What are the benefits of niacinamide for seborrheic dermatitis. How should niacinamide be used to treat seborrheic dermatitis. Is niacinamide an effective treatment for seborrheic dermatitis symptoms. What does research show about topical niacinamide for seborrheic dermatitis.

What is Niacinamide and How Does it Work for Seborrheic Dermatitis?

Niacinamide, also known as nicotinamide, is a form of vitamin B3 that has gained attention as a potential treatment for seborrheic dermatitis. But what exactly is niacinamide and how does it work to combat this common skin condition?

Niacinamide is a water-soluble vitamin that plays a crucial role in various cellular processes. When applied topically, it can penetrate the skin and provide several benefits:

• Improves skin barrier function
• Reduces inflammation
• Regulates sebum production
• Has antimicrobial properties

These properties make niacinamide a promising candidate for treating seborrheic dermatitis, a chronic inflammatory skin condition characterized by red, scaly patches often found on the face, scalp, and other oily areas of the body.

The Science Behind Niacinamide’s Effectiveness for Seborrheic Dermatitis

Research has shown promising results for the use of topical niacinamide in managing seborrheic dermatitis. A randomized, open-label study published in the Journal of Dermatological Treatment investigated the efficacy of topical nicotinamide (another name for niacinamide) for treating seborrheic dermatitis.

The study found that topical application of niacinamide led to significant improvements in seborrheic dermatitis symptoms. But what specific benefits did the research uncover?

Key Findings from the Study

• Reduced erythema (redness)
• Decreased scaling
• Improved overall skin condition
• Well-tolerated by patients

These results suggest that niacinamide could be an effective and safe option for managing seborrheic dermatitis. However, it’s important to note that more research is needed to fully understand its long-term efficacy and optimal usage.

How to Use Niacinamide for Seborrheic Dermatitis

If you’re considering using niacinamide to treat your seborrheic dermatitis, it’s essential to know how to use it properly. What’s the best way to incorporate niacinamide into your skincare routine?

1. Choose a topical niacinamide product (cream, serum, or lotion)
2. Clean the affected area with a gentle, non-irritating cleanser
3. Apply a thin layer of the niacinamide product to the affected areas
4. Use twice daily, or as directed by your healthcare provider
5. Be consistent and patient – results may take several weeks to become noticeable

It’s crucial to consult with a dermatologist before starting any new treatment regimen, especially if you have sensitive skin or are using other medications.

Comparing Niacinamide to Other Seborrheic Dermatitis Treatments

While niacinamide shows promise in treating seborrheic dermatitis, how does it stack up against other common treatments? Let’s compare niacinamide to some traditional options:

While each treatment has its merits, niacinamide offers a gentle, non-steroidal option that may be particularly suitable for long-term management of seborrheic dermatitis.

Potential Side Effects and Precautions When Using Niacinamide

Although niacinamide is generally considered safe for topical use, it’s important to be aware of potential side effects and take necessary precautions. What should you watch out for when using niacinamide for seborrheic dermatitis?

Possible Side Effects

• Mild skin irritation
• Redness
• Itching
• Dryness

These side effects are typically mild and often subside as your skin adjusts to the product. However, if you experience persistent or severe reactions, discontinue use and consult your healthcare provider.

Precautions

To minimize the risk of adverse reactions:

• Perform a patch test before full application
• Start with a lower concentration and gradually increase if needed
• Avoid using niacinamide with vitamin C products, as they may reduce each other’s effectiveness
• Be cautious if you have very sensitive skin or a history of allergic reactions to skincare products

Remember, what works for one person may not work for another. It’s essential to listen to your skin and adjust your routine accordingly.

Combining Niacinamide with Other Skincare Ingredients

Niacinamide can be a powerful ally in your skincare routine, but its effectiveness can be enhanced when combined with certain ingredients. What are some beneficial combinations to consider for seborrheic dermatitis?

Niacinamide + Hyaluronic Acid

This combination can help improve skin hydration and barrier function, which is particularly beneficial for seborrheic dermatitis-prone skin.

Niacinamide + Ceramides

Ceramides help reinforce the skin barrier, working synergistically with niacinamide to improve skin health and reduce inflammation.

Niacinamide + Zinc

Zinc has anti-inflammatory properties and can help regulate sebum production, making it a great partner for niacinamide in managing seborrheic dermatitis.

When combining ingredients, it’s crucial to introduce them gradually and monitor your skin’s response. Always consult with a dermatologist before making significant changes to your skincare routine.

Long-Term Management of Seborrheic Dermatitis with Niacinamide

While niacinamide can be effective in managing seborrheic dermatitis symptoms, it’s important to consider long-term strategies for keeping the condition under control. How can you incorporate niacinamide into a comprehensive management plan?

1. Consistent Use: Regular application of niacinamide, even when symptoms improve, can help maintain skin health and prevent flare-ups.
2. Holistic Approach: Combine niacinamide with other treatments as recommended by your dermatologist for optimal results.
3. Lifestyle Modifications: Manage stress, maintain a balanced diet, and avoid known triggers to support your skin health.
4. Regular Check-ups: Schedule periodic visits with your dermatologist to assess progress and adjust treatment as necessary.

Remember, seborrheic dermatitis is a chronic condition, and long-term management is key to keeping symptoms at bay. Niacinamide can be a valuable tool in your arsenal, but it’s most effective as part of a comprehensive skincare and lifestyle approach.

Future Research and Developments in Niacinamide for Seborrheic Dermatitis

As interest in niacinamide for seborrheic dermatitis grows, what can we expect in terms of future research and developments? Several areas of investigation are likely to shape our understanding and use of niacinamide for this condition:

Optimal Formulations

Researchers are exploring different concentrations and delivery systems to maximize the effectiveness of niacinamide for seborrheic dermatitis. This could lead to more targeted and efficient treatments in the future.

Combination Therapies

Studies are investigating how niacinamide interacts with other active ingredients to create more potent treatments for seborrheic dermatitis. This research could result in innovative combination products that offer enhanced benefits.

Long-Term Efficacy and Safety

While current research shows promising short-term results, more studies are needed to understand the long-term effects of niacinamide use for seborrheic dermatitis. These studies will help establish optimal treatment durations and identify any potential long-term side effects.

Mechanism of Action

Further research into how niacinamide works at the cellular level could uncover new applications and treatment strategies for seborrheic dermatitis and other skin conditions.

As research progresses, we can expect to see more refined and effective ways to use niacinamide in the treatment of seborrheic dermatitis. This ongoing work highlights the importance of staying informed about the latest developments in skincare and dermatology.

Topical nicotinamide for seborrheic dermatitis: an open randomized study

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10 Niacinamide Benefits (incl. Skin Health) + Side Effects

Niacinamide is a form of vitamin B3 that can treat pellagra, boost skin health, help with diabetes, and more. Topical formulations are used for acne, eczema, psoriasis, and other skin conditions. But how much is too much? Keep reading to learn the benefits, dosage, and potential side effects of niacinamide.

What is Niacinamide?

A Variation of Vitamin B3

Vitamin B3, also known as niacin, consists of two forms: niacinamide (or nicotinamide) and nicotinic acid. Although both molecules compose vitamin B3, they affect the body in different ways [1].

This article will only cover niacinamide.

How It Works

Niacinamide is needed to make NAD+/NADH and NADP+/NADPH, which slow aging and support cell repair, immune function, and energy use in the body [2, 3].

Snapshot

Proponents:

• Fights skin inflammation, acne, rosacea, and psoriasis
• Reduces dark spots and skin aging
• May prevent skin cancer
• May help with diabetes
• Lowers high phosphate levels
• May improve arthritis

Skeptics:

• Mild skin adverse effects (itching)
• Mild oral adverse effects (nausea)
• May lower blood platelets

Food Sources

Niacinamide is a water-soluble vitamin that can be found in animal products (such as meat and poultry) and non-processed cereals; it is also available as a supplement [4].

Best food sources of niacinamide [4]:

The body can also make niacinamide from the essential amino acid tryptophan, but it takes 60 mg of tryptophan to produce only 1 mg of niacinamide [1].

Niacinamide Benefits

Likely Effective:

1) Niacin Deficiency/Pellagra

Symptoms of a mild niacin deficiency include [5]:

• Indigestion
• Fatigue
• Canker sores
• Nausea

Severe niacin deficiency causes pellagra, which manifests with dermatitis, diarrhea, and dementia (known as the “three Ds”) [6].

Niacinamide (300-500 mg daily) can resolve the symptoms within one week. It’s FDA-approved for the prevention and treatment of pellagra and preferred over nicotinic acid because it doesn’t dilate the blood vessels and cause face flushing [7, 8].

Possibly Effective:

2) Acne

One of the causes of acne is excess sebum production, which makes skin oily. Topical niacinamide lowered skin oil production in 50 Japanese people and decreased skin sebum levels in 50 Caucasian (white) people [9, 10, 11].

On the other hand, some people with acne struggle with dry, damaged skin. Topical niacinamide increases beneficial skin lipids called ceramides. In turn, it strengthens the skin barrier, moisturizes the skin, and reduces water loss [12, 13, 14, 15, 16].

In a clinical study of 28 people with dry skin, niacinamide cream decreased water loss and increased hydration in the outer skin layer (stratum corneum) better than white petrolatum [12, 13, 14, 15, 16].

In other clinical studies of over 210 people with mild or moderate acne, niacinamide gel improved acne and decreased acne lesions as effectively as the antibiotic clindamycin [17, 18, 19, 20].

Oral niacinamide combined with zinc, copper, azelaic acid, pyridoxine, and folic acid reduced acne severity and improved overall skin appearance in a clinical study on 235 people. The same product improved both acne and rosacea in another clinical study on 198 people [21, 22].

However, in clinical trials conducted on a total of 185 people with acne, adding niacinamide to clindamycin had no effect or was only slightly better than clindamycin alone [23, 24, 25].

Topical niacinamide improves acne by moisturizing the skin and reducing excess sebum. The combination with clindamycin may not be as effective.

3) Skin Irritation and Inflammation

Rosacea

A topical gel containing niacinamide reduced skin peeling, redness, lesions, and irritation while increasing hydration and the skin barrier health in clinical studies of over 75 people with rosacea [26, 27].

Psoriasis

Topical niacinamide together with a synthetic form of vitamin D (calcipotriol) improved psoriasis in 50% of the cases in a clinical study on 66 people, compared to a 19% response with placebo [28].

Seborrheic Dermatitis

In 48 patients with facial seborrheic dermatitis, niacinamide 4% cream (once daily for 3 months) reduced the symptoms such as redness and scaling by 75%, compared to a 35% reduction with a placebo cream [29].

Atopic Dermatitis (Eczema)

Niacinamide 2% cream (twice daily for 2 months) reduced skin water loss and improved skin hydration in 28 patients with atopic dermatitis [16].

Other

Based on cellular studies, it might soothe irritated and inflamed skin by lowering inflammatory compounds (including NF-kB, IL-1, IL-6, TNF-a, and IL-12) [30, 31].

Additionally, niacinamide can block the growth of fungi (Candida albicans, Trichophyton rubrum, and Trichophyton mentagrophytes) causing skin yeast infections [32].

4) Dark Skin Patches

Two clinical studies support the use of topical niacinamide for skin lightening. In over 160 people with dark patches on the face, it reduced skin pigmentation, inflammation, and premature aging [33, 34].

A serum containing 5% niacinamide and tranexamic acid (a synthetic derivative of the amino acid lysine) improved skin tone evenness and texture in clinical studies with over 97 women with hyperpigmentation (dark skin spots) [35, 36].

Combined with vitamin C and ultrasound radiation, topical niacinamide decreased skin coloring after 4 weeks in 60 people with hyperpigmentation [37].

In cell studies, niacinamide blocked the transfer of melanin deposits to the outer skin layer, which may explain its skin-lightening effect [38, 39, 40, 41, 34].

Topical niacinamide improves skin appearance and reduces dark skin patches – both alone and in combination with vitamin C or tranexamic acid.

5) Skin Aging

Niacinamide stimulates the production of collagen and protective proteins (keratin, filaggrin, and involucrin), which give structure and elasticity to the skin. It may help smooth out wrinkles and prevent premature skin aging from UV rays (photoaging) [42, 43, 44].

Plus, it may delay skin aging by restoring DNA damage and lowering oxidative stress [45, 46].

Topical niacinamide decreased wrinkles and fine lines, skin redness, and yellowing while improving skin elasticity in clinical studies with 130 women [47, 48, 49].

In four trials of over 300 women, topical creams with niacinamide and other herbs and vitamins (retinol, resveratrol, safflower, vitamin E, kinetin, and others) reduced the appearance of wrinkles and fine lines and improved skin complexion [50, 51, 52, 53].

Topical niacinamide helps reduce wrinkles and fine lines, giving skin a more youthful look.

6) Skin Cancer Prevention

Nonmelanoma skin cancer is usually caused by excessive UV radiation, which can damage the DNA in skin cells and reduce their immune function. The most aggressive forms include squamous cell carcinoma and actinic keratoses [54, 55].

In a clinical study of 386 people at a high risk of skin cancer, oral niacinamide reduced the rate of nonmelanoma skin cancer by 23% compared to placebo. More precisely, it lowered the rate of new squamous-cell carcinomas by 30% and actinic keratoses by 13% [56].

In another clinical study of 74 people with skin cancer, oral niacinamide decreased actinic keratoses compared to placebo [57].

In human cells and mice, topical and oral niacinamide enhanced DNA repair and prevented UV-triggered immune suppression. It also reduced the growth, spread, and survival of melanoma cancer cells [58, 59, 55, 60, 61, 62, 63, 64, 65].

According to preliminary research, oral niacinamide may help prevent skin damage and cancer caused by excessive UV exposure. More studies are needed to confirm its effectiveness.

7) High Phosphate Levels

People with chronic kidney disease often have dangerously high blood phosphate levels [66].

In clinical studies with more than 450 adults and 60 children with kidney disease, oral niacinamide decreased high blood phosphate and increased the “good” HDL cholesterol without changing calcium levels [67, 68, 69, 70, 71, 72, 73, 66].

In rats, niacinamide reduced the activity of a transporter that carries sodium and phosphorus from the gut into the bloodstream, thus lowering phosphorus blood levels [74, 75].

Oral niacinamide may be beneficial for people with kidney disease as it lowers blood phosphate levels.

8) Diabetes

Type 1

In people with type 1 diabetes, insulin-producing beta cells in the pancreas get destroyed. Low insulin, high blood sugar, and low C-peptide often point to type 1 diabetes [76, 77].

In clinical studies with over 343 adults and 300 children with type 1 diabetes, adding niacinamide to insulin therapy maintained normal C-peptide levels. It preserved the function of beta cells and helped delay disease progression [78, 79, 80, 81, 82].

However, oral niacinamide failed to prevent diabetes type 1 in clinical studies of over 600 high-risk people [83, 84].

Type 2

Niacinamide improved C-peptide and blood sugar levels in a small trial of 18 people with type 2 diabetes [85].

In rats, niacinamide prevented diabetes by reducing beta-cell destruction, lowering oxidative stress, improving immune function, and maintaining normal insulin and glucose levels [86, 87, 88].

Oral niacinamide may help delay the progression of type 1 diabetes but likely can’t prevent it. It may improve blood sugar control in type 2 diabetes, but the evidence is scarce.

9) Osteoarthritis

Niacinamide blocks the inflammatory compound IL-1, which contributes to osteoarthritis [89, 90].

In a clinical study on 72 people with osteoarthritis, niacinamide improved joint movement, lowered inflammation, and decreased the use of anti-inflammatory drugs compared to placebo [91].

Further research is warranted.

Insufficient Evidence:

No valid clinical evidence supports the use of niacinamide for any of the conditions in this section. Below is a summary of up-to-date animal studies, cell-based research, or low-quality clinical trials which should spark further investigation. However, you shouldn’t interpret them as supportive of any health benefit.

10) Brain Protection

In 30 people with schizophrenia, vitamin B3 (niacin and niacinamide) improved the symptoms in 80% of the patients after one year, compared to 33% in the placebo group [92, 93].

In rats, niacinamide reduced brain damage and improved recovery after stroke. In mice, it decreased the expression of a gene linked to Alzheimer’s disease (PSER1), while restoring cognition and improving memory [94, 95, 96, 97].

It may lower oxidative stress in the brain and reverse damage to blood vessels and nerve cells [98, 99, 100].

Oral niacinamide may protect the brain and prevent neurological disorders, but the evidence is limited.

Niacinamide Side Effects & Safety

Topical

Topical niacinamide is considered to be safe and non-toxic up to a concentration of 4-5% [101, 50, 47].

Common, mild side effects include [33, 50]:

• Skin redness
• Itching
• Dryness
• Flaking

Oral

Oral niacinamide is safe at doses that don’t exceed the safe upper limit. In adults, this limit is 35 mg daily. Most short-term studies used doses above the upper limit and reported no safety issues. Possible mild adverse effects include [70, 66, 102]:

• Nausea
• Cramps
• Diarrhea
• Vomiting
• Watery stools

In rare cases, it can cause a low platelet count (thrombocytopenia), which can lead to excessive bleeding and prevent wounds from healing properly [71, 73].

Toxicity

In extremely high doses of over 3 grams, niacinamide can be toxic to the liver and cause insulin resistance [103, 104, 105].

Very high doses (2 g/kg) in rats caused and may increase the risk of diabetes type 2. High doses also caused liver damage, tumors, and stunted growth in animals [103].

Niacinamide Supplements & Creams

Dosage & How to Use

The below doses may not apply to you personally. If your doctor suggests using niacinamide, work with them to find the optimal dosage according to your health condition and other factors.

Topical Use

A topical gel or cream containing 4% or 5% niacinamide applied on the skin twice a day for up to 8 weeks reduces acne, hyperpigmentation, and skin aging [18, 17, 33].

Oral Use

• Acne: Nicomide tablets (750 mg of niacinamide, zinc 25 mg, copper 1.5 mg, folic acid 500 mcg) once, twice or 3 times a day. Another option is NicAzel tablets (nicotinamide 600 mg, azelaic acid 5 mg, zinc 10 mg, pyridoxine 5 mg, copper 1.5 mg, and folic acid 500 mcg) up to 4 tablets daily [20].
• Pellagra: 300-500 mg niacinamide daily [7].
• Skin cancer prevention: 500 mg niacinamide tablets once or twice daily [57, 56].
• Diabetes: 25-50 mg/kg niacinamide tablets or capsules daily for delaying the progression of type 1 diabetes [79].
• Reducing high phosphate levels: 500 mg up to 1.75 gr daily niacinamide capsules for 8-24 weeks in people with kidney disease [73].
• Osteoarthritis: 3 g of niacinamide daily for up to 12 weeks [91].

Takeaway

Niacinamide (nicotinamide) is a form of vitamin B3 that supports cell repair, immune function, and energy use in the body. Taken orally, it can support skin health, slows the progression of diabetes, and reduce high phosphate levels.

Skin conditions that may benefit from topical niacinamide include acne, eczema, psoriasis, rosacea, and seborrheic dermatitis. Creams and gels with up to 5% of niacinamide can also reduce dark skin spots and the signs of aging.

Unlike regular vitamin B3, niacinamide doesn’t cause flushing. Both oral and topical forms are safe and well-tolerated. Avoid extreme doses of over 2 grams, as they may damage the liver.

Experience with UVB 311 nm in the treatment of seborrheic dermatitis | Davidovich M.I.

Seborrheic dermatitis (SD) is a multifactorial chronic relapsing inflammatory skin disease. Rashes of SD are localized, as a rule, in 88% of cases in the face, in 70% – on the scalp, in 27% – in the chest, in 10% – in the back, inguinal and axillary folds, i.e. in those places where the sebaceous glands are most developed [1]. DM is characterized by erythematous-squamous lesions on the skin, often accompanied by itching [2–4].

Currently, there are discrepancies in terminology: many authors confuse the concepts of “seborrhea” and “seborrheic dermatitis”. Seborrhea is a skin condition caused by a disorder of sebum formation, which can be a background for the development of acne. DM is an independent disease, which some dermatologists call “seborrheic eczema” and “seborrhea” [5–9].

DM is a common disease; according to various authors, the frequency of its distribution is 1–5% [2, 5, 10–12]. DM accounts for about 10% of all dermatoses [5, 13].

Men get sick more often than women. The disease is also observed in infants (“seborrheic bonnet”), it occurs on the 12th week. the life of the child and disappears on its own by 8–9 months. DM develops in 20-25% of boys in puberty and in young people aged 19-20; the subsequent peak incidence occurs at 50 years.

Clinical manifestations and a frequent relapsing course of DM lead to psycho-emotional experiences of patients, reduce their social activity and quality of life, and contribute to the development of an inferiority complex in them [5, 9, 12, 14–16]. The idea of ​​one’s own external unattractiveness leads to the development of dysmorphophobia – a painful state of the psyche, accompanied by fears or beliefs about imaginary external deformity. Patients become withdrawn, easily irritated, they have difficulty adapting in the social and intimate spheres [2].

Despite a large selection of therapeutic methods, DM is characterized by a tendency to relapse and resistance to ongoing treatment.

Currently, phototherapy is the treatment of choice for many dermatoses, and since many patients with DM report improvement in the summer, the use of this type of treatment is fully justified.

In the world literature, there are single works devoted to the use of UVB therapy in DM.

Despite the accumulated experience in the use of narrow-wavelength UVB therapy, the mechanism of its action has not yet been finally elucidated. T. Wrone-Smith, B. J. Nickoloff (1996) determined that narrow-band UVB radiation promotes T-cell apoptosis more than broad-band SFT [17]. J. C. Viac et al. consider that narrow-band UVB therapy at a wavelength of 311 nm has a selective effect on skin immunity [18]. Other researchers have convincingly shown the immunosuppressive effect of narrow-band UVB on tumor necrosis factor (TNFα), the concentration of which in the blood serum of patients with psoriasis before treatment exceeded control values ​​(1.89±0.3 ng/ml at a rate of 1.48±0.43 ng/ml). ml, p<0.05), while PASI correlated with TNFα values ​​(r=0.52, p<0.05). A decrease in TNFα concentration as a result of 311 nm phototherapy was also accompanied by a decrease in PASI [19].

H. Sigmundsdottir et al. (2005) observed in patients with psoriasis treated with narrow-band UVB, a significant decrease in the production of IL, 1β, IL2, IL5 and IL6 in blood serum compared with these indicators before treatment. In addition, the concentration of INFγ, IL 8 and IL12p70 also decreased, but did not reach a statistical value [20].

D. Pirkhammer et al. (2000) studied the efficacy of UVB (311 nm) therapy. The open study involved 18 patients with lesions of the skin of the face, scalp, interscapular region and chest region. The treatment was carried out 3 times a week (average 23 procedures) with an average cumulative dose of 9.8 J/cm2. The authors did not observe side effects. Clinical remission was achieved in a maximum of 8 weeks. [21]. The authors noted the high efficiency of this method in DM.

T. Gambichler et al. (2005) in 28 articles, including 6 randomized controlled, 16 open prospective and 6 retrospective studies, which included 719 patients with atopic dermatitis, 305 patients with advanced vitiligo, 25 patients with polymorphic photodermatosis, 108 patients with early stage T-cell lymphoma, 88 patients chronic urticaria, 15 patients with lichen planus, 10 patients with prurigo associated with polycythemia, 18 patients with seborrheic dermatitis, 6 patients with prurigo, and 5 patients with perforating dermatitis showed that the best result of narrow-spectrum UVB therapy was observed in the treatment of atopic dermatitis and vitiligo [22 ].

Considering all of the above, we conducted our own study to study the efficacy and safety of phototherapy with 311 nm UVB rays in 40 patients with diabetes. As an example, we present our clinical observation.

Patient M., 50 years old, in December 2013, applied to the Clinic of Skin and Venereal Diseases of the First Moscow State Medical University named after I.M. Sechenov with complaints of rashes on the scalp, face, chest and back. Subjectively disturbed by itching. Allergological history is not burdened.

History of life: grew and developed according to age, in a prosperous family. In childhood, he suffered from chickenpox, often had ARVI. Currently unemployed, married, has a healthy child. Allergological history is not burdened. Bad habits: does not smoke, does not abuse alcohol.

Case history: ill for 10 years. The first rash appeared on the scalp. Independently periodically used anti-seborrheic shampoos. Gradually, the rash spread to the face and trunk. He went to the doctor in 2010 and was diagnosed with seborrheic dermatitis. He used antihistamines, vitamins, ointments with glucocorticosteroids and anti-seborrheic shampoos with a temporary positive effect. He received systemic and local antifungal drugs, but there was no improvement. A real exacerbation for 1 month developed after a stressful situation. He turned to our clinic for the selection of therapy.

On examination: rashes of a chronic inflammatory nature, localized on the scalp, face, chest and back. The rash is monomorphic, represented by erythematous-squamous foci of pinkish-yellow color, about 2–4 cm in diameter, with clear boundaries of irregular outlines. On the scalp there are grayish-yellow scales on an erythematous background. Hair and nails are not changed. Lymph nodes are not enlarged. Subjectively, rashes are accompanied by periodic itching (Fig. 1).

The clinical diagnosis was seborrheic dermatitis.

Concomitant diseases: chronic gastritis and biliary dyskinesia.

During the examination, no changes were detected in the clinical and biochemical blood tests, with the exception of an increased content of ALT – 53 U / l.

A course of phototherapy with 311 nm UVB rays was carried out, consisting of 11 procedures with a 4-time irradiation regimen per week with an initial dose of 0.05 J/cm2 and its gradual increase by 0.1 J/cm2 every two procedures. The maximum single dose was 0.6 J/cm2, the total dose was 4.1 J/cm2. Against the background of the therapy, there was a regression of rashes after the 5th procedure, itching stopped after the 3rd procedure. No side effects were noted. Locally, we used only Node DS shampoo with a frequency of 2-3 times a week.

As a result of phototherapy with 311 nm UVB rays, clinical remission was achieved (Fig. 2). Regarding concomitant pathology, a consultation and examination by a gastroenterologist was recommended.

After the therapy, the patient was under observation for 12 months. During this period, clinical remission was maintained.

Thus, phototherapy currently rightfully occupies a worthy place in the treatment of dermatosis. The use of UVB 311 nm in diabetes gives a quick and lasting effect, and also increases the duration of remission.

Non-standard approach to the treatment of seborrheic dermatitis

What is seborrheic dermatitis associated with? Most often with dandruff. It is from this position that television advertising approaches, promoting the next “miracle shampoo”.

It must be admitted that the patient population with this disease is indeed high, especially among young people. For some, it proceeds in a mild form, while someone suffers for years, receiving only a short-term remission from treatment.

Let’s find out what this disease is and why it manifests itself.
Seborrheic dermatitis is a chronic inflammatory relapsing disease that manifests itself as a violation of the production and change in the chemical composition of sebum, which affects the skin microbiome.
The pathogenesis of seborrheic dermatitis is not fully understood, but several theories are put forward: hormonal, immune, metabolic and environmental. Each of these theories is confirmed, because indeed the disease most often occurs during the formation of the hormonal background, is caused by a vicious immune response and, in a favorable environment, goes away on its own.
The author Palesko identified a number of antigens in the HLA system. According to the hypothesis, infectious agents carry antigenic determinants close to certain structures of the HLA system antigens, and the immune response can be realized against the body’s own antigens, which maintains chronic inflammation in pathogenic foci.

Fungi of the genus Malassezia play a special role in the pathogenesis of the disease. Their influence lies in the production of unsaturated and free fatty acids, which irritate the skin, contributing to:

• immune response provocation (inflammation),
• disruption of cell proliferation and differentiation,
• violation of the lipid-water mantle of the skin, due to this, the sebaceous glands work excessively on the production of sebum.