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Hair Loss: Infectious Agents

Seborrheic Dermatitis

Seborrheic dermatitis is first and foremost a skin condition, but it can involve infection and temporary hair loss if the dermatitis is located on the scalp or other skin areas. The dermatitis causes scaly, sometimes oily, inflamed skin that can be itchy or even painful to touch.

This is an inflammatory condition that is not well understood, although there does seem to be a genetic component and Caucasians, particularly of Celtic descent, are most susceptible. Some newborns develop seborrheic dermatitis when maternal androgens are passed from the mother to the baby across the placenta. Conditions such as Parkinson's disease, head injury, and stroke can also be associated with seborrheic dermatitis, and stress and chronic fatigue can make it worse. Times of hormone fluctuation, such as during puberty, can activate the onset.

In part, the trigger for seborrheic dermatitis may be androgen steroids. The sebaceous glands attached to the hair follicles begin to produce a very rich form of sebum. The sebum contains fewer free fatty acids and squalene but increased amounts of triglycerides and cholesterol. The excess, rich sebum production triggers the proliferation of skin flora. Yeast Pityrosporon ovale (also called Malassezia furfur) has been shown to increase in numbers with the intensity of seborrheic dermatitis. This excessive yeast proliferation causes more irritation and inflammation.

Although all this inflammation is not specifically directed at the hair follicle, if hair follicles are in the vicinity of the inflammatory cells then they can be affected. Hair follicles find inflamed skin an unhealthy environment in which to grow. Thus seborrheic dermatitis may non-specifically cause diffuse hair loss.

Although seborrheic dermatitis can involve a proliferation of yeast, seborrheic dermatitis is not infectious -- you cannot catch seborrheic dermatitis. Where yeast is involved in seborrheic dermatitis it comes from the affected individual's own skin. We all have yeasts of various types living on our skin -- the problem in seborrheic dermatitis is that the yeasts may grow to far greater numbers than normal.

Treatments

There are several treatments for seborrheic dermatitis. The simplest involves medicated anti-dandruff type shampoos to control the skin proliferation and scaling. Several shampoos might be recommended for alternating use on different days and each with its own particular activity.

Shampoos for seborrheic dermatitis may contain sulfur, selenium sulfide, zinc pyrithione, tar, salicylic acid, or oil of cade. These shampoos have been available for many years. More recently azole-based shampoos (such as ketoconazole [brand name: Nizoral]) have been made available over the counter. All can be effective in treating seborrheic dermatitis.

Some dermatologists may also prescribe antibiotics to control the skin flora and in doing so indirectly reduce the inflammation. The inflammation may be directly treated using a corticosteroid cream or lotion to control the body's immune response. Seborrheic dermatitis can be very persistent once it starts, so staying with treatment is required and preventative treatment is useful even when the symptoms are gone.

Published on March 1, 2010

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WebMD Medical Reference from the American Hair Loss Association

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