What is dandruff eczema? (Seborrhoeic Dermatitis)
Dandruff eczema is an eczema disorder primarily in the scalp and in the face, which can arise from puberty and onwards. In more severe strokes, the rash can also be found elsewhere with sebaceous glands (chest, back, armpit, step and navel). In infants, it is seen classically in the scalp, where it is called arp, but infants can easily have it more widespread.
Young adults with childhood eczema can also develop quite severe reactions in the head-neck area, so-called head-and-neck dermatitis. Suddenly severe dandruff eczema in especially male-to-have-sex-with-men should raise suspicion of HIV infection.
Why do you get dandruff eczema?
Up to 30 percent of the adult population has dandruff eczema to varying degrees. The cause of dandruff eczema is not yet fully understood, but we know that three factors contribute to the eczema:
The disease is found in areas with sebum production. An increased sebum production occurs, and therefore dandruff eczema can debut (possibly transiently) in the late puberty, where the sebaceous glands are stimulated by the production of male sex hormone.
Colonization with the skin fungus Malassezia furfur (Pityrosporum ovale), which can be detected by performing a fungal scab. Treatment with fungicides suppresses eczema, but it is quickly re-colonized if no local treatment is maintained.
Dandruff eczema flares up if the immune system is weakened, as seen for example in AIDS, and to a lesser extent by stress. Dandruff eczema can be found year-round, but is usually worst in the winter months. In summer, the disease is often seen as pityrisasis versicolor (white spots on the body).
How does dandruff feel eczema?
Most have one or more of the following symptoms:
Greasy or dry scales in the scalp, with varying degrees of itching and redness.
Hair loss in severe cases
Redness and scarring around eyebrows and nose.
Redness and scabies in armpits and around the genitals.
Folliculitis on the back and chest
With mild dandruff eczema one sees a symmetrically distributed slightly scaly and often itchy rash in the scalp. In case of severe dandruff eczema, the rash may spread to the face primarily around the eyebrows and nose, and transient hair loss may also occur. In the worst cases, the sprout also spreads to armpits and genitals, etc., where large sebum-producing glands exist. The hair follicle can be seen alone or as part of a dandruff eczema.
What can you do yourself?
The disease is chronic. The treatment aims at removing and suppressing the symptoms. This is done by reducing the strain on the skin fungus (the fungus can be “eradicated” but will quickly recover, it is part of our normal flora) and dampens the irritation of the skin and scalp. You can buy several over-the-counter shampoos that are excellent in light cases.
How does the doctor diagnose ‘dandruff eczema’?
Dandruff eczema is a clinical diagnosis. This means that the diagnosis is made on the basis of the disease’s completely characteristic disease picture. It is rarely necessary to take a biopsy (skin test) for support. The scales are often stuck in the hair, loosening the scales on the scalp, the skin does not bleed, as seen in psoriasis patients, there is another cause of scalp hair.
How to treat dandruff eczema?
Depending on the severity, the doctor will suggest treatment with medical shampoos containing tar, zinc pyrithione or ketoconazole. If there is a lot of redness and irritation, you can treat with cream with anti-swelling hormone often in combination with an antifungal agent.
More severe cases are most often treated in a dermatologist who, in addition to local medical treatment and tablets against yeast fungi, can offer treatment with soft X-rays (Bucky).
In case of harder cases of dandruff eczema, maintenance treatment is necessary, where you typically treat twice a week with medical shampoo and cream with anti-swelling hormone or calcineurin-inhibiting creams, which also act as anti-swelling but may initially irritate why they are best used for maintenance.
What is the prospect of the future?
The disease is chronic with a varying course, but in most cases it can be brought and kept calm with shampoos and various creams. Some only need cures at intervals, others need maintenance treatment. It is an individual assessment whether maintenance treatment is necessary.
If you have dandruff, you quickly get a sense of whether it is a single outbreak that can be handled with a small cure, or it is a more persistent flare that comes back after 1-2 weeks. If last happens, solid treatment will be able to control the disease twice a week once it has been treated.
The disease can be exacerbated by stress and acute or chronic severe illness.