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Reviewed by Dr Victoria Lewis, specialist registrar in dermatology
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General
Seborrhoeic eczema has little or nothing to do with sebum (the
oily secretion of the sweat glands), so the name is a poor one. The name
persists partly because some of the areas affected (eg the groins and armpits)
are also where there are greater concentrations of sweat glands within the
skin.
It is a well recognised pattern of eczema affecting all age
groups from young adults to the elderly. A type of seborrhoeic eczema is also
seen in babies during the first year of life.
Appearance and symptoms
Four common patterns are seen.
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Scalp and face: skin is greasy, red and
scaly. Affects the central face and forehead, the sides of the nose down to the
outer ends of the mouth, the edges of the scalp, eyebrows and behind the ears.
The scalp is very scaly (dandruff).
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Front of chest: a red scaly patch over the
breast bone.
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Back of trunk: multiple red raised dots
across and between the backs of the shoulder blades.
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Skin folds: a moist red skin reaction in the
groins, under the breasts and in the armpits. In childhood seborrhoeic eczema
the skin folds are most affected, but there can be a yellowish scaly crust on
the scalp, too (known as cradle cap).
The condition varies in severity. A mild case would be a little
bit of dandruff and flaky skin over the face. In severe cases, the skin is
widely affected and very itchy; the scalp is itchy, oily and, if very inflamed,
there is much scaling of the scalp skin.
Causes
Skin infection by yeast called Pityrosporum is thought to play a
part in seborrhoeic eczema. Anti-yeast treatment can therefore be effective,
although it usually needs to be repeated periodically.
Treatments
Scalp
Medicated shampoos containing anti-yeast medication may keep
mild activity under control. If there is a lot of scaling, additional
treatments such as sulphur and salicylic acid cream followed by selenium
shampoo or coal tar preparations can be needed.
Face, trunk and skin folds
A mixture of anti-fungal cream and mild steroid (1%
hydrocortisone) is the usual regime for flare-ups. This is used for
approximately two weeks at a time. Washing your face and body twice a week in
the shower with the medicated shampoos listed above helps to prevent
relapse.
Children
The main treatments for infants are
emollient creams, but mild steroid
and/or antifungal creams may be needed.
Cradle cap can be loosened with a mixture of salicylic acid in
aqueous cream, which is then washed out with baby shampoo.
Oils such as olive or arachis are also long-standing remedies
for de-scaling cradle cap.
Other types of eczema
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Based on a text by Dr Dan Rutherford, GP
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Last updated 15.09.2005
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