Wednesday, September 23, 2020

Let it snow, Let it snow, Let it snow!!!

This popular Christmas song brings with its lyrics the feel of a beautiful white Christmas. However for those suffering from Dandruff, they will agree with me when I say – this could very well be their theme song.

Seborrhoeic Dermatitis or Pityriasis Captitis or Dandruff (as commonly referred to by the general public) is a common, chronic and relapsing form of eczema that mainly affects the scalp and face. It can occur in both adults and infants.

The exact cause of Seborrhoeic Dermatitis is not clear. It is said to be associated with the fungus Malasezia. Babies under the age of 3 months usually get affected with Infantile Seborrhoeic Dermatitis and it usually resolves by 6–12 months of age. Adult Seborrhoeic Dermatitis tends to begin in late adolescence, more commonly seen among males than females.

The clinical presentation varies in the infants and the adults.

Cradle cap – which is characterized by the diffuse greasy scales on the scalp is the most commonest presentation in the infants. This rash may extend to the armpits and in some cases even extends to the groin folds – presenting like a type of napkin dermatitis. On the skin they look like pink patches that may peel or flake. Most of the babies are asymptomatic, in spite of the extent of the lesions.

In adults the scalp, face, creases around the nose, behind the ears, within eyebrows and upper trunk  are the most commonly affected sites .Some patients do give a history of  winter flares with improvement in the summer. They are constantly disturbed and embarrassed by the presence of the small white powder on the scalp or on their clothes. The patients also complain of itching in the affected areas.

Seborrhoeic Dermatitis is diagnosed clinically and in rare cases if necessary by a skin scrapping. A skin biopsy is hardly ever required.

Treatment of Seborrhoeic Dermatitis often involves several options, which includes Keratolytics like salicylic acid, or the use of topical antifungal shampoos and lotions. Mild Topical cortisone lotions can be used if severe inflammation is seen. In resistant cases in adults, oral antifungals or phototherapy may be started.

With proper treatment and management, the condition can be kept under control. Any further queries can be addressed at the Department of Dermatology at Bahrain Specialist Hospital.

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