HIV and Seborrheic Dermatitis

HIV increases risk and severity of a minor skin condition

Woman applying topical corticosteroids to shoulder
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Seborrheic dermatitis is a relatively minor skin problem that disproportionately affects people living with HIV. In fact, as many as 25 to 45 percent of people with HIV will get it, compared to only 8 percent of the general population. That number only rises in persons with advanced HIV infection, with some studies suggesting a lifetime risk of around 83 percent.

Seborrheic dermatitis is closely associated with the deterioration of a person's immune system.

HIV functions by targeting and killing cells (called CD4 T-cells) that are central to our immune defense. As the disease progress, the body is less able to fight off infections that an otherwise healthy person could.

Dermatologic (skin) problems are one of the earliest and most common signs of HIV.

Understanding Seborrheic Dermatitis

Dermatitis is a general term used to describe an inflammation of the skin. Dermatitis can have many causes and occurs in many forms. It usually involves an itchy rash on inflamed, swollen skin.

Seborrheic dermatitis is a minor skin eruption that usually involves the scalp and sometimes the face (usually around the eyelashes, eyebrows, and ears). In rarer cases, it can develop on the chest, armpits, or groin, especially if covered with a lot of hair.

Seborrheic dermatitis can vary in appearance from faint pink blotches with fine, waxy scales to severe episodes with large, red, scaly patches.

Serious outbreaks involving the trunk or groin are rarely seen outside of the HIV population.

While the exact cause of seborrheic dermatitis is unknown, there is some sketchy evidence that the yeast, Pityrosporum ovale, may play a part.

Treatment of Seborrheic Dermatitis

The symptoms of seborrheic dermatitis are treated the same in people with HIV as anyone else:

It is also important to address the underlying factors that give rise to seborrheic dermatitis. Since untreated HIV doubles the risk of this and other skin disorders, persons with HIV should be placed on immediate antiretroviral therapy (ART) in order to block the virus' ability to replicate. 

If used as directed, ART can suppress HIV to undetectable levels, thereby allowing CD4 T-cells to repopulate. By doing so, the risk of getting an HIV-related illness is greatly reduced, including dermatologic ones.

When to See a Doctor If You Have Seborrheic Dermatitis

Whether you are HIV-positive or not, your doctor should evaluate any case of seborrheic dermatitis that does not respond to typical over-the-counter remedies.

If you have HIV and have not started ART, it is important that you do so immediately. Current U.S. and guidelines recommend starting ART at the time of diagnosis, a strategy which is known to reduce the risk of illnesses by 53 percent.

If you suspect you have HIV, get tested either at your nearest clinic or by using an over-the-counter home testing kit available at most pharmacies.

Newer generation rapid tests are able to return results in as little as 20 minutes, allowing you to start treatment early to avoid any HIV-related illness.

Sources

  • National Institutes of Health (NIH). "Starting antiretroviral therapy early improves outcomes for HIV-infected individuals." Bethesda, Maryland; issued May 27, 2015.
  • Maurer, T. and Gerber, T. "Dermatologic Manifestations of HIV." HIV InSite Knowledge Base Center. San Francisco, California; March 1998.

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