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Therapeutics in Dermatology
A reference textbook in dermatology
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Adult seborrheic dermatitis

2 April 2013, by LY S.

A REMINDER OF EPIDEMIOLOGY

Seborrheic dermatitis (SD) is a chronic, recurrent, and extremely common inflammatory skin disorder with an estimated prevalence of 3% in the general population. This prevalence varies with age, dropping from 10% in children under the age of 5 (with 70% of cases arising in infants before the age of 3 months) to less than 1% in children aged between 6 and 12. SD then re-emerges in teenagers and young adults, with a prevalence of up to 4% in the 35 to 44 age group. The elderly are also affected, since the disorder was detected in 23% of a population of 186 patients aged over 65.

IMPACT AND PATIENT INFORMATION

While the psychosocial impact of SD is minimal in certain patients, it is undeniable in others, prompting them to seek medical help both for a flaky, itchy scalp and for unsightly, recurrent inflamed lesions on the face. These patients have often tried a variety of topical treatments and consider themselves to be in a situation of "treatment failure". They seek to "cure" their dermatosis. It is essential to inform them (or confirm!) that SD is a chronic condition. Explaining the role played by sebum and the effects of Malassezia proliferation, insisting on the saprophytic character of the yeast, should help to clarify this concept. Patients will then better understand the need to tailor treatment to the flare ups and to continue with maintenance treatment between flare ups, and this should help them get the concept of "treatment failure" into perspective. The different treatments and treatment methods should be fully explored with the patient, who should also be given advice on personal hygiene and advised to use non-irritant products (lipid-enriched cleansing bar, soap-free cleansers, micellar lotions, and suitable emollients and shampoos).

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