{"id":4413,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/seborrhoeicdermatitis\/"},"modified":"2024-10-11T10:34:39","modified_gmt":"2024-10-11T09:34:39","slug":"seborrhoeicdermatitis","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dermatology\/seborrhoeicdermatitis\/","title":{"rendered":"Seborrhoeic Dermatitis"},"content":{"rendered":"\n<p>Seborrhoeic dermatitis presents with red well defined areas covered with greasy scale, affecting mainly the scalp, face and upper trunk, and often the flexures. Aetiology is linked to a harmless yeast called Malassezia (Pityrosporum).<\/p>\n\n\n\n<figure class=\"wp-block-gallery has-nested-images columns-default is-cropped wp-block-gallery-1 is-layout-flex wp-block-gallery-is-layout-flex\">\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"641\" height=\"483\" data-id=\"1075\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-Seborrheic-underarm-April-2020.png\" alt=\"Dermatology Seborrheic underarm\" class=\"wp-image-1075\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-Seborrheic-underarm-April-2020.png 641w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-Seborrheic-underarm-April-2020-300x226.png 300w\" sizes=\"auto, (max-width: 641px) 100vw, 641px\" \/><figcaption class=\"wp-element-caption\"><span class=\"media-credit\">\u00a9 DermNet New Zealand<\/span> <a href=\"https:\/\/dermnetnz.org\/#gsc.tab=1&amp;gsc.q=seborrhoeic%20dermatitis\">Search DermNet | DermNet (dermnetnz.org)<\/a><\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"641\" height=\"483\" data-id=\"1074\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-Seborrheic-Dermatitis-April-2020.png\" alt=\"Dermatology Seborrheic Dermatitis\" class=\"wp-image-1074\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-Seborrheic-Dermatitis-April-2020.png 641w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-Seborrheic-Dermatitis-April-2020-300x226.png 300w\" sizes=\"auto, (max-width: 641px) 100vw, 641px\" \/><figcaption class=\"wp-element-caption\"><span class=\"media-credit\">\u00a9 DermNet New Zealand<\/span> <a href=\"https:\/\/dermnetnz.org\/#gsc.tab=1&amp;gsc.q=seborrhoeic%20dermatitis\">Search DermNet | DermNet (dermnetnz.org)<\/a><\/figcaption><\/figure>\n<\/figure>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>R.C 25-04-24<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer<\/h4>\n\n\n\n<p>Severe or extensive disease unresponsive to appropriate treatment &#8211; 4-6 weeks with mild to moderate topical steroid and 2 weeks for potent.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Management<\/h3>\n\n\n\n<p><strong>Treatment of cradle cap<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Use bath emollients regularly and sponge scalp clean.<\/li>\n\n\n\n<li>Avoid paraffin ointments. The use of olive oil is recommended by some and can be effective.<\/li>\n\n\n\n<li>If inflamed, use mild topical steroid for intermittent treatment.<\/li>\n<\/ul>\n\n\n\n<p><strong>Treatment of dandruff\/adult scalp involvement<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Regular use of shampoos containing zinc pyrithione, selenenium sulphide, ciclopirox, tar or ketoconazole.&nbsp; If very inflamed, intermittent use of potent topical steroid lotions\/gels.<\/li>\n<\/ul>\n\n\n\n<p><strong>Treatment of mild disease<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Regular use of emollients for dry flaky skin.<\/li>\n\n\n\n<li>Mild topical steroid to face e.g. hydrocortisone 1% ointment or topical anti fungal therapy alone or combined with mild steroid&nbsp;e.g. clotrimazole, miconazole or nystatin.<\/li>\n\n\n\n<li>Mild to moderate topical steroid e.g. clobetasone ointment to trunk or flexures.<\/li>\n<\/ul>\n\n\n\n<p><strong>Treatment of moderate disease<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Potent topical steroid ointment to torso and limbs e.g. betamethasone&nbsp;ointment until signs of improvement,&nbsp;then consider frequency reduction&nbsp; (e.g. 2 days per week) or step&nbsp;down in potency.<\/li>\n\n\n\n<li>Mild to moderate potency topical steroid to face then reduce frequency or potency.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Therapeutic Tip<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Use shampoos containing selenium sulphide, zinc pyrithione or ketoconazole to wash body &#8211; leave on for 5-10 minutes before washing off.<\/li>\n\n\n\n<li>Treat flexural involvement as intertrigo with barrier preparations or use of combination topical therapy such as Clotrimazole\/hydrocortisone 1% cream (trimovate cream works well but is not on formulary)<\/li>\n\n\n\n<li>More severe involvement is common with Parkinson&#8217;s, HIV, or a family history of psoriasis.<\/li>\n\n\n\n<li>Consider oral itraconazole 100mg once daily x 3 weeks in resistant cases.<\/li>\n\n\n\n<li>Other products to consider: topical metronidazole gel, benzoyl peroxide, 5% lithium succinate ointment, calcineurin inhibitors (tacrolimus, pimecrolimus) though many of these are off label.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">For Patients<\/h4>\n\n\n\n<p><a href=\"http:\/\/www.bad.org.uk\/for-the-public\/patient-information-leaflets\/seborrhoeic-dermatitis\/?showmore=1\" target=\"_blank\" rel=\"noreferrer noopener\">http:\/\/www.bad.org.uk\/for-the-public\/patient-information-leaflets\/seborrhoeic-dermatitis\/?showmore=1<\/a><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">For Health Professionals<\/h4>\n\n\n\n<p><strong>Link to PCDS&nbsp;<\/strong>&nbsp;<a rel=\"noreferrer noopener\" href=\"http:\/\/www.pcds.org.uk\/clinical-guidance\/seborrhoeic-eczema\" target=\"_blank\">seborrhoeic-eczema guidance<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Seborrhoeic dermatitis presents with red well defined areas covered with greasy scale, affecting mainly the scalp, face and upper trunk, and often the flexures. Aetiology is linked to a harmless yeast called Malassezia (Pityrosporum). R.C 25-04-24<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3853,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[111],"class_list":["post-4413","page","type-page","status-publish","hentry","category-seborrhoeicdermatitis"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/dermatology\/seborrhoeicdermatitis\/\" rel=\"tag\">Seborrhoeic Dermatitis<\/a>","rttpg_excerpt":"Seborrhoeic dermatitis presents with red well defined areas covered with greasy scale, affecting mainly the scalp, face and upper trunk, and often the flexures. Aetiology is linked to a harmless yeast called Malassezia (Pityrosporum). R.C 25-04-24","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4413","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4413"}],"version-history":[{"count":13,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4413\/revisions"}],"predecessor-version":[{"id":21188,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4413\/revisions\/21188"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3853"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4413"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4413"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}