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Dermatology/seborrheic dermatitis

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Question
Dear sir i am rafsan from bangladesh.i am facing a rapid hair lossi am suffering from seborrheic dermatitis for 3 years.there are lots of tiny dried white stuff on my scalp and they fall with hair.my scalp is very oily and itchy.please suggest me how to treat seborrheic dermatitis properly.

Answer
Hygiene issues play a key role in controlling seborrheic dermatitis. Frequent cleansing with soap removes oils from affected areas and improves seborrhea. Patients should be counseled that good hygiene must be a lifelong commitment. Outdoor recreation, especially during summer, will also improve seborrhea, although caution should be taken to avoid sun damage.

Pharmacologic treatment options for seborrheic dermatitis include antifungal preparations (selenium sulfide, pyrithione zinc, azole agents, sodium sulfacetamide and topical terbinafine) that decrease colonization by lipophilic yeast and anti-inflammatory agents (topical steroids).  For severe disease, keratolytics such as salicylic acid or coal tar preparations may be used to remove dense scale; then topical steroids may be applied. Other options for removing adherent scale involve applying any of a variety of oils (peanut, olive or mineral) to soften the scale overnight, followed by use of a detergent or coal tar shampoo.

As a last resort in refractory disease, sebosuppressive agents such as isotretinoin (Accutane) may be used to reduce sebaceous gland activity.

Dermatology

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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