Seborrheic eczema (seborrheic dermatitis)

Seborrhoeic eczema is a common, chronic inflammatory skin disease that particularly affects areas rich in sebaceous glands. Around three to five percent of the population suffer from it, with men being affected more frequently than women. The disease can occur at any age, but peaks in frequency in infants as scalp gneiss and in adults between the ages of 30 and 60. The exact cause is not fully understood, but several factors play a role: excessive sebum production creates a favorable environment for yeasts of the genus Malassezia, which occur naturally on the skin. In people with seborrhoeic eczema, these fungi multiply excessively and trigger an inflammatory reaction. Genetic predisposition, immunological factors, stress, exhaustion and hormonal fluctuations can exacerbate the condition. Neurological diseases such as Parkinson’s disease are associated with an increased incidence. Seborrhoeic eczema manifests itself as sharply defined, reddish areas of skin with yellowish, greasy scales. Typical localizations are the hairy scalp with scaling, the face especially eyebrows, nasolabial folds, forehead and the area behind the ears, the upper chest and back and occasionally armpits and groin. The skin may itch, burn or feel tight. In infants, seborrhoeic eczema appears as scalp gneiss with yellowish, adherent scales on the scalp, which usually heals spontaneously in the first year of life. The diagnosis is made clinically on the basis of the typical appearance and localization. Treatment includes topical antifungal preparations such as ketoconazole or ciclopirox in the form of shampoos, creams or lotions. If the inflammation is more severe, mild corticosteroids or calcineurin inhibitors can be used in the short term. Special anti-dandruff shampoos with active ingredients such as selenium sulphide or zinc pyrithione are effective for the scalp. Seborrhoeic eczema is chronic with a variable course, but can be well controlled with the right therapy.