Are you still worried about acne?

More and more young people are worried about acne, which affects their appearance and makes them feel unhappy. Acne generally refers to acne, which is a chronic inflammatory skin disease of the pilosebaceous gland unit. There are many reasons for acne, mainly related to excessive sebum secretion, blockage of the pilosebaceous gland duct, bacterial infection and inflammatory response. The following will introduce seborrheic dermatitis.

What is seborrheic dermatitis?

Seborrheic dermatitis, also known as seborrheic eczema, is not uncommon in clinical practice. It is a common chronic inflammatory skin disease that often occurs in sebum-producing areas such as the head, face, chest, back or perineum. It is mainly due to the hypersecretion of sebaceous glands, which causes a large amount of sebum secretion and accumulation on the skin surface. In addition, mental factors, eating habits, B vitamin deficiency and alcoholism also have a certain impact on the occurrence and development of this disease. From the clinical manifestations of patients, the main symptoms are itching, erythematous rash, greasy scales or scabs attached to the surface, etc.

Studies over the years have shown that seborrheic dermatitis tends to occur in areas with well-developed sebaceous glands. Pityrosporum is a lipophageal microorganism and seborrheic dermatitis may be related to the presence of Pityrosporum ovale [1]. Therefore, antifungal drugs have become one of the important treatment methods for seborrheic dermatitis.

Common drug treatments

1. Antifungal drugs

Traditionally, the main treatment drugs are glucocorticoids and antifungal preparations. However, the long-term use of glucocorticoids is prone to cause capillary dilation, skin atrophy, rapid drug resistance, perioral dermatitis, etc., which limits their clinical application.

Topical antifungal drugs are generally the first choice for mild and moderate seborrheic dermatitis, while oral antifungal drugs can be considered for severe seborrheic dermatitis. Itraconazole is a synthetic antifungal drug that is highly keratinophilic, lipid-soluble, and has anti-inflammatory effects. It has a broad antifungal spectrum and can maintain a high concentration in the stratum corneum and mucous membranes of the patient's skin after oral administration. It has a significant inhibitory effect on fungi such as pityrosporum, dermatophytes, yeast, and Aspergillus, thereby inhibiting the increase in dandruff and oil secretion caused by skin inflammation, and then alleviating clinical symptoms such as itching [2-3].

2. Calcineurin inhibitors

Antifungal drugs for the treatment of seborrheic dermatitis sometimes lead to drug resistance, and long-term topical glucocorticoids can induce hormone-dependent dermatitis, so the long-term use of these two types of drugs is subject to certain restrictions. In recent years, calcineurin inhibitors with anti-inflammatory effects, such as tacrolimus and pimecrolimus, have been used to treat seborrheic dermatitis. Clinical observations have found that their recurrence rate and adverse drug reactions are low.

3. Combination therapy

According to research, itraconazole has a good clinical effect in treating seborrheic dermatitis, but the recurrence rate is high [4]. Itraconazole combined with pimecrolimus can significantly improve the clinical efficacy of seborrheic dermatitis, increase skin moisture, reduce sebum levels, promote the recovery of skin barrier function, and inhibit the recurrence of seborrheic dermatitis to a certain extent.

The main adverse reactions of topical tacrolimus are initial irritation symptoms, such as erythema, itching and burning sensation. The initial application of tacrolimus and the short-term combination of glucocorticoid ointment can quickly and effectively control the inflammation caused by seborrheic dermatitis and tacrolimus stimulation, while the short-term topical glucocorticoid will not cause adverse reactions such as local skin atrophy and capillary dilation. After stopping the hormone, continuing to use tacrolimus can effectively treat seborrheic dermatitis and inhibit the rebound after the hormone is stopped. It can be said to be a strong combination.

Physical therapy

Physical therapy includes intense light pulse, photodynamic therapy, radiofrequency and other methods. It can significantly reduce the oil secretion of facial skin, increase skin elasticity and no obvious or intolerable conditions are observed.

Summary: Drug treatment of seborrheic dermatitis mainly focuses on antifungal, calcineurin inhibitors and glucocorticoids. Because long-term topical glucocorticoids have the potential risk of hormone-dependent dermatitis, specialists are gradually reducing their use. In the field of physical therapy, intense pulsed light has unique advantages in reducing erythema and can also reduce sebum secretion, so it has application prospects. Photodynamic therapy has the value of further research because it can inhibit sebaceous gland secretion.