How to get rid of - Dry, Cracked Skin on Feet

Compared to the skin covering the rest of our body, the skin on our feet is normally drier. This is because it lacks the sebaceous glands or oil glands that can keep it moisturized. To compensate for this, the skin on our feet relies on the sweat glands to at least prevent it from becoming extremely dry. However, there are conditions wherein the skin on feet becomes severely dry it becomes cracked [1].

Causes

  • Prolonged standing, walking, or running
  • Excessive physical activity that involves frequent movement of the feet
  • Back-open shoes that provide no protection to the sides of the feet
  • Improper foot care and hygiene
  • Obesity gives extra bearing to the already exhausted feet.
  • Prolonged water exposure removes the moisture off of your feet.
  • Soaps and cosmetic products containing harsh chemicals cause dryness and leave irritating substances on the skin. You think they help but it is actually the opposite. Gentle mild products are still better.
  • Dry skin is one of the signs of aging. As we age, the outermost layer of the skin called stratum corneum gets thicker, resulting to lessened skin cell turnover. Moreover, fats that serve as a cushion to our toes and heels become thinner, decreasing its protective purpose.
  • Deficiency of vitamin A, vitamin E, and essential fatty acids [omega-3, alpha-linolenic acid (ALA), and gamma-linolenic acid (GLA)] contributes to unhealthy skin.
  • Medical Conditions:
  • Diabetes involves poor wound healing. Moreover, high levels of blood glucose increase the number of microorganisms, making the infection more difficult to cure.
  • Athelete’s Foot (Tinea Pedis) is the most common fungal skin infection. The fungi cause your toes to feel burning and itching sensations. Physically, these fungi deprive your feet of the nutrients that they need to be kept healthy, causing them to dry and crack.


Check for more information on :
  • In Atopic Dermatitis (Eczema), Psoriasis, and other skin diseases, dry cracked skin is an inherent characteristic.
  • Thyroid Disease, in this case Hypothyroidism, contributes to skin dryness and cracking because depressed function of the thyroid gland leads to slow blood circulation. As a result, there are decreased nutrients and fatty acids that reach your feet. Additionally, the skin glands are also deprived of secretions needed to keep your skin hydrated.
  • Neuropathy, also connected with diabetes, is also called nerve damage. One good thing about pain is that it is protective. It tells you that your body is in danger. When you feel it, you find measures on how to avoid it and prevent it from doing further damage. In the case of neuropathy, you cannot feel the pain. When your feet are dried and cracked, you will not notice it until you see it. This might be dangerous because by the time that you notice it, it may be too late especially if the damage is already deep it has already caused severe wound infection. This is not good news to diabetics [2, 3, 4, 5, 6].

Signs and Symptoms 

  • Skin tightness
  • Skin dehydration
  • Shrunken skin
  • Itchiness
  • Appearance of fine lines
  • Formation of flakes
  • Scaling
  • Peeling
  • Redness
  • Bleeding fissures [7]
  •  

Home Remedies for Dry, Cracked Skin on Feet

  • One of the simple and best cures for dried cracked feet is to use moisturizers after taking a bath in order to lock in the moisture. If your feet are extremely dry, you may use oil to decrease water evaporation from your skin. To prevent cracking, you may use creams to soften your skin and prevent forming fissures. Diabetics, however, should watch out in using cosmetics because moisture on enclosed areas (i.e. toes) might lead to infection
  • Epsom salt promotes circulation to your feet. Its magnesium content removes toxins, promoting healthier skin. Put one half cup of Epsom salt into a lukewarm water. Soak your feet for 10 minutes. Rub the affected area with pumice stone. Put it back into the water for another 10 minutes. Pat it dry then apply petroleum jelly. Do this for two to three days.
  • Lemon juice is a weak acid tolerable by the skin if soaked into it. It softens the dry and rough skin so that the affected area is easily scrubbed off when used with a foot brush or loofah. 
  • You may also want to try combining juice from a whole lemon with one teaspoon of Vaseline. Apply all of the mixture to the cracked areas. Cover your feet with wool stocks to preserve the moisturizing effect and prevent your bed sheets from staining. Do this every night before you go to sleep.
  • Pour a cup of apple cider vinegar into a gallon of warm water. This makes a disinfectant wherein you can use to soak your feet for 10 to 15 minutes. It is also said that this is relaxing for tired feet. Moisturize with lanolin products after gently patting it dry with a clean soft cloth.
  • You can also use apple cider vinegar to create a homemade foot scrub. Mix a few tablespoons of apple cider vinegar or honey, a handful of rice flour, and one tablespoon of olive oil. This makes a thick paste which you can use to massage your feet. Rinse with warm water. Do this once or twice a week.
  • After taking a night bath, apply vegetable oil on the affected areas. Cover your feet with clean socks. Do this every night before going to bed.
  • Another natural treatment for dried cracked feet is the coconut oil. Coconut oil has antimicrobial and antifungal properties, not to mention its moisturizing effects. Simply apply it to cracked areas of your feet and cover with socks.
  • To create a homemade moisturizing cream for your cracked heels and toes, shake a combination of one tablespoon of olive oil and a few drops of lavender or lemon oil until thick and milky. Use whenever necessary.
  • You can use an overripe banana to get rid of your dry, cracked skin on feet. Put an overripe banana and a half of avocado (optional) into a blender. This makes a homemade remedy that you can leave on the cracked feet for 15-20 minutes. Alternately wash it with lukewarm and cold water. Do this everyday.
  • Combine one cup of ground oatmeal, one half cup of all-purpose flour, one-fourth cup of honey, and one-fourth cup of olive oil. Before applying the paste, soak your feet first in warm water. Leave the paste into the cracked areas of the feet for 30 minutes then wash it off with lukewarm water. Apply foot cream or moisturizer thereafter. Do this few times a week.
  • Mix a tablespoon of powdered oatmeal and few drops of jojoba oil. This makes a homemade treatment which you can leave on for 30 minutes. Wash with cold water thereafter.
  • Mentholated rub may help. It is also effective in healing toenail fungi.
  • Wrap your foot with wet dressings every night. You may use clean wet socks covered by dry socks. This is done only in the absence of infection. Moisture attracts more microorganisms that could make the infection worse than it already is [1, 2, 8].

When to Consult a Doctor

Many might believe that they should consult a dermatologist when it comes to this matter but in fact, it is better to consult a podiatrist since they are the foot experts. Seek consultation if you have the following:
  • If wounds, ulcers, or infections develop from the affected area
  • If the affected area is expanding and continues to spread
  • If there is a presence of other skin diseases
  • If the condition is persistent despite of home treatment
  • If the condition wakes you up at night and keeps you from sleeping well
  • If the condition interferes with your activities of daily living [7]

How to get rid of Dry, Cracked Skin on Feet

  • Treat the underlying medical condition.
  • Hydrocortisone cream can be used for severe skin itchiness and inflammation.
  • Humectants (with alpha-hydroxy acid) such as glycerin and lactic acid promote moisturization and exfoliation (slaughing off of skin to replace it with newer skin cells).
  • Emollients such as lanolin, urea, and silicon oils keep your skin from becoming severely dry by becoming a moisture barrier [2, 3].

Prevention

  • Hydrate yourself with plenty of water.
  • Avoid staying in very hot or very cold weathers.
  • Avoid steam baths and saunas.
  • Avoid harsh soaps that could cause dryness of the skin. Simply use gentle soaps with moisturizers.
  • Wear socks that are non-irritating to the skin, i.e. cotton.
  • Wear comfortable shoes. Let your feet breathe. Never allow excessive sweating for your feet.
  • Use a room humidifier if you stay in a place with low humidity. A hot, dry environment robs your skin of the proper moisture that it needs. Humidity prevents itchiness and flaking of your skin.
  • Avoid caffeine and alcohol which are thought to worsen the itchy sensation.
  • Foods rich in omega-3, ALA, and GLA include halibut, salmon, sardines, and walnuts. Oils of safflower, flaxseed, canola, baroage, and evening primrose are also rich in these essential fatty acids. All of these help to lock in the moisture into your skin.
  • Foods rich in vitamins A and E such as carrots, kale, olive oil, anchovies, and almonds keep your skin healthy [1, 2, 3, 7].
References:
  • http://www.footvitals.com/skin/dry-feet.html
  • http://www.wikihow.com/Heal-Cracked-Skin
  • http://foothealth.about.com/od/beautifulfeet/a/Dryskin.htm
  • http://www.diabetes.org/living-with-diabetes/complications/foot-complications/
  • http://www.webmd.com/skin-problems-and-treatments/tc/athletes-foot-topic-overview
  • http://www.lowthyroiddiet.com/low-thyroid-symptoms.htm
  • http://www.drscholls.ca/en/foot-health-center/rough-dry-cracked-skin
  • http://www.top10homeremedies.com/how-to/how-to-heal-cracked-feet.html/3

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Anuria - Definition, Causes, Symptoms and Treatment

Anuria Definition


From the word itself, you can derive its definition. The prefix “a-“ or “an-“ means absence. Uria refers to urine. So by the context of the word, anuria or anuresis means no urination.

But in the clinical setting, this is actually not the case. Medically, anuria means having a urine output of less than 100 mL per day. The kidneys do not totally stop producing urine. If the kidneys stop functioning, the person dies.

The term anuria was coined in order to denote that the urine output is dangerously low. If untreated, it can be a cause of death.

Anuria is almost always associated with the term oliguria. Oliguria means having a urine output of less than 500 mL per day. It is an early sign of kidney problems. Anuria comes in late, when the disease progresses and if it is in its advanced state. Obviously, anuria is worse than oliguria.

Anuria Causes

Prerenal Causes

Prerenal causes of anuria refer to problems of the structures “before the kidneys,” i.e. the blood vessels that supply the kidneys.

The kidneys are very vascular organs, especially its medullary part. If the blood supply to the kidneys is low, it means other organs are in dire need of blood and oxygen supply, hence, the kidney which is an organ of elimination, receives less.

Decreased renal perfusion or mean systemic arterial pressure decreases renal output via autoregulatory mechanisms and neurohumoral pathways.

The following are the prerenal causes of anuria for adults and children [1, 2, 3]:

1. Hypovolemia
  • Hemorrhage
  • Diarrhea
  • Vomiting
  • Burns
  • Pulmonary edema
  • Diuretics
  • Intraoperative fluid loss
  • Fluid loss related to use of drains
2. Low systemic vascular resistance
  • Sepsis
  • Shock
  • Antihypertensive drugs
  • Side effects of drugs
3. Heart Failure
  • Decreased cardiac output
  • Arrhythmia
  • Myocardial infarction
  • Cardiomyopathy
  • Cardiac tamponade
4. Others
  • Increased intra-abdominal pressure
  • Direct compression of the renal vein
  • Compression of the inferior vena cava
  • Anaphylaxis
  • Pancreatitis
  • Diabetes mellitus
  • Diabetes insipidus
In neonates, additional prerenal causes are the following [3]:
  1. Respiratory distress syndrome
  2. Perinatal asphyxia
  3. Congenital heart disease
  4. Indomethacin
  5. NSAIDs or ACE inhibitors used by the mother

Renal Causes

Renal causes of anuria refer to the problems of the “kidney itself.” A very low urine output is due to diseases of the glomerulus and renal tubules.

In the presence of glomerular and tubular diseases, the renal parenchyma will not be able to effectively and efficiently filter the urine. As a result, there will be less urine output.

The following are the renal causes of anuria for all age groups [1, 2, 3]:
  1. Nephrotoxic drugs: aminoglycoside, amphotericin B, diuretics, NSAID, cephalosporin, penicillin, angiotensin-converting enzyme (ACE) inhibitor, cisplatinum, cyclosporine, tacrolimus, radiological contrast
  2. Endogenous toxins: uric acid, haemoglobin, myoglobin
  3. Glomerulonephritis
  4. Autoimmune diseases
  5. Systemic diseases
  6. Vascular diseases: haemolytic uremic syndrome, renal artery or vein thrombosis, vasculitis
  7. Congenital kidney diseases
  8. Family history of renal diseases
  9. Muscle trauma
  10. Hematuria

Postrenal Causes

Postrenal causes of anuria refer to the problems of the structures “after the kidney,” i.e. obstruction of urine flow.

There is no problem with renal perfusion and there is no noted renal disease. The problem most likely lies on urinary obstruction. The urine cannot pass through structures as it should be so there will be less urine output.

The following are the postrenal causes of anuria [1, 2]:
  1. Lower urinary tract symptoms (LUTS): frequency, weak stream, dribbling
  2. Benign prostatic hypertrophy
  3. Calculi
  4. Mass in the neck of the urinary bladder
  5. Retroperitoneal fibrosis
  6. Kinks in the catheter (if the patient uses one)

In children and neonates, the following are the postrenal causes of anuria [3]:
  1. Stenosis of urinary meatus
  2. Posterior urethral valves
  3. Bilateral ureteral obstruction
  4. Neurogenic bladder

Treatment for Anuria

Cardiopulmonary Resuscitation

Fluid resuscitation of 250-500 mL aliquots may be the key in order to increase urine output and stabilize heart rate and blood pressure. The goal is for the patient to have a urine output of at least 0.5 mL/kg/hr.

Central venous pressure is maintained at 8-12 mmHg via central venous catheter. Blood pressure is very accurately measured through an arterial line. If fluid challenge fails, inotropes come to the rescue.

Nephrotoxic drugs

If the patient is taking drugs that are toxic to the kidneys (as noted above), discontinue these medications. It is also important to release the obstruction, decrease intra-abdominal pressure, and treat underlying infection.

Hyperkalemia


Picture 1 ECG shows hyperkalemia in its early state.
Image Source: http://nswhealth.moodle.com.au

Picture 2: ECG shows progressing hyperkalemia.
Image Source: http://nswhealth.moodle.com.au


Picture 3: ECG shows hyperkalemia in its late state.
Image Source: http://nswhealth.moodle.com.au

Hyperkalemia is a medical emergency wherein potassium level reaches >6.5 mmol/L and ECG shows peaked T waves and widened QRS complexes. It may also be accompanied by ventricular arrhythmias and asystole.

In the presence of hyperkalemia, BLS/ALS is initiated above all. Discontinue medications and infusions that contain potassium.

Administer 10 mL of calcium gluconate 10%; 50 mL of glucose 50%; and 10 units of rapid-acting insulin. 100 mmols of sodium bicarbonate 8.4% and inhaled beta-2 agonist are also given. These will shift the potassium into the cells. However, potassium still leaks out of the cells therefore these are not permanent treatment for hyperkalemia. Excess potassium need to be excreted from the body in order to eradicate its signs and symptoms.

For a less severe case of hyperkalemia, i.e., potassium levels of 5.5-6.5 mmol/L, potassium is restricted and resonium 15-30 g should be administered [1].

Treatment for Anuria in Children

Neonates and children are more prone to dehydration than adults so this is one of the things the health care providers should watch out for.

Dehydration in children is treated by 20 mL/kg fluid bolus of normal saline solution or lactated Ringer’s solution. In cases of fluid overload, fluid restriction and furosemide (diuretics) therapy is ordered. If the cause is postrenal (obstruction or stenosis), perform urinary catheterization [3].

References:

  1. Jacques T et al, 5 Causes of Anuria: DETECT 2nd edition, 2009
  2. Glabowski N, Diagnosis in the Anuric/Oliguric Patient /N%20Grabowski%204%20May%202011%20diagnosis%20of%20renal%20failure.pdf
  3. Jain A & Mattoo TK, AAP Textbook of Pediatric Care, Anuria and Oliguria
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EBOLA VIRUS - Symptoms, Outbreak, Prevention (Vaccine) and Treatment

From time to time mankind has been terrorized by the emergence of fatal, rapidly spreading, incurable diseases. In the long list of scary outbreaks of SARS, Bird flu and Swine flu, Ebola is the new addition. Though Ebola fever has been known to exist for a long time, not much has been known about it, as the occasional outbreaks have been confined only to African countries. In this modern era of transport and communication, there are numerous opportunities for spread of such a disease from one part of the world to other if proper preventive measures are not employed. This article will make you aware of the facts about Ebola Virus disease and wipe away the myths.

What is Ebola Virus Disease [EVD]?

Ebola virus disease or Ebola hemorrhagic fever as previously called is a dangerously fatal communicable disease caused by a group of 5 Virus which belong to genus Ebola Virus. They are Bundibugyo Ebola virus, Zaire Ebola virus, Sudan Ebola virus, Reston Ebola virus and Tai forest virus based on their territory of distribution, of which the first three are associated with more severe outbreaks than the other two. [1, 3, 4]

What is Ebola virus?

Ebola virus is an enveloped virus. It contains a single strand of helical negative sense RNA as its genetic material which is attached with different protein molecules in its core called nucleocapsid. The virus is actually tubular in structure but appears in various forms like coiled and loops after various procedures used to visualize the virus. When the virus enters into the human body, it attacks the immune system of the body and lowers the protective cells and the cells necessary for blood clot formation. This lowers the ability of our body to form clots which leads to severe internal and external bleeding which causes the person to bleed to death. [1, 2, 3]


Picture 1: Microscopic view of Ebola virus
Image Source: 360nobs.com


Picture 2: Ultra structure of Ebola virus
Image Source: popularmechanics.com


How is Ebola virus disease transmitted?


Ebola is primarily concentrated in the tropical rainforests of the African continent. Ebola virus disease gets transmitted from animals to humans initially which then involve human to human transmission. Fruit bats act as the intermediate host for this dangerous virus and humans, primates like monkeys and chimpanzees and pigs are the end hosts.

The virus gets transmitted from animal or one person to another through physical contact with bodily secretions, organs, inanimate objects with dried secretions from the infected animal or human being. It is believed that the initial outbreaks occurred when people handled dead infected chimpanzees and monkeys. [1, 3, 4]


Picture 3: Ebola Virus cycle
Image Source:upload.wikimedia.org

So, the possible ways of transmission of Ebola virus and high risk situations are

  • Coming in physical contact with the secretions and fluids like blood and saliva of an infected person/animal or someone who have died of this disease
  • Coming in physical contact with inanimate objects with dried secretions of infected person/animal like needles, intravenous lines, cotton swabs used for the infected person
  • People who handle burial ceremonies of the infected people who have died which poses high risk for exposure to the virus
  • Health care workers who have very high risk of exposure to the diagnosed and undiagnosed patients
  • Lab workers who handle samples for diagnosis and for research purpose[1,4,5]

It is to kept in mind that, this disease does not spread by air as droplet infection

Symptoms and Signs of Ebola Virus disease


Ebola virus disease is an acute viral illness. When someone is exposed to Ebola virus, the clinical features of the disease develop in 2-21 days. The initial symptoms include sudden fever associated with body pain, fatigue, and headache, sore throat which may be followed by vomiting blood, coughing up blood or bloody diarrhea. There may be fiery rash over the body. The condition of the patient deteriorates very rapidly causing damage to liver and kidney which aggravates the condition resulting in death due to uncontrollable bleeding. As the initial symptoms are non specific and are found in numerous other common diseases, high level of suspicion is necessary to diagnose it early based on the rapid severity of symptoms. [1, 4, 6,7]


Picture 4: Hemorrhagic rash which occurs over entire body
Image Source: ebolavirus2014.com

How to diagnose Ebola Virus Disease?


Diagnosing Ebola virus disease is an essential step to break the spread and to treat the patient. Location of a person in a geographic area of Ebola, History of recent trip to an Ebola affected area, Occupation related to high risk of exposure along with rapidly deteriorating health condition with above said symptoms must elicit suspicion. Other diseases associated with similar clinical features like malaria, cholera, typhoid and other hemorrhagic fevers must be ruled out first, as they are more prevalent. [1, 4, 6]
  • Ebola virus disease can be confirmed by the following methods
  • Enzyme Linked Immunosorbent Assay
  • Reverse Transcriptase Polymerase Chain Reaction
  • Antigen Detection Tests
  • Isolation of the virus by cell culture
  • Identifying the virus through electron microscopy

As, handling the samples is highly dangerous, all the diagnostic tests should be done in a maximum containment facility with proper protection gears.


Picture 5: Containment facility
Image Source:images.sciencedaily.com

Prevention and Treatment of Ebola Virus Disease


Till date, there are no preventive vaccines or specific drugs available for the treatment and cure of Ebola virus disease, but development of drugs are being undertaken by various pharmaceutical companies like Mapp Biopharmaceutical Inc which has developed an experimental drug called ZMapp which is a combination of three different monoclonal antibodies which bind to the Ebola virus and act. The NIH’s National Institute of Allergy and Infectious diseases are backing up the development of vaccines for Ebola. But all these efforts are in the initial stage and no drug or vaccine have been tested for its effectiveness against the disease in humans. [1, 4, 7, 8]

The treatment for Ebola virus disease includes
  • Intensive supportive measures
  • Maintenance of fluid and electrolytes
  • Maintenance of oxygen level and respiration
  • Medications as per the need of the patient

Even with intensive medical support the fatality of this disease is 90%

So prevention is the only possible way to save ourselves from this disease.

  • As Ebola virus is susceptible to various disinfectants like sodium hypochlorite, methyl alcohol etc, animal farms in the reservoir areas must be cleaned properly with appropriate disinfectants

Picture 6: Spraying of disinfectant in hospital waiting area
Image Source: silverbirdtv.com
  • If there arises a suspicion that, the animals might have become sick with Ebola virus, veterinary doctor and public health person must be notified immediately
  • The infected animal must be quarantined and culling should be done. The carcass of the dead animal must be buried deep or incinerated and proper disinfection should be carried out.
  • Movement of the animals must be restricted to prevent an outbreak.
  • People who handle infected animals and carcass should wear a full protection gear including goggles and containment suits and animal handling should be reduced or avoided if possible

Picture 7: complete protection gear for high risk people
Image Source: jto.s3.amazonaws.com

  • Reduce the physical contact with patients with Ebola virus disease
  • Health personals and Lab workers must handle the samples and objects with utmost care
  • Hand washing and Protection gear should never be forgotten
  • Prompt burial of the dead body should be carried out

Picture 8: Handling of dead victims
Image Source: grabghana.com

  • To prevent the spread from an epidemic to an unaffected place, all means of immigration facilities like airports and ports must be under strict surveillance and the staffs should be trained to identify people who show symptoms of Ebola Virus Disease

Public awareness is the key to break the spreading of such a dreaded disease

Ebola outbreaks

Ebola fever was first identified in 1976 in an African village called Yambuku on the banks of River Ebola from where this deadly disease gets its name. The first outbreak happened simultaneously in 2 different African countries and usually the Ebola outbreaks are associated with more number of deaths. Sometimes the disease occurs sporadically. The recent outbreak in 2014 has happened in Liberia, Sierra Leone and Guinea.

The death toll has crossed over 1000 according to the WHO reports. Efficient steps have been taken by the CDC and other health organization to stop the spread of this outbreak. Treating the victims, contact tracing and quarantine are the effective means by which previous outbreaks have been stalled.

Though the disease is rare and have very less chance of getting introduced into non African countries, it is necessary for everyone to be aware about the basic facts and myths of this disease to play their part well in the protection of their own health and that of the community as well. [1, 4]

Reference
  1. http://www.who.int/mediacentre/factsheets/fs103/en/http://www.who.int/mediacentre/factsheets/fs103/en/ 
  2. http://en.wikipedia.org/wiki/Ebola_virus 
  3. http://en.wikipedia.org/wiki/Ebola_virus_disease 
  4. http://www.webmd.com/a-to-z-guides/ebola-fever-virus-infection 
  5. http://www.cdc.gov/vhf/ebola/ 
  6. http://www.mayoclinic.org/diseases-conditions/ebola-virus/basics/symptoms/con-20031241
  7. http://www.nlm.nih.gov/medlineplus/ency/article/001339.htm 
  8. http://www.who.int/csr/disease/ebola/en/

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Seborrheic Dermatitis - Scalp Pictures, Causes and Treatment

What is Seborrheic Dermatitis?

Seborrheic dermatitis is a type of skin inflammatory disease that causes flaky, scaly, itchy, and reddish skin. This condition typically affects skin areas which are rich in sebaceous or oil glands, such as the face, scalp, and torso [1]. Additionally, this skin condition is chronic and has a tendency to relapse [2].

 

Seborrheic Dermatitis Causes

The exact cause of seborrheic dermatitis is still not determined. However, there have been some factors which are associated to the occurrence of the disease. It includes:


Fungal (Yeast) Cause 

  • 1. Presence of yeast species on the skin
Yeast species called Malassezia, is linked to the development of seborrheic dermatitis. This group of yeast secretes toxic substances which causes skin irritation and inflammation. Normally, the presence of this yeast is not harmful to the body. However, most patients with this condition are known to have less resistance to yeast.

  • 2. Fungal growth in lipid-abundant areas
The fungi involved in seborrheic dermatitis grow in an environment which is rich in lipid. This is why the common areas involved in this condition are the scalp, eyebrows, nasolabial folds, ears, and chest. [1, 2]

 

Immune System- Related Cause


Immunodeficiency
  • HIV/AIDS
Inflammatory/Immune reaction
  • Increase in immunoglobulin A (IgA)
  • Elevated NK1 and CD16+ cell counts
  • T-cell function depression

 

Neuropsychiatric Cause


1. Neurologic disorders
  • Stroke
  • Essential tremors
  • Trigeminal nerve dyskinesia
  • Tardive dyskinesia
  • Spinal injuries

2. Psychiatric disorders
  • Alzheimer’s disease
  • Parkinson’s disease
  • Schizophrenia
  • Mood disorders

 

Nutritional Cause


1. Vitamin deficiencies in:
  • Vitamin B6 (Pyridoxine)
  • Biotin
  • Vitamin B2 (Riboflavin)

2. Vitamin excess
  • Excessive vitamin A 
 

Hormonal Cause

  • Increased androgen in puberty
  • Presence of maternal androgens in infants

Other factors

  • Season change
  • Illness and reduced general health
  • Stress: Psychological stress, sleep deprivation, fatigue [1, 2, 3]

 

Seborrheic Dermatitis Symptoms

The usual body areas which are affected by seborrheic dermatitis are those which produce the most amount of sebum (oil). So, this condition involves skin areas such as the face (eyebrow area, nose, and forehead) and the scalp. Other possible affected areas include armpits, chest, underneath the breasts, ears, and groins.

Mild

  • Patches of flaky skin: May appear grayish, yellowish, or whitish in color
  • Dandruff or scaling
  • Itchiness and soreness
  • Red greasy skin

Moderate

  • Red, scaly patches
  • Greasy skin
  • Yellow-brown colored crusts may appear over the patches.
  • Itchy and slightly raised rash
  • Inflammation of areas such as eyelids or outer ear canal

Severe

  • Reddish or yellowish scaly pimples which are located on the eyebrows, nose, hairline, ears, upper back, and chest
  • Severe Seborrheic Dermatitis is unusual.
  • People who develop severe cases of this condition are those with compromised immune system. [1, 4, 5]

 

Seborrheic Dermatitis Pictures




Picture 1: Areas commonly affected by Seborrheic Dermatitis
Source: aafp.org



Picture 2: Seborrheic Dermatitis on Forehead
Source: hardinmd.lib.uiowa.edu



Picture 3: Seborrheic Dermatitis on sides of the nose
Source: hardinmd.lib.uiowa.edu



Picture 4: Seborrheic Dermatitis on scalp
Source: dermatitisseborrheic.net




Picture 5: Seborrheic Dermatitis on the outer ear canal
Source: ghorayeb.com



Picture 6: Seborrheic Dermatitis on the chest and underarms
Source: library.med.utah.edu



Picture 7: Form of Seborrheic Dermatitis in Infants (Cradle Cap)
Source: dermaproblems.com




Picture 8: Scaly skin caused by Seborrheic Dermatitis
Source: richinfoods.com

 

Seborrheic Dermatitis Natural Treatment

 

Natural Substances

Some natural substances may be beneficial in providing relief from seborrheic dermatitis. These include:
  • Avocado Extracts
  • Aloe Vera
  • Oregano oil
  • Tea tree oil
  • Fish oil supplements
  • Honey

 

Hygiene and Clothing

  • Refrain from using harsh detergents and soaps.
  • Use anti-dandruff shampoo following the recommended schedule.
  • For babies, use mild shampoo and soft-bristled brush to loosen scales.
  • Shave mustache or beard to prevent the condition for worsening.
  • Low buzz haircut
  • Avoid scratching to prevent irritation.
  • Wear clothes which are smooth and cotton. This is important to promote ventilation of the skin and prevent irritation.

 

Diet

  • Antifungal diet: Made up of increased vegetable intake and decreased sugar consumption. [1,5]

 

Seborrheic Dermatitis Treatment

Antifungal agents (Medical treatment)

These work by decreasing the numbers of Malassezia yeast that are present on the affected body areas. Some of the most commonly prescribed antifungals are:


1. Ketoconazole
  • Comes in foams, gels, creams, and shampoos
  • Prescription Ketoconazole (2% strength), Over-the-counter Ketoconazole (1% strength)

2. Terbinafine (Lamisil)
  • Usually recommended in the form of tablets
  • Indicated to provide treatment of severe cases
  • This is prescribed with caution due to the serious side effects that it may cause, such as liver problems and allergic reactions.

3. Ciclopirox
  • A common content of skin products and shampoos
  • Side effects in some people include itching, irritation, and burning

 

Corticosteroids

These are given to lessen discomfort, itching, and inflammation. Usually, they are advised to be taken in a short period of time to prevent serious side effects such as excessive hair growth, skin damage, infection, hormone suppression, and blood sugar elevation.


1. Hydrocortisone
  • Applied on areas such as scalp
  • Usual recommended form is 1% strength cream. Though it also comes in higher strength creams.

2. Betamethasone
  • Prescribed as lotion or cream
  • Used on scalp and other body parts
  • Use is limited to few weeks at a time

3. Desonide
  • Also, it is prescribed as ointment or gel for topical application.

Antihistamines

  • Cetirizine
  • Loratidine
  • Diphenhydramine
  • Chlorphreniramine

Calcineurin Inhibitors

  • This medication acts by inhibiting the immune system activities.
  • Known to be effective corticosteroid and antifungal lotion and cream.
  • Used only if all other treatment has not been effective.
  • Some examples include: Pimecrolimus (Elidel) and Tacrolimus (Protopic)

 

Medicated Shampoo

A medicated shampoo is prescribed for treatment of Seborrheic Dermatitis. This kind of shampoo can be utilized twice a week. For those with dandruff, the shampoo should be rubbed on the hair thoroughly at least 2-3 times per week. When using it, let it stay for about 5 minutes. Then, rinse it thoroughly to remove dandruff. The active ingredients present in this shampoo include:
  • Salicylic acid
  • Selenium sulphide
  • Zinc pyrithione
  • Coal tar

 

Phototherapy

  • A procedure called Photodynamic Therapy is used to lessen the Malassezia fungus growth and skin inflammation.
  • Phototherapy recommended by dermatologists utilizes UV-A and UV-B laser as well as blue and red LED lights. [1, 5, 6, 7]


References:
  1. http://en.wikipedia.org/wiki/Seborrhoeic_dermatitis
  2. https://www.clinicalkey.com/topics/dermatology/seborrheic-dermatitis.html
  3. http://www.bad.org.uk/site/872/Default.aspx
  4. http://www.patient.co.uk/health/Seborrhoeic-Dermatitis-of-Adults.htm
  5. http://www.mayoclinic.com/health/seborrheic-dermatitis
  6. http://www.onhealth.com/seborrheic_dermatitis/page2.htm
  7. http://familydoctor.org/familydoctor/en/diseases-conditions/seborrheic-dermatitis/treatment.html
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