root quickly becomes covered with grease and looks untidy. The inflamed skin is gradually covered with growing yellow or milky seborrheic plaques.

photo of the scalp

The multiple scales covering the plaques stick together and are tightly attached to the scalp by sebum. Scraping them reveals red, hyperemic areas underneath.

A long process and progression of seborrheic dermatitis on the scalp can provoke alopecia of a nested form, manifested by areas of baldness of various diameters.

Timely relief of inflammatory reactions can restore hair growth in the affected areas.

Effective treatment of seborrheic dermatitis, ointments and preparations

Modern medicine today has in its arsenal a large number of effective medications in the form of ointments and drugs for the treatment of seborrheic dermatitis.

Drug therapy includes various therapeutic regimens based on complex treatment using a wide variety of therapeutic agents.

1. Systemic drugs - antibacterial action - "Fluconazole" 100 mg/day and complexes of various vitamin groups containing copper and zinc.
2. Infectious processes are stopped with antibiotics - by prescribing Macropen or Erythromycin. The dosage is calculated individually, according to age.
3. Intense itching is relieved by prescribing antihistamines - Cetrina, Zodaka or Claritin 1 tablet/day (for adults).
4. Intense inflammatory processes are stopped by systemic glucocorticosteroid drugs - tablets and injections of Diprospan, Prednisone and Dexomethasone. The calculation of the dosage regimen is strictly individual.

For effective and efficient treatment of seborrheic dermatitis of the scalp and to prevent exacerbation of the disease, shampoos with a therapeutic effect, ointments, lotions and creams are prescribed. The shampoo should not contain components that irritate the skin - these are parabens, fragrances or silicone. The most studied and effective shampoos are:

• antifungal and anti-inflammatory - “Perhotal” and “Sulsena”
• stopping fungal proliferation and having antibacterial properties - “Sebiprox” and “Tar”;
• antimicrobial, reducing peeling processes - “Friderm”;
• having the property of keratolization, reducing sebum secretion - “Algopix”

Shampoos are recommended to be used twice a week for a month. In order for the active ingredients of shampoos to fully demonstrate their healing properties, it is necessary to leave the shampoo for at least 10 minutes during the process of washing your hair.

For skin lesions on open areas of the face, local remedies for seborrheic dermatitis are prescribed - ointments, lotions, creams and lotions. These could be:

• 2% Sulsena paste;
• aerosol or cream with zinc oxide in the form of a “Skin cap”;
• creams and ointments with antifungal properties - such as Ketodin, Sebazol, or Ketozol;
• hormonal drugs (for severe inflammation) - individually selected courses of Elokoma, Belosalika, or Akriderm;
• prescribing an antifungal agent - Triderm ointment.

In parallel, a course of treatment of background pathologies is carried out, and (if possible) elimination of provocative factors that provoked the disease.

Probable forecast

The prognosis of the disease is favorable. But seborrheic dermatitis can be completely cured only by strictly following the prescriptions of the treatment regimen chosen by the doctor. Only medical supervision can protect the patient from unpleasant complications by coordinating the treatment process in a timely manner.