Why Seborrheic Dermatitis Causes Red Flaky Skin Around the Nose

Steroids and shampoos can provide relief

A flaky, itchy scalp is a symptom of seborrhea.
A flaky, itchy scalp is a symptom of seborrhea. BSIP/UIG/Getty Images

Have you noticed red flaky skin around your nose or in your eyebrows? How about in your scalp -- especially over your forehead or ears? If you answer yes, you may have something called seborrheic dermatitis or seborrhea.

The Cause of Seborrhea

Seborrhea is a chronic inflammatory skin disorder that affects the areas of the head and trunk that have sebaceous glands. A type of yeast that has an affinity for these glands called Pityrosporum ovale may be the cause, but this has not been proven yet.

It is believed that the build-up of yeast in these glands irritates the skin, causing redness and flaking.

Who Gets Seborrhea?

Seborrhea is more common in men than women and affects 3 percent of the general population. It occurs more commonly in older people who are bedridden or have neurologic conditions such as Parkinson's disease. Seborrhea also affects almost 85 percent of people with AIDS.

Treatment of Seborrhea

Adults who have seborrhea usually experience a waxing and waning course. In other words, it can't be "cured." The good news is with proper maintenance, seborrhea can be controlled. Furthermore, most of the treatments can be found over-the-counter.

Proper hygiene plays an important role in treatment. Frequent washing with soap gets rid of the oils in the affected areas and improves symptoms. Sunlight inhibits the growth of the yeast; therefore, exposure of affected areas to the sun is helpful, although caution should be exercised to avoid sun damage.

The main medical treatments are anti-fungal shampoos and topical steroids.

Seborrhea Shampoos

There are several good anti-fungal shampoos on the market that can be purchased without a prescription. The main shampoos are selenium sulfide, found in Selsun; pyrithione zinc, found in Head & Shoulders; and Sebulon, coal tar, found in Sebutone and Tegrin.

Finally, there's ketoconazole, found in Nizoral.

All of these shampoos have a medicated smell. The way to use them is to shampoo and leave on for at least 10 minutes, then rinse off. The shampoos can be used on the face and other parts of the body as a lotion with the same instructions as long as precaution is used around the eyes. Do this daily until the redness and flaking is controlled; then use two to three times a week as needed to keep symptoms from returning.

Topical Steroids For Seborrhea

Topical steroids reduce the inflammatory response and help control itching. You can buy hydrocortisone cream (1 percent) over-the-counter, and it's safe to use on the face. Apply twice a day to the affected area until the redness resolves. Save the hydrocortisone for flare-ups and use the anti-fungal shampoo for maintenance because long-term steroid use can cause side effects like acne and thinning of the skin.

When to See a Doctor For Seborrhea

You should see your doctor if you're not sure you have seborrhea.

Other conditions that can be similar are psoriasis, rosacea, atopic dermatitis, or superficial fungal infections.

You should also consult your doctor if you have tried this over-the-counter treatment and you still have symptoms, especially if you have very thick flakes. Your doctor may recommend a stronger steroid or a combination medicine to help dissolve the dead skin. Finally, if it is not advised that you shampoo your hair daily, ask your doctor about a special steroid preparation in oil that can be used on the scalp like a pomade.

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