Interview with a dermatologist / Seborrheic dermatitis

All inflammatory conditions and skin diseases require special care, and in quite a few cases, medical attention. That’s why we decided to talk to an expert, Dr. Borna Pavičić, specifically about the problem of seborrheic dermatitis. This disease is often mistaken for skin dehydration, while the underlying problem is actually a more serious one. Dr. Pavičić is a specialist dermatovenerologist from the Clinic for Dermatology and Venereology KBC Zagreb and director of the dermatology and venereology practice "Dermatologija Pavičić" with many years of experience. In addition to providing detailed information about the causes, symptoms and treatment of seborrheic dermatitis, at the end of the conversation he reveals his favourite Skintegra products.

Dermatolog, dr. Borna Pavičić

What are the symptoms of seborrheic dermatitis? On which parts of the body can it occur?

Seborrheic dermatitis affects seborrheic areas of the skin (full of sebaceous glands) - scalp, face, area behind the ears, chest, upper back, armpits, elbows and knee pits, but most often occurs in the area of ​​the scalp and face.

The symptoms of seborrheic dermatitis can differ depending on the localization, so there are sharply limited red patches on the scalp, covered with whitish-yellowish scales. On the face, it most often appears in the area of ​​the eyebrows, next to the nose and in the nasolabial folds, on the cheeks and on the chin in the form of sharply limited dry red spots with discrete flaking and itching.

What are the triggers of seborrhoea? Do any external factors affect it?

Seborrhoea or excessive secretion of sebum is inherited in an autosomal dominant manner and occurs in about 70% of people. In addition to heredity and the hormonal influence of androgens, stress, emotional excitement and nutritional factors (fatty and spicy food, alcohol) also have an important influence. Also, seasons play a big part (summer is usually better for everyone).

Seborrheic dermatitis

Why is seborrhoea often mistaken for skin dehydration?

People mistake it for dehydration due to the symptoms of seborrhoea, especially the peeling and flaking of the skin with itching, which can be similar to dehydrated skin.

How is seborrheic dermatitis treated in the acute phase?

In the acute phase, seborrheic dermatitis is characterized by redness and small peeling of the skin in predilection places, most often on the face and scalp. In the acute phase, when the inflammatory component is more pronounced, short-term anti-inflammatory therapy can be applied in the form of local corticosteroid preparations or immunomodulators - calcineurin inhibitors. Local antimicrobial creams and imidazole derivatives (ketoconazole) are also often used.

Cosmetic products are the basis of care and a complement to therapy, both in the acute phase and in the phase of remission or maintenance. The key is to use mild topical neutral preparations.

What products do you recommend for daily care when the condition is under control? What ingredients are better avoided?

Regular application is continuously necessary. This includes the phase of remission, i.e. when the condition is under control, in order to continue to maintain it as such and thus reduce the possibility of deterioration. Products with salicylic acid can help with this condition due to increased skin flaking but also due to the anti-inflammatory effect of salicylic acid. It is important to avoid products with greasy bases and aggressive formulas to avoid additional irritation.

When is it necessary to see a doctor and what does a dermatological examination look like?

As early as possible. I recommend you schedule an appointment before the symptoms appear in order to react in time and thus prevent a stronger inflammation. This also helps you keep the condition under control by taking adequate care and therapy. 

The dermatological examination consists of a detailed history, a clinical examination and, if necessary, a swab of the facial skin. Lastly, adequate care and therapy are recommended. Given that it is a chronic-recurring disease, regular follow-up is also necessary in order to modify the treatment according to the skin status.

From your experience, what are the most common mistakes when treating skin prone to seborrheic dermatitis?   

The most common mistake is using inadequate neutral local preparations, greasy bases, and aggressive soaps, which often lead to irritation and further worsening of skin changes. In today's digital age, hundreds of information, advertisements and recommendations for various preparations are available.  Choosing the wrong products worsens the condition. Unfortunately, patients often come to the examination late, in the stage of severe inflammation, when the treatment process is long and difficult.

Lastly, what’s your favorite Skintegra product?

Given that one of my narrower fields of work is medical cosmetology, that is, diseases and problems of the facial skin, my favourite products are from the line for oily, acne-prone skin. I like the rounded offer of products for the daily routine when the gel/cleanser and the corresponding cream are used in combination, so my favourites are definitely Amphibian, Clarion and Tria Light.

Also, I have to single out a new favorite, CICA-CERA cream.

Today, sensitive, unbalanced and reactive skin is a growing problem in practice; you could call it imbalanced skin. CICA-CERA cream, with its formulation (ceramides and cica complex) has a regenerative effect. By restoring the skin barrier, the skin becomes more resistant to inflammation and external factors, thus lowering the chances of dryness and irritation. Therefore, even though the cream is a treatment, I definitely recommend you use it daily as a preventive care, especially in the mentioned cases of sensitive and reactive skin.

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