Can Seborrheic Dermatitis Cause Hair Loss?
Seborrheic dermatitis is a common chronic inflammatory scaling eczema rash of the scalp that overlaps with the non-inflammatory condition pityriasis capitis, commonly known as dandruff. The appearance can range from greyish white scales throughout the scalp as seen in dandruff to yellow to reddish thick crusty patches. In severe cases it can directly cause hair loss on the scalp. In cases where the rash is itchy, scratching can exacerbate or cause hair loss.21-22, 74, 76
Symptoms and microscopic indicators of seborrheic dermatitis are also very similar to contact dermatitis, psoriasis, pityriasis amiantacea, and tinea capitis. Diagnosis can be difficult between all these conditions — although psoriasis is typically more inflammatory and likely to extend beyond the scalp hairline. In fact, evidence suggests that it may be a pre-psoriatic condition in some people.22, 76
Causes of Seborrheic Dermatitis
In both dandruff and seborrheic dermatitis the presence of Mallasezzia furfur yeasts are present on the scalp, but the relationship to the yeasts is not clear since people without the disorders also have these yeasts present. Nevertheless, when either one is treated with antifungal agents the yeast is reduced and symptoms subside, and when the yeast recolonizes the symptoms recur.22, 76
Other conditions that seborrheic dermatitis is either a symptom of or triggered by include:22, 76
These suggest that a poor diet and suppressed immune system status either cause or contribute to the development of seborrheic dermatitis. Many are also associated with telogen effluvium and even scarring alopecia.59, 76
In addition, topical minoxidil (used as a hair loss treatment) can make seborrheic dermatitis worse.13 Elderly people can also be at greater risk for developing the rash due to infrequent shampooing.13 However, although external factors can aggravate seborrheic dermatitis, it is considered to be an endogenous eczema caused by internal factors, including genetics.21
Medical, Herbal, & Nutritional Supplement Treatments for Seborrheic Dermatitis
Traditional medical therapies to manage symptoms include:
- Itraconazole 100 —systemic compound for less-severe cases 76
- Ketoconazole – a synthetic antifungal used in topical creams or shampoos; available in over-the-counter strengths and 2% concentration by prescription 76
- Pimecrolimus (1%) cream76
- Salicylic acid ointment 22
- Selenium sulfide, pyrithione zinc, and tar shampoos 76
- Sodium sulfacetamide topical ointment – inhibits bacterial growth76
- Steroidal creams (such as 1-2.5% hydrocortisone) for more severe cases 76
- Sulfur precipitate (3%) combined with 2% salicylic acid (prescription; topically applied) 76
- Systemic 13- cis retinoic acid (1-mg/kg dosages) in severe cases 76
- Tacrolimus (0.03%) ointment 76
- Tar ointment 22
Tar and salicylic acid ointments are left on for a few hours. After washing, scales can be gently scraped out with a metal comb. Most treatments will need to be repeated because of flare-ups.22
Herbal remedies for seborrheic dermatitis include essential oils proven effective (in varying degrees) as both antifungal and antibacterial topical agents:66
Table 30: Herbal Treatment Options for Scaly Scalp Conditions
HERBAL TREATMENT OPTIONS FOR SCALY SCALP CONDITIONS
RECOMMENDATIONS ON USE
& EVIDENCE OF BENEFIT
- Placebo-controlled cases show topical aloe (0.5%) is effective at treating moderate psoriasis.
- Be sure to use an ointment that contains a minimum 15% concentration.
- Avoid using on open sores.
- Do not ingest — highly toxic if consumed.
|GERMAN CHAMOMILE(Matricaria recutita)
- Studies show topical chamomile has antimicrobial, wound healing, and anti-inflammatory properties and is about as effective as 0.25% hydrocortisone treatments. It can also help manage the stress of hair loss.
- Can be consumed as a tea as well (2-3 teaspoons per cup of water).
(Fagus, Betula, and Juniperus)
- Look for gels, ointments, and soaps that contain 5-10% concentration of tars from beech, birch, and juniper trees.
- Works well with careful exposure to UVB rays from sunlight.
|PANSY FLOWER(V. tricolor hybrids)
- Contains salicylic acid.
- Make a wet dressing using 1-2 teaspoons of flowers per 8-ounces of water.
- Suitable to use on infants.
- Contains furocoumarins, which behave as natural psoralens in combination with ultraviolet A radiation (similar to PUVA treatments).
- Clinical studies show when taken orally and combined with UVA it works as well as the conventional PUVA regimen using the pharmaceutical psoralen drug methoxsalen and with fewer adverse side effects.
- About 5% of turmeric is the bioactive polyphenol curcumin, which has antioxidant, anti-inflammatory, and antimicrobial properties.
- Choose a topical formulation that microencapsulates the curcumin to avoid staining while also increasing bioavailability.
Typically hair regrows once the scaly rash is treated, although occasionally scarring, permanent hair loss has been reported (usually associated with pityriasis amiantacea).22
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More so in males.
Or cradle cap in infants.
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