It is the most common irritating disease of the scalp, yet it can spread to face, back, neck and chest. Seborrheic dermatitis (SD) is a common skin condition seen frequently in clinical practice. Seborrheic dermatitis is a chronic relapsing erythematous scaly skin disease, the prevalence of which is around 1 to 3% of the general population in the United States. It has two incidence peaks, the first in the first three months of life and the second beginning at puberty and reaching its apex at 40 to 60 years of age. Still, it affects most of the people once in a while regardless of gender, age or race. Both genetic factors and environmental factors play roles in this disease.
SIGNS AND SYMPTOMS
Reddish skin rashes with scaling, erythema, and itching-occur most often on the scalp, face, chest, back, axilla, and groin.
CAUSES
Infection by Malassezia yeast.
PATHOPHYSIOLOGY
The currently accepted theory on the pathogenesis of this disease advocates that yeast of Malassezia spp., present on the skin surface of susceptible individuals, leads to a non-immunogenic irritation due to the production of unsaturated fatty acids deposited on the skin surface.
DIAGNOSIS
Clinical evaluation
TREATMENTS
Antifungal agents such as topical ketoconazole is the mainstay of therapy for seborrheic dermatitis of the face and body. Because of possible adverse effects, anti-inflammatory agents such as topical corticosteroids and calcineurin inhibitors should be used only for short durations. Several over-the-counter shampoos are available for treatment of seborrheic dermatitis of the scalp. Antifungal shampoos (long-term) and topical corticosteroids (short-term) can be used as second-line agents for treatment of scalp seborrheic dermatitis.
PROGNOSIS
treatment almost always results in an excellent response, however there is high chance of recurrence.
COMPLICATIONS
secondary bacterial infections
Erythroderma
Disease & Ayurveda
Darunaka/Daranaka
Nidana
Unwholesome diet with opposite potency
Improper hygiene
Causes for vitiation of the kapha dosha and Vaata dosha
Purvaaroopa
Not mentioned
Samprapti
Due to the causative factors, vitiated doshas (mainly kapha) vitiate rasadhatu and reaches skin of the scalp and develop into scaly rashes with itching and other discomforts.
Lakshana
Itching of the scalp
Hair fall
Dry and cracked skin of the scalp
Divisions
Not mentioned
Prognosis
Saadhya in most cases
Yaapya in chronic & complicated cases
Chikithsa
Main treatment of darunaka is bloodletting (siravedha) in head. It is done by making minute cuts on the skin of scalp and letting out the vitiated blood. By this method, the aavarana (obstruction causing lack of supply & malnourishment to the skin & hair roots) is removed and the skin of the scalp is cleaned leading to proper hair growth.
Proper personal hygiene is strictly advised.
Samana
kshalana – washing with kashayas like koradooshatrunakwaatha or triphalakwatha
lepana – applying external medicines like priyalabeejadi lepa, aragwadhadi lepa etc.
Sirovasti
Abhyanga
Sodhana
Avapeedanasya
Vamana with madanaphalakwatha
Virechana with erandatailam, or avipathi choornam
Commonly used medicines
Aragwadhadi kwatham
Sonithamrutham Kashayam
Malathiadi keram
Durvaadi keram
Dhurdhurapatradi keram
Dantapala Tailam
Avipathi choornam
Nimbamruthadi erandam
Brands available
AVS Kottakal
SNA Oushadhasala
Vaidyaratnam oushadhasala
AVP Coimbatore
Home remedies
Proper personal hygiene is an important measure. Herbs that can help the discomforts of the disease includes the following:
Neem
Holy basil
Apple cider vinegar
Baking soda
Tea tree oil
Epsom salt
Diet
Pathya
Light meals and easily digestible foods
Green gram, soups, buttermilk boiled with ginger, turmeric, curry leaves etc.
Freshly cooked and warm food processed with cumin seeds, ginger, ajwain etc
Apathya
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products other than buttermilk- Cause indigestion, increase Kaphadosha, can lead to obstruction in channels and respiratory problems.
Curd – causes vidaaha and thereby many other diseases
Red chilli and other pungent, hot and spicy food items.
Vihaara
Better to avoid exposure to excessive sunlight wind rain or dust.
Avoid stress and emotional hurricanes.
Maintain a regular food and sleep schedule.
Avoid sedentary lifestyle. Be active.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Yoga
Dandruff, like any other skin disease, is directly related with stress and lack of circulation. Proper destressing and sweating therapies with Yoga can be beneficial when practised regularly.
Yoga for dandruff
vajrasana
Nadisudhi pranayama
Bhujangasana
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
DOI: 10.1016/j.jid.2018.07.027
A study was done to determine whether specific dietary patterns or total antioxidant capacity are associated with seborrheic dermatitis. Participants with a skin examination and a food frequency questionnaire were included. The study concluded that a high fruit intake was associated with less seborrheic dermatitis, whereas high adherence to a “Western” dietary pattern in females was associated with more seborrheic dermatitis.
DOI: 10.1111/ijd.13408
A randomized, comparative clinical trial, using two groups, was conducted over 6 months. Patients in Group ISO were treated with isotretinoin 10 mg every other day. In Group X, patients received antiseborrheic topical treatment. The rate of sebum production significantly decreased in Group ISO.Low-dose oral isotretinoin can be a therapeutic modality for moderate to severe seborrhea and seborrheic dermatitis.
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Dr. Rajesh Nair, Expert. Ayurveda Medicine, India
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
rajesh@ayurvedaforall.com
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