What to do about eczema

Arusha Campbell-Chambers

Many persons may notice dryness, flaking, redness and pale patches on their skin, especially around the nose, on eyebrows, ears, scalp, chest and/or on the back. They may also find that the skin is very sensitive and burns easily when using various topical products. These skin changes can occur as a result of a relatively common skin condition called seborrhoeic dermatitis, or seborrhoeic eczema.

This is a scaly inflammatory skin rash most common on sebum- (oil) rich areas of the skin such as the scalp, eyebrows, sides of nose, ears, middle of chest, back, underarms and groin. It can occur in infancy and adulthood and can affect all races. It is believed to be associated with a type of yeast in the skin. The condition may be triggered by humidity, seasonal changes and stress. This condition is not the same as ringworm of the scalp.

Red, greasy patches

It may present as reddish, scaly or greasy patches which may be paler or darker than the person's normal skin colour. It can cause 'cradle cap' on the scalp in infants and may present as dandruff or very thick scaling in the scalp of adults. It tends to affect infants in their first three months of life, but tends to come and go in adults.

Infants may be treated with mild steroid creams mixed with an anti-fungal, sulphur and/or salicylic acid and a mild shampoo. In adults, medicated shampoos containing zinc pyrithione, selenium sulphide, ketoconazole, ciclopirox, steroid, salicylic acid, sulphur and/or coal tar may be used at least twice weekly in active disease and weekly for maintenance.

The shampoos may be used on an alternating schedule. Since some of these medicated shampoos may leave the skin drier, it is helpful to apply them directly to the scalp for five to 10 minutes, rinse out and then follow with the use of a conditioning shampoo, then conditioner to the actual hair.

Check for HIV infection

Combinations of topical steroids, antifungals, sulphur, salicylic acid may be used on affected areas of skin, while preparations like 'oily cap' (arachis oil and salicylic acid mixture) may be used for severe scalp involvement. Although anyone can be affected with this condition, severe cases which are resistant to treatment may be a clue that the individual may have the HIV infection.

Oral medication may also be needed to treat severe and extensive cases of seborrhoeic dermatitis. Affected individuals should in general use products on their skin that are gentle, suitable for sensitive skin and ideally fragrance-free. Although there is no permanent cure for this condition, it can be controlled with proper treatment.

Dr Arusha Campbell-Chambers is a dermatologist and founder of Dermatology Solutions Skin Clinics & Medi-Spas; email: yourhealth@gleanerjm.com.