Scientific Area

Seborrheic dermatitis

CATEGORIES SCIENTIFIC AREA

Scientific collaboration between Professor Marco Toscani and Dr. Pasquale Fino, Chair of Plastic, Reconstructive and Aesthetic Surgery, Umberto I Health Center – “Sapienza” University of Rome.

Seborrheic dermatitis is a very common scalp condition characterized by the presence of yellow and oily flakes on the skin.

It is associated with erythema, small scaly, and intense itching.
Seborrheic dermatitis is a well-known condition but is still not easily identifiable. Many men and women starting from puberty have oily, greasy, shiny and thickened skin with large hair follicles, especially noticeable around the nose and mouth, forehead, torso, scalp (affected by so-called oily dandruff).
Seborrheic dermatitis appears in these individuals. It is characterized by red, reddish-yellow or dark red skin patches, covered with small and medium sized, thick and greasy flakes, sometimes appearing as scaly formations with blisters that are not easily noticed.

Seborrheic eczema is a typical form surrounded by seborrheic dermatitis limited to certain areas of the body, found at the level of the sternum and shoulder blades, characterized by various round patches with clearly defined convex edges. Another form is characterized by pityriasiform and psoriasiform patches. Complications of seborrheic dermatitis are: eczematization (the most common complication), external otitis, occipital and nuchal eczema, umbilical eczema, areola eczema in women and lastly perineum-genital eczema.

Often, seborrheic dermatitis is located on the scalp and along its edges. An irregular patch often emerges from the scalp onto the forehead called a “seborrheic crown”. It is important to remember that seborrheic dermatitis in and of itself does not cause hair loss.
The etiopathogenesis of seborrheic dermatitis is not completely clear. Recognized concurrent causes are bacterial, fungal (Malassezia), infectious, mechanical, irritative, psychosomatic and sebaceous dysfunction (most probably of genetic origin) factors. In the case of seborrheic dermatitis sebum undergoes a chemical transformation. In fact, a reduction of triglycerides, squalene and cholesterol occurs.

Hair treatments like lotions and shampoos are commonly used as local anti-seborrheic treatments. Non-halogenated corticosteroids in the form of gels or lotions are very effective. Antibiotics and antifungal treatments may also be used. Positive results have also been achieved by using retinoic acid and ketoconazole, general purpose antifungals.

Cuneiform hair or dwarf hair

This is very short hair, between 1 cm and a maximum of 2 cm in length, which usually has insufficient pigmentation. This hair has a base structure that is quite large, almost like normal hair. It then tends to get smaller towards the end, thus taking on the form of a very pointed cone.
This hair has a strong tendency to fall out.

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Thin hair

Genetic factors influence and determine the size of the diameter in hair.
Its volume varies from person to person. This is why some individuals are born with thin hair, while others are born with thick hair.

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Structure and chemical composition of hair

The hair on our bodies has a particular structure and is divided into thin and thick hair. Thin hair, also called lanugo or vellus, is located on all skin surfaces except for the palms of the hands and the soles of the feet. Thick hair, also called terminal hair, is dark and located only in some areas such as the scalp, the armpits, the pubic area, the beard area in the case of men, etc…

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Life cycle of hair

The life cycle of hair and its subsequent growth occur at a speed of 1-1.5 cm per month. Hair is a living element that follows a follicle cycle with an average duration of 2-6 years. In humans, unlike other mammals that are subject to a periodic change, this cyclic evolution is not synchronous (therefore each hair is independent from the others).

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Hair types and morphology

Some parameters and characteristics should be taken into consideration when assessing hair types and morphologies: shape, density and appearance. The appearance of hair, in the form of lanugo, occurs during the fourth month of pregnancy.

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Dandruff or pityriasis

Dandruff is a scalp condition that usually arises between the ages of 10 and 25. It may improve between the ages of 45 and 55 or may continue during old age.
Its cause is a result of an accelerated turnover of epidermal cells, which following an increase in migration speed, are unable to reach complete maturity before detaching. Whitish-yellow flakes (masses of corneum cells) form and detach, gathering in patches or often spreading evenly across the scalp.

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