Eczema is a chronic skin disease that has an undulating course - exacerbations are replaced by remissions. The pathological process can occur in various clinical forms, combined with each other by similar symptoms and developmental mechanism. One of the types of disease is seborrheic eczema, the origin of which does not depend on whether a person has seborrhea. Pathology often affects men over 40 years of age.

Disease code according to the ICD-10 system: L21 Seborrheic dermatosis.

Causes

The main cause of dermatosis is the reproduction of pathogenic microflora in the area of ​​the sebaceous glands. But it should be noted right away that conventionally negative fungi are normally present on the skin of every person, however, seborrheic eczema develops only in a certain group of people. Most experts are inclined to believe that allergic reactions and infections, namely staphylococci, Candida fungi, Pityrosporum ovale and Pityrosporum orbiculare, become the provoking factors of pathology.

It is also known for certain that this dermatosis can be caused by external and internal causes. Let's talk about them in more detail.

Internal (systemic) causes of seborrheic eczema:

• pathology of the central nervous system, neuropsychiatric disorders;
• hormonal disorders;
• weakened immunity;
• diseases of the liver and kidneys, gastrointestinal tract;
• chronic infections;
• metabolic problems;
• allergic reactions;
• unfavorable heredity, tendency to dermatitis and other types of dermatoses;
• excessive activity of the sebaceous glands;
• stagnant phenomena in the body associated with a sedentary lifestyle.

External causes of seborrheic eczema:

• bad habits - alcoholism, smoking;
• frequent contact with detergents alkaline type;
• cold season;
• insufficient care of the skin and scalp.

In addition, the development of seborrheic eczema is considered the first sign of AIDS in HIV-infected individuals.

Symptoms

The combination of several reasons from the list listed above may well become an incentive for the appearance of this form of dermatosis. Experts noted that the pathological process develops in stages, launching a whole list of systemic disorders in the body.

The mechanism of development of seborrheic eczema is as follows:

• The natural protection of the dermis is destroyed under the influence of negative internal factors.
• The susceptibility of nerve endings increases.
• The pathogenic microflora tends to penetrate into the deep layers of the skin.
• The body produces antibodies and, at the same time, sensitization processes take place in it, against the background of which a vigorous immune response may develop during secondary contact with allergens (pathogenic microorganisms).
• The concentration of inflammatory mediators increases, provoking edema and flushing of the skin, itching, excessive activity of the sebaceous glands and other symptoms of seborrheic eczema. By the nature of the development, the disease can be called a delayed allergy.

At the initial stage of the pathology, pink or red nodules and a large number of scales appear on the hairy areas of the body. white, when removed, weeping foci or areas are formed, merging into large plaques. Loose elements have clear boundaries, accompanied by itching of varying degrees - from mild to painful.

Eczema of the seborrheic type primarily affects the scalp, after which, as the pathology progresses, it can spread to other parts of the body - first the area behind the ears, eyebrows, forehead and cheeks, going down to the neck, back of the head, chest and back. With insufficient adherence to hygiene standards, the scales are layered on top of each other, provoking a strong inflammatory process, which is quite difficult to stop.

If the lesion is severe, then the condition may be aggravated by involvement in the foci of eyelid pathology, namely the development of diseases such as blepharitis and conjunctivitis. In this case, the eyes acquire an edematous red appearance, the person experiences discomfort when blinking, suffers from lacrimation and excruciating itching.

In addition to the eyelids, the inflammatory process spreads to the smooth skin of the face, the inner surfaces of the limbs, the navel and shoulder blades, and the mammary glands. Due to uneven lesions with clear boundaries, seborrheic eczema is often referred to as a "map" because of its visual similarity to the latter. Additionally, the picture of the disease can be complicated by such pathologies as folliculitis, hydradenitis and

Types, types, forms

Pathogenic fungi "gather" around the sebaceous glands, since the secretion produced by them is necessary for microorganisms to feed. This leads to hyperemia and swelling of the dermis. A strong immune system can restrain the growth and progression of the disease, a weak one is not able to resist pathological changes, against which the mechanism of dermatosis development is triggered.

Seborrheic eczema affects children and adults:

• In children, dermatosis develops quite often, mainly due to congenital factors or feeding characteristics, that is, in most cases, the lesion occurs in infants. The disease requires compulsory treatment, since the inflammatory process easily spreads to other parts of the body and only rarely goes away on its own.
• In adults, symptoms of seborrheic eczema mainly affect the scalp. As a rule, the pathology is usually diagnosed among men.

By the type of clinical picture, dermatosis can be of several forms:

• Fatty. Most obvious on the scalp. The condition is associated with excessive work of the sebaceous glands, which provokes a situation with constantly dirty hair- even after washing with special shampoos, they acquire a moist "greasy" look. In this case, a person may complain of constant itching and burning.
• Dry. The sebaceous glands, on the other hand, produce less secret, in connection with which severe dryness of the skin develops. The symptoms of pathology are peeling of the dermis and the formation of a large amount of fine dandruff.
• Mixed. At the same time it combines dry and oily type of seborrheic eczema. The inflammatory process covers a significant area of ​​the body, while in some parts of it there is excessive secretion of the sebaceous glands, and in others, on the contrary, peeling and lack of natural moisture.

In addition, seborrheic-type eczema is divided into two forms:

• Acquired. Development occurs under the influence of dysfunctional disorders of the systemic type in the body and pathological external factors.
• Congenital. The result of unfavorable heredity.

In the course of diagnostic work, specialists try to determine the etiology of the disease, since the further tactics of treatment depends on what its initial cause was. For example, it is almost impossible to fight with a congenital form of eczema, while with an acquired form one can fully count on the success of therapeutic measures if all the factors provoking the development of the disease are eliminated.

Localization

Consider in the following table on which parts of the body the seborrheic form of eczema can be located and how the clinical picture of the disease depends on it.

Diagnostics

When a patient turns to a specialist with complaints of the appearance of rashes and itching, the task of the doctor is to differentiate the disease. This will eliminate the likelihood of developing other skin pathologies and will allow you to prescribe the correct treatment regimen. It is important to distinguish seborrheic eczema from conditions such as candidiasis of the dermis, psoriasis vulgaris, diaper rash in infants and other forms of dermatosis.

In order to accurately diagnose, a dermatoscopy procedure is prescribed, based on the collection of tissue scrapings from the affected area of ​​the skin and the subsequent examination of the resulting sample under a microscope for pathogenic microorganisms. If necessary, the patient may additionally be recommended to take laboratory tests and allergy tests, as well as a study of the gastrointestinal tract.

To exclude other pathological conditions, an examination is prescribed by such narrow specialists as an immunologist, endocrinologist, nutritionist and allergist.

Treatment

The fight against seborrheic eczema should start with lifestyle changes..

The correct functioning of the nervous system is of great importance in this, since stresses and experiences often become the triggering mechanism for the development of skin dermatosis. The patient is strongly advised to avoid mental fatigue and sleep at least 8 hours a day.

Also, during a recurrence of seborrheic eczema, it is important to follow a hypoallergenic diet, avoiding foods such as citrus fruits, chocolate, whole milk, eggs, brightly colored vegetables and fruits. Hospitalization in in this case not required, patients receive the necessary treatment recommendations on an outpatient basis.

Conservative treatment. Consider in the following table what medications a doctor can prescribe to relieve symptoms of seborrheic eczema.

Local therapy. Since conditionally pathogenic fungal flora is directly involved in the development of seborrheic eczema, antimycotics will certainly be included in the complex treatment regimen for the disease.

If the pathological focus is located on the scalp, special therapeutic shampoos are prescribed:

• Nizoral (from 459 rubles);
• Keto-plus (from 461 rubles);
• Cynovite (from 235 rubles).

Most of them are based on zinc with pyrithione, a complex that normalizes the synthesis of sebum and reduces the desquamation of the dermis. After applying the shampoo to the head and lathering on the hair, leave it for at least 5 minutes to achieve the desired therapeutic effect. It is recommended to use the funds 2 times a week for a course of 2 months.

If the eczema has reached the oozing stage and it comes about the acute phase of the disease, it is necessary to treat the foci of inflammation with compresses soaked in a weak solution of potassium permanganate. After the skin is dry, anti-inflammatory drugs with steroids, for example, Triderm or Sinaflan, are applied on it with a thin layer.

After the acute stage of the pathology subsides, non-hormonal wound-healing drugs, such as Bepanten and zinc paste, are shown. They can be used for a long time for several months.

To prevent infection of inflammatory foci, it is recommended that they be regularly treated with fucorcin and furacilin solutions. With the development of purulent complications, they resort to antibiotics, for example, local remedies - erythromycin ointment and Levomekol.

If desired, preparations for external use are prepared with their own hands, and a dermatologist will tell you how to do this. With seborrheic eczema, the following recipe is popular: mix 1 tsp. birch tar with 1 tsp. apple cider vinegar and 3 tsp. fish oil, the resulting product is gently rubbed into the scalp or other areas of the body affected by the disease, except for the face. Leave to dry for 2 hours, then wash off with warm water without soap.

Physiotherapy. Local physiotherapy techniques such as ultraviolet irradiation of the affected skin, magnetotherapy, laser therapy, darsonvalization and PUVA therapy suppress the inappropriate immune response and promote patient recovery.

Also, with seborrheic eczema, cryo methods have shown their effectiveness, namely cryomassage and cryodestruction, which consist in cold exposure to the damaged areas of the dermis. Due to the influence of extremely low temperature values, the blood vessels are locally narrowed, the severity of the inflammatory process decreases and the secretion of the sebaceous glands is normalized.

Experts believe that physiotherapy techniques, used in conjunction with conservative treatment, improve the regenerative capabilities of the skin, alleviate the symptoms of pathology and promote a speedy recovery.

Alternative treatment. To combat seborrheic eczema of the scalp, traditional healers advise using a very simple recipe: wash your hair with regular shampoo and in clean skin rub a small amount of table salt for 10 minutes, then rinse it with clean water. Literally 6 of these regular procedures are enough to achieve complete recovery, since salt is considered an excellent antiseptic and exfoliating agent.

When localizing seborrheic eczema in other parts of the body, rubbing salt into them is not recommended, it is better to try the following folk recipe: in equal proportions, mix chopped ginger, galangal and nutmeg, pour the components with alcohol. After 2 days, treat the foci of inflammation in the morning and evening.

Compresses based on infusions of oak bark, St. John's wort, chamomile and peppermint will help reduce swelling and itching. Lotions can be applied to the affected surface of the dermis up to 5 times a day. With the localization of eczema on the scalp with the listed infusions, it is allowed to rinse the hair after washing.

Relapse

Exacerbation of seborrheic eczema is similar to the acute phase of the disease. The same factors that led to the initial inflammatory process - failures of the immune system, nervous disorders, allergens, etc. - can provoke a new development of pathology.

The patient is selected for complex treatment using antifungal, hormone-containing and anti-inflammatory drugs. If necessary, antihistamines, antibacterial and sedatives are prescribed. The doctor can also give advice on nutrition and prescription use. traditional medicine.

The course and treatment of the disease in children, pregnant and lactating women, the elderly

Children. Pathology usually occurs in infancy. The child's scalp begins to peel off, characteristic yellow scales and crusts appear, while the presence of a problem does not affect his well-being. Most often, with the observance of careful hygienic measures, the disease does not progress and after some time it is able to pass on its own. To speed up this process, pediatricians advise to take care of the baby's skin and hair with special mild detergents and adhere to the rules of complementary feeding. At the same time, it is advisable for a nursing mother to follow a hypoallergenic diet.

The following factors become the causes of seborrheic eczema in a young child:

• illness of a woman during pregnancy;
• serious stress and difficult psycho-emotional state of the expectant mother while carrying a fetus;
• congenital lactose intolerance in an infant;
• poor quality or inappropriate nutrition for the baby;
• a hereditary predisposition to allergies.

If eczema has not stopped developing, that is, the ailment continues to progress, despite the careful hygiene of the baby and the hypoallergenic nutrition of the nursing mother, rash elements in the form of plaques begin to spread from the scalp to the face, neck and spread to any parts of the body. The clinical situation causes the baby serious discomfort, as a result of which disturbances in the functioning of the digestive tract develop and the nervous system is upset - the child begins to eat poorly, often spits up, falls asleep with difficulty and spends little time in sleep.

After the diagnosis, a combination therapy is prescribed, the basis of which is the following points:

• Antifungal agents: used on the scalp and other parts of the body, from 6 months children are allowed Sebazol and Dermazole.
• Non-hormonal anti-inflammatory medications: they have practically no contraindications and can be used for the required amount of time. These include Skin-Cap, zinc paste, Friederm.
• Ointments with steroids: are prescribed when it was not possible to cope with inflammation in other ways. In children, Elokom and Advantan are used.
• Antihistamines: quickly eliminate skin hyperreaction and ease the baby's condition. Claritin, Telfast are allowed in pediatrics.
• Multivitamin complexes: necessary to support the immune system and improve the health of the child. From birth, Multitabs, Vitrum, etc. are allowed.

If the cause of seborrheic eczema in a baby is malfunctioning internal organs and systems, treatment of the underlying disease is mandatory, otherwise eczema will recur again and again. If the eyelids are damaged, additional consultation with an ophthalmologist and the selection of the necessary medication are required. It is not recommended to treat the disease at home without the knowledge of a specialist.

Pregnant women. Sometimes eczema develops for the first time in women in position, but more often it is a relapse of seborrheic eczema. Inflammatory lesions, similar to yellow scales and scaly patches, in future mother can be localized on any part of the body, but more often the scalp, ears, the area between the shoulder blades and natural folds of the skin suffer. The resulting plaques merge with each other and provoke itching, which gives the woman many unpleasant moments.

If the disease proceeds without complications, it is not dangerous for the expectant mother and her child. It is important to start treating eczema on time in order to prevent the addition of a secondary infection and stop the symptoms of pathology.

As a drug therapy, the doctor may prescribe the following groups of medicines:

• Antiseptic solutions: it is recommended to treat affected areas with Castellani paint, which kills pathogenic microflora and fights local inflammatory changes.
• Creams and ointments with steroids: contribute to the rapid relief of the expressed stage of the disease. In pregnant patients, it is used with caution in short courses strictly under the supervision of a physician. The drugs are applied 2 times a day to the affected skin until the symptoms of inflammation subside. Expectant mothers are allowed Flucinar and Lokoid ointments.
• Non-hormonal external agents: soften and moisturize the skin, fight the residual effects of eczema after the action of glucocorticosteroid medications, prevent the recurrence of pathology. On average, they are prescribed for a period of 1 to 2 months: Bepanten, zinc paste and Vishnevsky liniment.
• Antihistamines: prescribed for the expectant mother if the allergenic nature of the disease is proven. During pregnancy, Suprastin, Telfast are allowed.

During the period of exacerbation of seborrheic eczema and its treatment, it is recommended to limit contact with water if signs of wetness appear. It is important to avoid injury to these skin areas and to reasonably minimize all water treatments in relation to them. It is also necessary to completely exclude the use of cosmetic and decorative products.

It must be remembered that it is not eczema itself that is transmitted to the child, but the tendency to allergies. For example, in the future he may face hay fever, psoriasis or bronchial asthma. To prevent this from happening, it is important to prevent the development of dermatosis in the expectant mother during pregnancy, for example, using proper nutrition and skin care. If you cannot avoid the disease, you do not need to hesitate with a visit to a doctor and treatment.

Nursing. During lactation, exacerbation of seborrheic eczema is often provoked by two factors:

• changing the nature of the production and quality of the secretion of the sebaceous glands;
• excessive accumulation of pathogenic fungi on the surface of the dermis.

These circumstances may be associated with chronic stress and inaccuracies in the nutrition of a young mother, the presence of bad habits, a weakening of the immune system, which is often found after childbirth. The disease manifests itself in the same way as in other groups of people, most often the scalp, face and back of the head, as well as the woman's chest and back suffer from seborrheic eczema.

The pathological process may not affect the well-being of a young mother, but can cause a lot of uncomfortable sensations, so it is important not to postpone the visit to the doctor and undergo the necessary course of treatment on time. The process of healing and restoring the skin can be delayed and complicated by the fact that most drugs are contraindicated during lactation. In any case, it is necessary to carry out complex therapy.

Adjustments are made to the nutrition of a nursing mother, adherence to a hypoallergenic diet is an important condition for combating eczema. To stop the inflammatory process on the skin, local ointments and creams are prescribed that moisturize and nourish the dermis, which have a wound healing effect, such as Bepanten and zinc paste - they are safe during lactation. Regular use of these medicines makes it possible to prevent a relapse of the disease. In the absence of an allergic reaction to herbs, it is additionally allowed to treat the foci of inflammation with decoctions of chamomile, calendula and St. John's wort.

If the itching is pronounced and large areas of the skin are affected, hormone-containing drugs cannot be dispensed with. Breastfeeding for the period of their use is temporarily stopped, and the child is transferred to artificial nutrition adapted mixture. In order not to interrupt lactation, it is necessary to express milk regularly, stimulating its production. Ointments with steroids are used for a short period of time - Afloderm and Sinaflan are allowed for nursing mothers.

If the therapeutic measures taken do not give a positive effect, the doctor may advise you to completely interrupt lactation. This is due to the fact that upon termination breastfeeding the woman's hormonal background returns to normal, which, in turn, relieves the symptoms of seborrheic eczema. Of course, this option does not give a 100% guarantee that the dermatosis will be eliminated, but the likelihood of such an outcome is quite high.

Elderly. Seborrheic eczema of the head and other parts of the body can develop in any age group- from babies to the elderly. In the latter, the onset of pathology is almost always associated with a decrease in the resources of the immune system. It is noted that men face this ailment much more often than women. The peak incidence occurs at the age of 40-60 years.

Symptoms of seborrheic eczema have common features characteristic of this pathological process. Treatment should be carried out simultaneously with therapy for underlying diseases and sanitation of infectious and inflammatory foci.

Persons with oily or mixed forms of dermatosis are advised to limit the use of fried, smoked and sweet foods to the maximum, refuse to visit baths, saunas and stay in a warm and humid climate. It is also important to learn how to choose the right skin and hair care products - it is necessary that they correspond to their type and fat content.

Local treatment of seborrheic eczema in an elderly person is carried out with anti-inflammatory and antimicrobial agents, for example, salicylic ointment or sulfuric talker. Inside, vitamins of groups A and B are prescribed. Physiotherapy methods have good results: laser treatment, darsonvalization, magnetotherapy, cryodestruction and cryomassage. Pronounced symptoms of eczema require the selection of ointments and creams with steroids. In the case of a secondary infection, antibacterial local and systemic agents are prescribed in the form of tablets.

Treatment of seborrheic eczema in Russia (Moscow, St. Petersburg)

If a person is faced with itching and inflammation on the scalp and body, increased sweating, the formation of loose elements and scaling foci, he needs to consult a doctor, and as soon as possible. An accurate diagnosis can only be made by a specialist, who will also help to choose the optimal treatment tactics corresponding to the clinical case that has arisen.

The correct approach to the treatment of seborrheic eczema enables specialists to control the manifestations of the disease and prevent the likelihood of relapse. Dermatologists, cosmetologists and trichologists in modern clinics in Russia, such as Moscow and St. Petersburg, will help you quickly identify and solve the problem.

The fight against seborrheic eczema on the face and body is carried out with the help of a complex of caring agents, drugs and physiotherapy methods. Thanks to the combined approach, it is possible not only to eliminate the symptoms of pathology, but also to influence the causes of the disease. At the same time, experts in no way advise to self-medicate and purchase advertised medicines without first consulting a doctor.

To relieve itching of the scalp and quickly recover in domestic clinics, methods of darsonvalization, cryomassage, ultraviolet therapy are used, which make it possible to improve the results of conservative treatment.

Which clinics can I go to?

Medical center "On Clinic", Moscow, Tsvetnoy Boulevard, 30. The clinic's specialists will correctly determine the causes of dermatosis, select an effective and safe treatment and give appropriate recommendations for prevention. The cost of therapy depends on the current clinical situation. Consider the approximate prices for the provision of medical services:

• dermatologist's appointment - 2100 rubles;
• dermatoscopy - 1500 rubles;
• selection of treatment - 1000 rubles;
• cryomassage - 1500 rubles. for the procedure.

Anastasia, 34 years old. “I turned to On Clinic in 2015 with seborrheic eczema. She underwent treatment, including physiotherapy. Before visiting the medical center, I suffered from relapses every month, after the therapy there were no rashes, so I recommend the clinic to everyone. "

Julia, 37 years old. “Seborrheic rashes on the scalp have periodically appeared since childhood, of course, it looked terrible. Now, with the opening of such modern centers as On Clinic, you can forget about the disease, the main thing is to follow the doctor's recommendations and strictly follow the treatment regimens. "

Medical center "Union Clinic", St. Petersburg, st. Marata, 69. The center offers a wide range of medical services for the diagnosis, treatment, prevention and rehabilitation of various dermatological diseases, including seborrheic eczema. The work of doctors working in the clinic is comprehensively aimed at a positive outcome and complete recovery of patients. Consider the approximate prices for the provided medical services at Union Clinic:

• dermatologist's appointment - 1200 rubles;
• dermatoscopy - 200 rubles;
• selection of treatment - 500 rubles;
• cryodestruction - from 700 rubles. for the procedure.

Consider the reviews for this clinic:

Natalia, 35 years old. “I am very pleased with the work of the doctors at the Union Clinic Medical Center. They helped me cope with eczema. "

Alexandra, 23 years old.“From adolescence I suffered from problems with the skin of the face and scalp, and had to wash my hair from oily content 2 times a day. The medicated shampoos were of little help. At the age of 19 she turned to the Union Clinic near her home. She underwent examination, received recommendations for treatment, which, by the way, lasted 4 months. Now everything is over, the skin is normal, the hair has finally acquired beauty and gloss. Thanks to the doctors, now I trust them. "

Complications

If the foci of seborrheic eczema are left untreated or the therapy prescribed by a specialist is not completed, the affected skin becomes an entrance gate for the penetration of pathogenic microflora, most often staphylococcal and streptococcal. Infectious complications worsen the symptoms of the underlying disease. Intractable erosion, ulcers, purulent rashes appear. As a rule, this situation is usually encountered by men in whom the seborrheic form of eczema is localized in the growth zone of the mustache and beard, and they continue to shave their hair during treatment. With mechanical action on the foci of inflammation (shaving or combing), the disease regresses.

Seborrheic eczema located on the scalp can cause partial alopecia or permanent hair loss. This also happens when you ignore the treatment and supervision of a specialist.

Are they being recruited into the army with seborrheic eczema?

In most cases, the seborrheic form of eczema is not an obstacle to military service. Only with a significant defeat with acute symptoms can one count on a delay or premature end of military service in the ranks of the Russian army.

Is seborrheic eczema contagious?

The disease is considered a conditionally non-contagious ailment, since infection with fungal flora occurs under conditions of a simultaneous decrease in immunity, skin damage and allergic reactions. That is, seborrheic eczema can be called contagious if the above factors are observed. To prevent transmission of infection, you must carefully follow the rules of personal hygiene and deal with the elimination of existing health problems.

Diet

Proper nutrition is considered an important point in the treatment of any type of eczema, which is forgotten by many patients. In order to quickly cope with an exacerbated disease and maintain it in the stage of prolonged remission, it is necessary to completely abandon food that has potential allergenic activity:

• nuts and honey;
• Foods rich in gluten (some cereals, baked goods);
• whole milk;
• Strawberry;
• citrus;
• caffeine, chocolate;
• mushrooms;
• red and black caviar.

Additionally, during treatment, it is important to give up alcohol and carbonated drinks, semi-finished products, salty and smoked foods, fried and fatty foods. A person's diet should include vegetarian soups, stewed vegetables, boiled meat, fruits, cereals and herbs.

Forecast

If the patient carefully observes all medical recommendations, he can achieve a stable long-term remission and not remember the disease for a long time. It is difficult to completely recover from seborrheic eczema - as a rule, the pathology quickly becomes chronic and makes itself felt when the immune system fails. Therefore, it is important to monitor the state of your health and, at the first signs of trouble, seek help from a specialist.

Prophylaxis

Preventive measures for seborrheic eczema boil down to the following recommendations:

• daily shower with mild detergents;
• balanced diet;
• dairy-vegetable diet;
• rejection of bad habits;
• exclusion of direct contact with household chemicals;
• wearing clothes made from natural materials;
• supervision by a specialist.

You also need to closely monitor the condition of the skin. Any rashes and redness cannot be ignored, since they may indicate the onset of a pathological process.