Is your head full of dandruff a problem? This article will show you the culprit of dandruff: seborrheic dermatitis

Author: Liu Shuai, The Second Affiliated Hospital of Nanchang University

Reviewer: Wang Xiaozhong, Professor of the Second Affiliated Hospital of Nanchang University

The male lead in an idol drama lifts his hair and smiles evilly, instantly charming thousands of girls. This makes many young men envious, but when they play with their hair, they may end up with an embarrassing scene of "flying snow" all over their shoulders. The "culprit" of all this is probably seborrheic dermatitis, which troubles many people.

1. Pathogenesis and manifestations of seborrheic dermatitis

At present, the medical community has not yet discovered the clear mechanism for the occurrence of seborrheic dermatitis, but it has been basically determined clinically that seborrheic dermatitis is the result of a "game" between Malassezia, sebaceous glands and the immune system.

Figure 1 Copyright image, no permission to reprint

Malassezia is a fungus that naturally lives on human skin, secretes substances that protect the skin, and the immune system also regards it as a "family brother". However, for some unknown reason, the immune system and Malassezia, which were originally mutually beneficial, have become "brothers at odds", causing inflammation, redness and swelling of the skin, and the "mixing" of sebaceous glands produces annoying dandruff.

Seborrheic dermatitis usually occurs in areas rich in sebaceous glands, most commonly on the scalp and the sides of the nose. It is generally distributed symmetrically and manifests as red spots with clear boundaries and light yellow greasy scales. The disease manifests as redness and swelling of the skin and greasy yellow scabs on the scalp, and even hair loss in severe cases; on the sides of the nose, it manifests as an increase in yellow fat particles and perennial red spots in the areas of sebum secretion.

2. Treatment of seborrheic dermatitis

The most common areas of seborrheic dermatitis are related to people's image! But don't panic, there is already a complete set of treatment methods for it in clinical practice. This article will introduce the common treatments for seborrheic dermatitis. Of course, the actual treatment should be based on the doctor's advice.

1. Weaken the enemy - sterilize

Once we find that Malassezia cannot coexist harmoniously with the human body, we must strike hard and use antifungal ointments to sterilize and protect the skin. These antifungal drugs also have anti-inflammatory effects, and their side effects are minimal when used topically. They are suitable not only for use in combination with anti-inflammatory drugs during active inflammation, but also for use during stable periods to consolidate the therapeutic effect.

2. Stop the fight - anti-inflammatory

Itching, scaling and redness of the skin often indicate inflammation, which requires anti-inflammatory treatment to prevent the situation from getting worse. Currently, the commonly used anti-inflammatory drugs are divided into two categories: weak hormone ointments and non-hormonal calcineurin inhibitors. Both types of drugs have certain side effects, and it is generally not recommended to purchase and use them on your own. You need to follow the doctor's advice and use the drugs with caution.

3. Cleaning up the battlefield – photoelectric therapy

After the two steps of sterilization and anti-inflammatory treatment, the inflammation of the patient's skin should be basically stable. Although the patient's skin may still have red bloodshot, there are no obvious peeling and itching symptoms. At this stage, the sterilization and anti-inflammatory ointments have completed their "mission", and the next step is to take professional medical beauty methods, using lasers of specific wavelengths to restore the blood vessels paralyzed in the "battle" between Malassezia and the immune system.

Usually, doctors will use pulse dye laser (PDL) and photorejuvenation to treat patients with seborrheic dermatitis. PDL uses a laser with a wavelength of 595nm to efficiently remove red blood streaks, but the treated area may show obvious "purple spots" symptoms after treatment, and it takes about half an hour to recover. It is less popular and more expensive. Photorejuvenation uses intense pulsed light (wavelength of 400-1200nm) to relieve red blood streaks, and this method has good results.

3. Prevention strategies for seborrheic dermatitis

Who doesn’t want to maintain healthy skin? As the saying goes, prevention is worse than cure. So, this article will introduce the prevention strategies for seborrheic dermatitis.

1. Strengthen the skin's "defense line" - gentle skin care

As the largest organ of the human body, the skin is exposed to a variety of stimuli including ultraviolet rays every day. Therefore, it is necessary to take reasonable care of the skin to reduce the damage caused by stimuli.

(1) Reasonable cleaning

Use milder cleansers, and avoid using highly irritating facial cleansers, shower gels, and shampoos containing soap and sulfate. When removing makeup from your face, rub it gently, and do not rub it repeatedly; when there is more oil secretion in the afternoon, you can wash your face with clean water.

(2) Proper sun protection

If you go out when the sun is strong (such as in summer), you need to take necessary sun protection measures and wear a sun hat, but be careful not to apply a large amount of sunscreen on the same part, as this may be counterproductive.

(3) Moisturize carefully

In areas with a drier climate, special attention should be paid to the skin and fresh, low-irritation moisturizing products should be used daily.

(4) Avoid stimulation

Seborrheic dermatitis itself has the characteristics of damaging the skin barrier, so we need to reduce skin irritation and avoid further damage to the skin. In the acute stage of the disease, we must avoid wind and sun exposure, avoid scalding and scratching the skin, and do not use strong irritating facial cleansers to clean the skin.

2. Get back to the basics - regular life

In addition to paying attention to gentle skin care, we must also ensure a regular work and rest schedule (no staying up late) and a balanced diet. After all, the human body is like a symphony, and only when everything is harmonious can the human body stay healthy.

In order to protect the skin, we should eat light food every day, avoid spicy and irritating food, and don't drink alcohol. People without taboos should eat more crude fiber food, protein and vitamin-rich food, such as whole grains, milk, eggs, lean meat, fish, fresh vegetables and fruits. Properly increasing the fiber content in the diet can promote intestinal peristalsis and reduce lipid absorption. Only by rejecting the temptation of high-calorie, high-fat food can we avoid the "dandruff disaster".

The incidence of seborrheic dermatitis in adults is 2% to 5%, which is a serious threat to skin health. In recent years, with the continuous improvement of medical standards, countless patients suffering from "dandruff" have been able to get rid of the disease. I believe that with the continuous development of medical technology in the future and the increasing public awareness of seborrheic dermatitis, the prevention and treatment of seborrheic dermatitis will definitely get better and better!

References

[1]Wikramanayake TC, Borda LJ, Miteva M, et al. Seborrheic dermatitis—Looking beyond Malassezia[J]. Experimental Dermatology, 2019, 28(9): 991-1001. DOI:10.1111/exd.14006.

[2] Zhang Fan, Li Yuanhong, Li Shurun, et al. Research progress in clinical diagnosis and treatment of seborrheic dermatitis[J]. Chinese Journal of Medical Aesthetics, 2022, 12(10):83-90.