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Rosacea vs seborrheic dermatitis: Chronic Skin Conditions Like Rosacea


Chronic Skin Conditions Like Rosacea

Rosacea is a chronic skin condition that usually affects your nose, cheeks, chin and forehead. Symptoms include redness, flushing, burning, visible blood vessels, swelling, bumps, and pimples. Rosacea can be hard to diagnose because several other skin conditions cause similar symptoms. Like rosacea, these skin conditions can also affect your face.

Other skin diseases that can act like rosacea include acne, contact dermatitis, lupus, seborrheic dermatitis, and steroid rosacea. However, these conditions also have differences that tell them apart.

Here’s what you should know about these other skin conditions.

Acne is often confused with rosacea. Some symptoms are the same. Both conditions cause redness, swelling and pimples. However, rosacea and acne are totally different conditions. They have different causes and they need different treatment.

Key differences include:

  • Acne usually occurs at an earlier age and often goes away with time. Rosacea tends to occur during middle age and does not clear by itself.

  • Acne can also affect the back, neck and chest. Rosacea usually does not.

  • Acne causes blackheads. Rosacea does not.

  • Acne causes redness but not flushing or visible blood vessels.

This type of dermatitis develops when your skin touches something that causes an allergic reaction or irritation. Contact dermatitis can look like rosacea because it causes redness, pimples and burning. The big difference is contact dermatitis usually occurs only where there was contact. It also goes away with time.

Other differences include:

  • Contact dermatitis causes cracking, itching, scaling, and oozing of the skin. These do not occur with rosacea.

  • Contact dermatitis can affect areas of skin that rosacea does not. This includes the hands, neck and legs as well as skin creases all over the body.

Lupus—specifically lupus erythematosus (SLE)—causes inflammation throughout the body. It’s sometimes confused with rosacea because it often causes a red rash on the nose and cheeks. This so-called “butterfly rash” may get worse after you’ve been out in the sun. The sun also can trigger rosacea symptoms. However, there are big differences between these two conditions. Lupus can cause fever, joint pain, headache, fatigue, and skin rashes in other parts of the body. Rosacea does not.

This skin condition is sometimes mistaken for rosacea. It often occurs along with rosacea, which can add confusion. Seborrheic dermatitis causes redness and burning where skin glands are located on the face. The cause is unknown.

Key differences include:

  • Seborrheic dermatitis can affect the scalp, eyebrows, and ear canals. Rosacea does not.

  • Seborrheic dermatitis causes scaling of the skin. Rosacea does not.

This condition has many of the symptoms of true rosacea. These include redness, swelling, bumps, and visible blood vessels. However, steroid rosacea is not a skin disease. It is a reaction to a steroid medication applied to the face. This reaction can occur if you use steroids for a long time to treat another skin condition. While steroids may make rosacea worse, true rosacea will continue after steroid use stops. Steroid rosacea ends when you stop taking steroids.

A dermatologist is the best doctor to determine whether you have rosacea or one of these other skin conditions. Getting the correct diagnosis allows you to get started on the right treatment and find relief.

Dermatological Conditions | Acne, Dermatitis and Rosacea

Are you sure that the recent outbreak on your skin is acne and not some other potential skin problem?

Redness, lesions, rashes, and itchiness – while all these generic skin symptoms are often associated with acne; they can be potential signs of some serious and chronic skin problems, like Rosacea and Seborrheic Dermatitis, too. Though rarely grave and life-threatening, both these inflammatory skin disorders can lead to severe skin complications, if ignored and left untreated.

That’s why, it is more than important not to confuse all kind of skin lesions and bumps with acne and consult a dermatologist for proper diagnosis and treatment. Learning about your skin condition and its signs and symptoms is the first step in the right direction.

So, here’s all that you need to know about these overlapping skin problems and ways to effectively treat them.

What is Rosacea and Seborrheic Dermatitis?

Rosacea is a chronic skin condition that causes pimples, pustules, redness, and swelling on the face. Often referred to as “adult acne,” Rosacea is best known by redness on the cheeks, which gradually progresses to forehead, chin, and nose. Over the time, Rosacea may even spread to eyes, ears, chest, and back. It usually begins as a flushing and blushing reaction, which may occur in response to emotional, physiological, and environmental factors.

Some of the common symptoms of Rosacea include:

  • Red, flushed skin
  • Stinging or burning sensation on the skin
  • A red, enlarged nose
  • Visible blood vessels on the skin
  • Pimples and pustules

Seborrheic Dermatitis, like Rosacea, is also an inflammatory skin disorder that affects face, scalp, and other areas of the body. The yellow, greasy scales mostly appear inside the ears, in the eyebrows, on the forehead, and around the nose, and often increase and worsen with time. Also, there’s no flushing and blushing reaction in dermatitis.

Common symptoms of Seborrheic Dermatitis include:

  • Scaly areas on the skin itch or burn
  • Greasy or yellowish patches
  • Dandruff flakes on the scalp

Though the actual cause of Seborrheic Dermatitis is still unknown, it’s believed to be caused due to malfunctioning or over secretion of sebaceous glands. 

Difference between Rosacea and Seborrheic Dermatitis

While both Rosacea and Seborrheic Dermatitis are inflammatory skin conditions, the two are quite different from each other. Also, the specific areas of infection are also different and may provide a clue for diagnosis.

In Seborrheic Dermatitis, yellow, greasy scale appears in eyebrows, ears, scalp, forehead, and nasolabial folds, while cheeks and adjoining areas are affected in Rosacea. The absence of acne-like pustules in Seborrheic Dermatitis is another big differentiator.

Common differences between Acne, Rosacea, and Seborrheic Dermatitis

Feature Acne Rosacea Seborrheic Dermatitis
Comedones Yes No Yes
Telangiectasia No Yes No
Deep, diffuse erythema No Yes Yes
Age of onset Peak: adolescence Peak: 40-50 years Peak: 30-60 years
Areas of involvement Can also affect back and chest Usually the central face Eyebrows, ears, scalp, forehead, and nose

Treatment for Acne, Rosacea, and Seborrheic Dermatitis

Seeking medical advice is the best way to treat any skin associated problem and this holds true for Acne, Rosacea, and Seborrheic Dermatitis too. Since all these conditions are often overlapping and confusing, only an expert dermatologist will be able to clinically diagnose and treat the disease. Using OTC drugs and beauty products could only worsen the skin problem.

In case you are suffering from Acne, Rosacea, or Seborrheic Dermatitis, or are unsure of the frequent breakouts that are occurring on your skin and what to get them checked, get in touch with EPIC Health. Our certified team of expert dermatologists and medical estheticians offer comprehensive assessment of your skin to diagnosis any underlying skin problem and offer the best treatment options available. They can also educate you about all the potential triggers that can aggravate your condition and suggest sunscreen recommendations, over the counter treatments, and makeup and skin care products that can help relive the problem.

Come, get in touch with EPIC Health dermatologists today and get comprehensive, tailored treatment for your individual skin problems. We can help you stop the progression of the disease and reverse its side effects. Dial 248-336-4000 or book an appointment with our EPIC dermatologist and medical estheticians today!

Do You Have Rosacea, Psoriasis, or Eczema?

Rashes, bumps, redness, itching—these issues can indicate a number of skin conditions, including rosacea, psoriasis, and eczema. While the symptoms may seem generic—and perhaps in mild cases not warrant much attention—it’s worth seeing a doctor to get a formal diagnosis, particularly if they persist. While rosacea, psoriasis, and eczema tend to be chronic conditions, they’re rarely life-threatening. However, they can lead to complications if left untreated.

This primer can help you sort out the differences between these three potential look-alikes.


Rosacea is more common among people who are 30- to 50-years-old and fair-skinned. It’s slightly more common in women versus men. Even so, rosacea can develop at any age, even during childhood.

Symptoms of Rosacea

Rosacea primarily occurs on the face and causes symptoms like easy and severe blushing or flushing, hotness, redness, bumps, and swelling. These symptoms often come and go, with periods of time when they’re more severe and times when they’re milder.

In addition, the symptoms of rosacea typically follow a pattern. Initially, the central areas of the face are affected, with flushing spreading over time to the cheeks, forehead, chin, and nose. Rosacea can even spread to include the eyes, ears, chest, and back.

With the areas of redness on the face, tiny blood vessels, pimples, and/or pustules crop up, but no blackheads appear. This can help distinguish rosacea from acne.

Over time with rosacea, the blood vessels on a person’s face become enlarged, making the redness a more visible, albeit harmless, condition.

Lastly, rosacea may eventually lead to thickening of the skin, most commonly of the nose (called rhinophyma). Rhinophyma tends to strike men who have had rosacea for years and may become disfiguring enough to require surgery.

Rosacea Triggers

Scientists are still trying to understand the underlying causes of rosacea, but common triggers include:

  • Temperature extremes or changes
  • Sunburn
  • Stress
  • Menstruation
  • Personal care products and cosmetics that contain alcohol
  • Scrubbing of the face
  • Hot beverages
  • Spicy foods
  • Caffeine
  • Alcohol
  • Certain medications

Rosacea Treatments

A variety of topical treatments may be helpful in treating rosacea, including:

  • Antibiotics
  • Anti-yeast creams
  • Azelaic acid
  • Topical ivermectin (Soolantra, Sklice)

Topical steroid creams can worsen rosacea and are not generally used. In cases when they are recommended, they should only be used for short bursts (no more than two weeks at a time) to decrease redness.

Laser treatment or electrodesiccation—use of a tiny needle that delivers electricity to the blood vessel to destroy it—may also improve symptoms.

Lastly, blood pressure medications like beta-blockers and Catapres (clonidine) are sometimes helpful in reducing flushing associated with rosacea.


When you have psoriasis, your immune system treats your skin like a foreign invader, attacking and damaging it.

Psoriasis can develop at any age, even during childhood. It tends to run in families and waxes and wanes in severity over the course of a lifetime.

Symptoms of Psoriasis

The most common form of psoriasis is called plaque psoriasis, in which areas of the skin become covered by thick, red patches (the so-called plaques), topped by a silvery-white scale. It can occur anywhere on the skin but usually affects the elbows, knees, and scalp. The areas where plaques form can be itchy and tender.

Plaque psoriasis can also affect the scalp, causing it to become very scaly, resembling dandruff. Nails, too, may be targeted and if so, they may become pitted, ridged, and loose.

Other forms of psoriasis have other notable features:

  • Guttate psoriasis: This type of psoriasis causes small, tear-drop shaped, salmon-pink spots to appear on the skin. The spots most often form on the trunk, arms, and legs, but can also cover the entire body.
  • Pustular psoriasis: With this type of psoriasis, a person develops inflamed, red skin covered with pus-filled bumps often found on the palms of the hands and soles of the feet.
  • Inverse psoriasis: Like the name, this type of psoriasis causes lesions that are not scaly but instead are smooth, red, and shiny. Unlike plaque psoriasis, the areas of skin affected by inverse psoriasis are usually areas of skin folds, such as armpits, under the breasts, and/or the groin area.
  • Erythrodermic psoriasis: This is a rare, potentially severe form of psoriasis that causes widespread redness, swelling, and itching all over the body. In extreme cases, complications like dehydration, overwhelming infection, and congestive heart failure may cause this condition to become life-threatening.

A form of arthritis called psoriatic arthritis is a potentially debilitating complication that develops in about 10% to 20% of people with psoriasis. While this joint condition affects people in unique ways, a few classic symptoms include prolonged morning stiffness, fatigue, and sausage-shaped fingers and/or toes (called dactylitis).

Psoriasis Triggers 

You may be surprised to learn that infections are frequent triggers of psoriasis flares, especially strep infections, which are highly correlated with guttate psoriasis.

Other possible triggers for psoriasis include:

  • Skin injury
  • Severely dry skin
  • Stress
  • Taking certain medications, like lithium or an interferon

Psoriasis Treatments

A variety of topical treatments may help improve symptoms of psoriasis, including:

Exposure to ultraviolet light may improve symptoms, whether it’s natural, outdoor sunlight, or a special lamp/light at a doctor’s office. 

Severe psoriasis may require treatment with powerful medications that suppress your immune system, such as:


Eczema (also known as atopic dermatitis) can develop at any age, even during infancy. It usually begins before age 5. About 50% of children will still experience eczema in adulthood, but it typically gets milder with age.

Eczema tends to run in families, especially those prone to allergies and asthma.

Symptoms of Eczema

Eczema is believed to be the result of excessive inflammation that evolves into a cycle of redness and itching, as scratching and rubbing only aggravate the skin further. Affected areas may become cracked, discolored, blistered, crusty, or scaly, and may weep clear fluid. People with eczema are at an increased risk for developing skin infections, especially with the bacteria Staphylococcus aureus.

Eczema can crop up anywhere, although common areas are in skin folds and on the cheeks, backs of the hands, tops of the arms, and fronts of the legs.

Eczema Triggers

Triggers for eczema include:

  • Temperature changes
  • Dry skin
  • Irritants (for example, wool, dyes, cosmetics, perfumes, and soaps)
  • Foods, especially the major allergens (i.e., eggs, peanuts, fish, soy, wheat, and dairy)
  • Stress
  • Dust mites
  • Pollen
  • Animal dander

Eczema Treatments

When you have eczema, it’s important to keep your skin clean and well-moisturized. Take short, warm (not hot) showers and use a non-soap cleanser. Applying a moisturizer to the entire body within three minutes of getting out of the shower can go a long way in protecting your skin’s barrier.

When skin care is not enough, topical steroids can improve redness and itching, but should only be used for short periods of time. Topical prescription medications like Elidel (pimecrolimus) and Protopic (tacrolimus) can improve itching and redness. Oral antihistamines may also be helpful.

In severe cases of eczema, oral steroids—Trexall (methotrexate), Sandimmune (cyclosporine), Dupixent (dupilumab), or Imuran (azathioprine)—might be needed.

A Word From Verywell

Rosacea, psoriasis, and eczema are common skin problems with some shared—and some unique—symptoms, triggers, and treatments. Aside from evaluating these issues, your doctor will also consider other skin conditions that mimic these three. As some can be more serious, a professional evaluation is best.

Rational Management of Papulopustular Rosacea With Concomitant Facial Seborrheic Dermatitis

J Clin Aesthet Dermatol. 2011 Jan; 4(1): 40–42.

A Case Report

Clarkston Dermatology, Clarkston, Michigan

Corresponding author.ADDRESS CORRESPONDENCE TO: Heather L. Roebuck, BS, MSN, FNP-BC, Clarkston Dermatology, 5701 Bow Pointe Drive, Suite 217, Clarkston, MI 48346; E-mail: [email protected]

DISCLOSURE: Dr. McFalda is a speaker for Allergan, Astellas, and Medicis. Ms. Roebuck is a consultant for Intendis and a consultant and speaker for Amgen, Abbott, and Ortho Neutrogena.

This article has been cited by other articles in PMC.


Objective: To report a case of papulopustular rosacea with concomitant seborrheic dermatitis and discuss how signs and symptoms were ameliorated using a rational therapeutic approach. Design: Patient case report. Setting: Clinical practice. Participant: One male patient with rosacea, seborrheic dermatitis, and actinic keratoses. Measurements: Change in signs and symptoms over time. Results: Improved skin care practices and treatment with azelaic acid 15% gel twice daily in combination with low-dosage oral isotretinoin resulted in improvement in symptoms of both rosacea and seborrheic dermatitis. Conclusion: In patients with multiple skin disorders, use of medications with benefits for more than one of the skin conditions may, in some cases, reduce the overall number of medications needed, thus simplifying treatment.

Rosacea is a common inflammatory skin disorder characterized by facial erythema, papules, and pustules; it is reported to affect approximately 16 million Americans.1 As there are many common facial dermatoses, rosacea often coexists in a given patient with other facial skin disorders, such as actinic keratosis, acne vulgaris, and/or seborrheic dermatitis.2 The presence of these concomitant conditions can confound diagnosis. Acne vulgaris and rosacea, for example, often appear to be quite similar, although rosacea lacks the comedones of acne and is often associated with confluence of erythema and presence of inflammatory papules and pustules on the central face.

Beyond confounding diagnosis, the presence of concomitant skin disorders may complicate treatment, in some cases necessitating the use of different therapeutic agents. There is often, however, an opportunity to use treatments that, due to their multiple mechanisms of action, are beneficial not only for rosacea, but also for other coexisting skin conditions. The authors report here a case of papulopustular rosacea with concomitant seborrheic dermatitis as well as actinic keratoses and discuss how therapy was carried out with a single topical agent that addressed more than one concomitant facial dermatosis, in combination with intermittent systemic therapy. The importance of recommending a gentle skin care regimen in patients with rosacea is also emphasized.

Case Report

A 78-year-old Caucasian man with Fitzpatrick skin type 2 presented with papulopustular and phymatous rosacea. He had concomitant seborrheic dermatitis of 15 years’ duration and a history of actinic keratoses on the forehead and right ear, which had previously been treated with cryosurgery.

The patient’s rosacea was first diagnosed in 1960 when he was 29 years old. Between 1994 and 2004, he managed his rosacea with the brand formulation of metronidazole gel 0.75% twice daily. In 2004, he was switched to the generic metronidazole gel 0.75%, which he used through 2006. At presentation, his skin care regimen consisted of a common brand sensitive skin cleanser.

In February 2009, the patient presented with erythema, papules, pustules, and rhinophyma (). He reported concerns regarding the progression of phymatous changes on his nose and expressed interest in a new treatment regimen to more effectively manage his rosacea. He was initiated on azelaic acid (AzA) 15% gel twice daily in combination with isotretinoin 40mg twice weekly. In addition, the importance of a good skin care regimen as an integral component of rosacea therapy was discussed with him, and the patient was instructed to use a ceramide-based hydrating cleanser (CeraVe, Coria Laboratories, Fort Worth, Texas) and moisturizing lotion (CeraVe) and Neutrogena Healthy Defense® SPF 45 Daily Moisturizer with Helioplex® (Neutrogena, Los Angeles, California).

A 78-year-old Caucasian man with papulopustular and phymatous rosacea, seborrheic dermatitis, and a history of actinic keratoses on the forehead and right ear, at the initial visit

In March 2009, the patient returned for management of actinic keratoses, which were successfully treated with cryosurgery. He remained motivated and adhered to the prescribed treatment plan for rosacea and seborrheic dermatitis. He continued to be monitored monthly in accordance with the iPLEDGE program requirements through his Veterans Affairs health services.

In May 2009, the patient returned for follow up. Papules, pustules, and erythema were reduced, and his nose appeared less phymatous (). Significant improvement was noted in his inflammatory papules and facial scaling, and sebaceous hyperplasia lesions decreased in number and size. His treatment is ongoing.

The patient at two months’ follow up after treatment with azelaic acid 15% gel twice daily in combination with isotretinoin 40mg twice weekly


AzA is a naturally occurring dicarboxylic acid with anti-inflammatory, antimicrobial, antikeratinizing, antioxidant, and antityrosinase mechanisms of action.3,4 Indicated for the treatment of rosacea, the multiple mechanisms of action of AzA gel 15% would suggest utility in other skin conditions as well, including seborrheic dermatitis. A recent pilot study conducted in patients who had mild-to-moderate facial seborrheic dermatitis found that six weeks of treatment with AzA 15% gel twice daily resulted in a more rapid onset of therapeutic effect and a greater improvement in scaling, erythema, and pruritus than vehicle alone.5

Isotretinoin, an oral retinoid, is most commonly used for the treatment of severe, refractory, inflammatory acne. It has also been used to treat rosacea in patients who experienced insufficient or transient effects with the use of conventional topical and systemic therapies.6 Treatment with oral isotretinoin 10mg/day for 16 weeks resulted in significant decreases in papules, pustules, erythema, and telangiectasias. The risk of potential side effects associated with systemic isotretinoin therapy and its lack of an approved indication for rosacea treatment may limit its utilization to treat papulopustular rosacea that has truly failed to respond to other options. 7

Isotretinoin, by reducing sebum production, can also improve the symptoms of seborrheic dermatitis. In a small study, 10 men with seborrheic dermatitis were treated with isotretinoin 1mg/kg/day for six weeks. All showed significant improvement in symptoms.8 In the case presented here, the choice of isotretinoin 40mg was influenced by the limitations of the patient’s insurance, which would only cover isotretinoin 40mg. A twice-weekly dosing schedule was used to achieve an overall lower dose of isotretinoin more similar to that typically used for rosacea.

This case clearly illustrates the importance of sunblock in a skin care regimen. The development of actinic keratoses increases with greater ultraviolet light exposure, which also exacerbates signs and symptoms of rosacea.9,10 Photoprotection is an important component of therapy for both rosacea and actinic keratoses.11


Here the authors report on a case in which a patient with papulopustular rosacea and facial seborrheic dermatitis was successfully treated with a single topical medication, an oral medication, and the incorporation of a gentle skin care regimen. AzA gel 15% twice daily was used in conjunction with isotretinoin 40mg twice a week, skin-care education, a gentle skin-care regimen, and photo-protection. In patients with multiple skin disorders, use of medications that can yield therapeutic benefits for more than one of their conditions may reduce the overall number of medications needed, thus simplifying treatment and reducing cost of therapy. Isotretinoin, indicated for the treatment of severe recalcitrant nodular acne, in this case was used for its benefits for both the patient’s rosacea and seborrheic dermatitis. AzA 15% gel, a medication approved for treatment of papulopustular rosacea, exhibits multiple properties, including anti-inflammatory, antimicrobial, anti-keratinizing, comedolytic, antioxidant, and antityrosinase effects, some of which may be operative in the treatment of both papulopustular rosacea and seborrheic dermatitis. Other potentially concurrent common facial disorders for which AzA may be of therapeutic benefit include acne vulgaris and hyperpigmentation.


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Other skin conditions can mimic signs of rosacea

Key Points

Sewickley, Pa. – Clinicians need to keep in mind possible differential diagnoses that mimic rosacea when they see patients who exhibit symptoms that appear to suggest the disease, according to the director of the Bikowski Skin Care Center.

“Rosacea classically presents as erythematous papules and pustules with flushing and blushing of the central third of the face,” Dr. Bikowski says. “There may be an erythematous background and telangiectasia present.”

Might be mites

Demodex dermatitis, which Dr. Bikowski says he is seeing with increasing frequency in his clinical practice, is characterized by a diffuse erythema and fine observable and palpable scaling that is present on sites such as the forehead, nose, cheeks and chin. Indeed, the diagnosis may be masked by other skin conditions such as papulopustular rosacea or seborrheic dermatitis.

Both irritant and allergic contact dermatitis, as well as lupus, are other conditions that can resemble rosacea, according to Dr. Bikowski.

“The issue is whether everything that is on the face that is red and scaly is rosacea or not,” he says. “Because rosacea and seborrheic dermatitis are very common conditions, they often may occur together. You often see the classic, clinical presentation of rosacea, with the dryness and scaling of seborrheic dermatitis. A number of patients, especially those who don’t respond to the usual rosacea and seborrheic dermatitis treatments, have Demodex dermatitis.”

The Demodex mite lives in the hair follicles on the face. Rosacea is not believed to be caused by Demodex mites, but some patients have a heightened response to the presence of these mites on the face.

“There is a certain percentage of the population that has an increased reaction to the presence of this mite or the mite products, producing Demodex dermatitis,” Dr. Bikowski says.

He stresses that there is no proof that the Demodex mite causes rosacea. “I think the mite produces a separate condition which is recognizable and treatable,” he says.

Ruling out mites

To exclude Demodex dermatitis in the differential diagnosis, Dr. Bikowski suggests clinicians opt for topical treatment in the form of permethrin or crotamiton cream, applied twice daily, for two to four weeks.

“If you have a therapeutic trial of each of those products, about a third of the patients will clear (the condition) within two to four weeks with that therapy,” Dr. Bikowski says. “If they do not clear, then you know that you have rosacea and/or seborrheic dermatitis.”

Dr. Bikowski contrasts the goals of therapy in managing rosacea and/or seborrheic dermatitis compared to the goals of therapy in managing Demodex dermatitis.

“The best you can hope to achieve over the short term or long term if you make a diagnosis of rosacea and/or seborrheic dermatitis is to treat and control,” Dr. Bikowski says. “Demodex dermatitis can theoretically be ‘cured’ in two to four weeks, and patients can stay clear of the condition for months and even years.”

While there is no time urgency in treating Demodex dermatitis – the condition will not worsen and become grave – the failure to make a correct diagnosis is a failure to treat the condition in a timely fashion, Dr. Bikowski says.

Revisiting Facial Seborrheic Dermatitis: A New Therapeutic Option

Seborrheic dermatitis is a chronic superficial mycotic disorder that usually appears as areas of erythema covered by greasy yellow-to-brown flakes or scales. The condition most often affects the nasolabial folds, glabella, forehead, scalp, ears, trunk, and other areas of increased sebaceous gland activity. In some patients, the axillae, groin, and other intertriginous areas are involved. Distribution is usually symmetrical.1-3 Although seborrheic dermatitis is included among the “red face” disorders, it is not usually accompanied by flushing or inflammatory papules and pustules, although it often coexists with rosacea or other papulopustular dermatoses.4 Severity is variable, ranging from barely perceptible scales and erythema to coarse, thick scales and intense erythema that does not blanch to the touch.5 The lesions may be generalized or even erythrodermic, and pruritus may be present, as well. 1-2 Because the typical clinical course includes remissions and relapses and may be progressive,6 it is important to provide directed therapy both for exacerbations and prophylaxis.

An extremely common disorder, seborrheic dermatitis is estimated to occur in about one to five percent of the US population,1-2 peaking within the first three months of life and again during the fourth to the seventh decades.1 Dandruff, considered by many to be the mildest form of seborrheic dermatitis, may occur in as many as 50 percent of the world’s population.7 The risk is increased by as much as 83 percent in people who are immunocompromised,8 and it is also raised to a lesser extent in those with Parkinson’s disease or other neurologic disorders,9 and those with mood disorders.10 Other triggers, including stress3 and reduced exposure to sunlight, have also been reported.2

Although no conclusive etiology has been established, certain contributing factors are widely recognized. Hormones probably play a role: androgens stimulate development of the pilosebaceous unit, and seborrheic dermatitis is in fact more common in men than in women and reappears after puberty.2

One factor important in current approaches to therapy is the relationship between seborrheic dermatitis and lipid-dependent Malassezia yeasts (formerly Pityosporum ovale), normal inhabitants of the skin.11 That is supported by evidence of reduction of symptom severity with use of antifungals active against Malassezia12 as well as correlation between Malassezia yeast density and clinical severity of the condition.13 Exactly how Malassezia contributes to seborrheic dermatology is in question. Suggested mechanisms include underlying abnormal immune response,14 defective skin barrier function,11 and inflammation resulting from yeast-mediated release of irritant free fatty acids.11 The link between seborrheic dermatitis and neurologic disorders such as Parkinson’s disease is not well understood; one hypothesis is that neurogenic immobility prevents proper skin hygiene, leading to a larger residual pool of sebum that thus encourages the growth of Malassezia yeasts. 11

The differential diagnosis of seborrheic dermatitis is wide, including many common disorders, such as psoriasis, atopic dermatitis, acne vulgaris, rosacea, Demodex dermatitis, and tinea infections. Scalp and face lesions may be similar to those of impetigo and intertriginous lesions to those of candidiasis.1 Other disorders to rule out are dermatophytoses, pityriasis versicolor, irritant/allergic contact dermatitis, systemic lupus erythematosus, Langerhans cell histiocytosis, and secondary syphilis.1,3

Although diagnosis of seborrheic dermatitis is usually clinical, based on history and the appearance and site of the lesions, a negative KOH examination may help to rule out candidiasis, tinea infection, or Demodex dermatitis. Histology may also be helpful: the characteristic spongiform appearance of early seborrheic dermatitis can help distinguish it from psoriasis, although differentiation in later stages is more difficult.2

An important point for both diagnosis and management is that seborrheic dermatitis is often accompanied by other dermatologic disorders. Among the most common concurrent disorders are acne vulgaris, rosacea, and Demodex dermatitis. Among patients with rosacea, the incidence of seborrheic dermatitis may be as high as 35 percent,15 with facial symptoms present in more than one quarter of cases.4 Therapy that addresses coexisting conditions is, of course, preferred; otherwise, treatment of one of these disorders may well exacerbate the other.

Extending the Therapeutic Armamentarium
There is no cure for seborrheic dermatitis, but it can be lessened and controlled with one or more of the agents shown to be effective in the condition. Most are topical or shampoo formulations. Current treatment and prophylaxis regimens usually include antifungal agents, most often azoles. Antikeratolytic agents such as selenium sulfide, propylene glycol, sulfur, and coal are used to address scaling and flaking.1-3 Mild topical steroids, which should be used primarily during exacerbations, can help control erythema and pruritus. 1 The immunomodulatory activity of topical calcineurin inhibitors such as tacrolimus and pimecrolemus may be particularly useful in patients with concomitant rosacea. Oral antifungal agents or phototherapy are reserved for the most severe cases.1 Equally important with choice of agent is an appropriate skin care regimen, including cleansers and moisturizers that help restore the skin barrier—especially ceramide-containing preparations that provide balanced physiologic lipid replacement.

Azelaic acid is currently indicated in the United States for topical treatment of inflammatory papules and pustules of mild to moderate rosacea and indicated elsewhere for acne. In addition, it appears potentially effective for seborrheic dermatitis. The clinical efficacy and safety of azelaic acid 15% gel for rosacea is well known; studies show significant, rapid improvement in signs and symptoms with this agent, as well as good tolerance.16-17 Its mechanisms of action address both symptomatic and suggested etiologic aspects of seborrhea as well as rosacea. Studies confirm antimicrobial properties, sebosuppressive activity,18 antikeritinizing activity,19-20 anti-inflammatory and immunomodulatory effects,21-23 and antimycotic activity24—including specific activity against Malassezia.25 Azelaic acid may therefore be considered a useful addition to the armamentarium for seborrheic dermatitis. It may be especially valuable because of its concomitant action against rosacea, a common accompanying disorder. Two patient histories are presented in which azelaic acid provided effective treatment for seborrheic dermatitis.

Case 1
A 32-year-old man came to the office with multiple symmetrical confluent scaly red patches on his lower face, to include the nasal creases, nasolabial fold, and chin (Fig. 1a). These were associated with minimal to moderate itching and burning. He also had minimal scalp flaking. The patches and flaking had developed over the previous two years, waxing and waning, but gradually becoming more severe, especially during the winter. The patient had been treating himself with over-the-counter lotions and preparations, but he was becoming worried because the condition seemed to be getting worse, especially on his face. A potassium hydroxide preparation showed no evidence of tinea infection. He was diagnosed with seborrheic dermatitis and prescribed a daily cleansing and moisturizing regimen using a ceramide-containing preparation along with twice-daily application of azelaic acid 15% gel to the affected areas. On a follow-up visit two weeks later, the lesions had improved notably (Fig. 1b). He was instructed to continue to use the prescribed regimen. He continued the medication over several months without any adverse effects.

Discussion. This case history illustrates the typical progressive onset of seborrheic dermatitis during adulthood. Because the condition—like rosacea, acne, and atopic dermatitis—features a skin barrier dysfunction, use of a barrier-repair cleanser and/or lotions is important. Balanced ceramide-containing lotions will help restore normal skin barrier function and may in fact aid in absorption of medications. In this case, azelaic acid, which addresses many other underlying processes of seborrheic dermatitis,18-25 along with a cleansing/moisturing regimen aimed at strengthening barrier function, provided a quick-acting, effective, well-tolerated therapeutic regimen for an acute exacerbation.

Case 2
A 67-year old man presented with a flare-up of his long-standing seborrheic dermatitis that was no longer responding to topical steroids. He had been using a regimen of over-the-counter topical corticosteroids, along with moisturizers and cleansers, as the mainstay of therapy. He was taking no medication for his concomitant mild rosacea, which appeared as a few scattered facial papules and pustules. On examination, the patient had red patches with scaling on his forehead, eyebrows, glabella, and nasolabial folds, as well as behind the ears (Fig. 2a). He was instructed to stop using the steroid preparation and prescribed azelaic acid 15% gel twice daily. His signs and symptoms began to abate immediately. On his return for follow-up visit four weeks later, the lesions had almost disappeared and his rosacea had also lessened (Fig. 2b).

Discussion: Topical steroids will treat inflammation and erythema but are not ideal in seborrheic dermatitis because they have no fungicidal or keratinolytic properties, and long term use may lead to cutaneous atrophy or, paradoxically, steroid use/abuse/misuse dermatitis.1 Azelaic acid’s constellation of properties matches the known mechanisms underlying seborrheic dermatitis. In this patient, the agent has the additional advantage of working to reduce concurrent rosacea signs and symptoms. Azeleic acid is a promising alternative to current antifungal and anti-inflammatory agents.

Dr. Bikowski has served on the advisory board, served as a consultant, received honoraria, and/or served on the speaker’s bureau for Allergan, Barrier, CollaGenex, Coria, Galderma, Intendis, Medicis, OrthoNeutrogena, PharmaDerm, Quinnova, Ranbaxy, Sanofi-Aventis, SkinMedica, Stiefel, UCB, and Warner Chilcott.

Top 6 Reasons Why Your Skin Is Red And Common Rosacea Misdiagnosis

Have you ever noticed splotches of redness on your cheeks and the center of your face?

This may be visible after intense exercise, or after certain meals. You may even notice significant redness after consuming alcohol. 

A 2018 study by Dr. Jacob Thyssen and colleagues at the University of Copenhagen found that 415 million people worldwide currently suffer from rosacea. This chronic inflammatory skin condition leaves the skin on the face visibly red, and frequently warm, slightly swollen, and with inflamed blood vessels.

Patients are often confused and frustrated with the redness that appears on their skin, as rosacea is sometimes misdiagnosed, and acne-like pustules may form. 

Understanding the cause of the inflammation allows our physicians to develop an accurate and effective treatment plan that will reduce visible flushing.  

Understanding Rosacea vs. Redness

Unfortunately, rosacea is often confused with other skin conditions, given the symptomology and similar appearance on the skin. 

To mitigate misdiagnosis, always be sure to check with a board-certified dermatologist to confirm the diagnosis. 

Below, we’ve listed the top 5 conditions that cause facial redness, often misdiagnosed as rosacea, and how to better understand your skin for the best possible treatment.

#1 Atopic Dermatitis

Atopic dermatitis, also commonly referred to as eczema, refers to a chronic inflammation appearing as a recurrent itchy dry, flaking rash. When seen on the face, eczema may appear as cracking, red splotches visible on any part of the skin.

To the frustration of many patients, eczema recurs. Understanding the trigger for your eczema can help to prevent as many recurrences. The triggers can be grouped into 3 main areas:

  1. Skin barrier breakdown
  2. Inflammation
  3. Bacterial overgrowth on the skin

Irritants cause a break in the skin barrier to break, which may cause eczema to flare. Common irritants include:

  • Soaps and chemical cleansing agents
  • Fragrances, perfumes & dyes
  • Wheat, dairy, soy, and certain nuts
  • Animal dander

A patch test may help you understand the trigger behind your eczema and offer advice on strengthening your skin barrier for reduced sensitivity and increased skin resilience. 

A recent sickness, an allergic reaction, or stress can increase the level of inflammation on the skin, which leads to redness and could cause a flare.  

#2 Psoriasis

Psoriasis looks very similar to rosacea, and the two are frequently confused during diagnosis. 

With psoriasis, there is a rapid overproduction of new skin cells. There is a genetic predisposition, but certain causes can make psoriasis worse:

  • Certain foods or medications
  • Stress
  • Cold, dry environmental conditions
  • Lack of sunlight
  • Hormonal imbalances
  • Smoking

Psoriasis on the face appears similar to rosacea, but treatment options for psoriasis are very different. Certain medications used in the treatment for psoriasis, including topical creams and corticosteroids, may make rosacea worse. It is best to consult with one of our physicians to understand your diagnosis and develop an effective treatment plan.

#3 Lupus

Lupus is a chronic autoimmune disorder that can wreak havoc on the skin. Often, lupus will leave a butterfly-shaped rash across the nose and cheeks. Lupus can affect more than just the skin. Patients with lupus may experience rashes all over the body, chest pains, swollen joints, and extreme fatigue. 

A board-certified physician can help you determine whether your redness and skin irritation is lupus or something else like eczema or psoriasis. Generally, patients with lupus have a rash visible on specific areas on each side of the nose and the upper lip. 

Our physicians carefully assess your skin and perform biopsies to determine if lupus is the cause of your skin redness. 

#4 Tinea (Ringworm)

Tinea, otherwise known as ringworm, is a fungal infection that can appear as a distinct “ring” pattern on the skin, setting it apart from the typical butterfly pattern of rosacea. Tinea is caused by a family of fungal species that live on a variety of surfaces, including:

  • Bedding
  • Clothing
  • Towels and other linens 
  • Damp surfaces (for example, shower floors, especially of public showers)
  • Pets

Teens and young adults are at a higher risk for developing ringworm, especially if living in a warm, humid climate. An accurate diagnosis must be made by a physician, and a biopsy may be necessary for optimal treatment. 

#5 Menopause or Other Hormone-Related Triggers

Women in menopause typically experience hot flashes, due to a significant drop in estrogen production. The link between estrogen and hot flashes is still unknown. However, it is suspected that the hypothalamus, which controls body temperature, may be affected by the hormonal changes.

Other hormone-related skin disorders that may cause redness in the skin may include:

  • Cushing’s Syndrome
  • Acne
  • Hashimoto’s Thyroiditis and other autoimmune disorders

#6 Seborrheic Dermatitis

Seborrheic dermatitis is a chronic widespread, but a harmless skin condition. It can appear as flaky white scales with redness on the scalp and face. It is caused by a yeast that grows naturally on our skin. It eats the oil produced by our skin and hair. In certain patients, the yeast overgrows, causing the redness and flaky white scale. The redness and irritation can cause itchiness making it appear similar to rosacea. 

There are common triggers that can cause seborrheic dermatitis to flare, which include:

Treatment Starts With an Accurate Diagnosis

There are a variety of conditions that may cause your skin to appear flushed and red. Receiving an accurate diagnosis from our physicians is the best way to initiate an effective treatment plan.

It is certainly possible for the redness to be a temporary concern when exercising or in hot/cold climates. However, if redness lasts more than 2 weeks, schedule an appointment to see us.

External remedies of the Sensibio series in the complex treatment of rosacea and seborrheic dermatitis

Thanks to the inclusion of the Sensibio series of therapeutic cosmetics in the complex therapy of 28 patients with rosacea and seborrheic dermatitis, clinical cure was achieved in 12 patients, significant improvement in 16. The best results were achieved in the treatment of patients with seborrheic dermatitis. It was found that the Sensibio NHO cleansing solution, Sensibio Forte cream and Sensibio DS + cleansing gel are well tolerated and do not cause undesirable side effects.

Treatment of rosacea and seborrheic dermatitis is an urgent task of modern dermatology. Currently, there is a continuous search for funds and methods that have both high therapeutic efficacy and a small range of side effects and good tolerance for long-term use.

The inclusion of a complex of medicinal cosmetics in the therapeutic program for the management of a patient with rosacea and seborrheic dermatitis is extremely important, since it can shorten the duration of drug therapy, reduce the dosage of the drug, as well as consolidate the positive result of treatment and significantly prolong remission.Rosacea and seborrheic dermatitis are chronic recurrent dermatoses of a systemic nature, in which, depending on the severity of general disorders, the intensity of local inflammatory manifestations also changes, the main ones of which are persistent erythema and hypersensitivity of the skin. These are multifactorial diseases caused by exogenous and endogenous triggers, including diseases of the digestive tract, endocrine and hormonal disorders, infectious diseases, angioedema, insolation, overheating and thermal procedures, prolonged use of ointments containing glucocorticosteroids, hypersensitivity to various irritants (cosmetics), etc.etc. [1, 2].

In the general structure of dermatological diseases, rosacea is about 5%, seborrheic dermatitis – 1–3% [2].

Rosacea is a chronic, recurrent facial skin disease that occurs primarily in women. The disease usually debuts during the third to fourth decade of the patient’s life and reaches its prime between 40-50 years. Rosacea occurs in all races, but predominantly in fair-skinned patients [3] and, as a rule, has a clear stage course. Currently, it is customary to adhere to the detailed classification jointly developed by the German dermatologists G.Plewig and Th. Jansen and American dermatologist A.M. Kligman. The classic manifestations of rosacea include: episodic hot flashes (rosacea diathesis), stage 1 – erythematous-telangiectatic, stage 2 – papulopustular, stage 3 – pustular-nodular; to special forms of rosacea – steroid, granulomatous, conglobate, fulminant, gram-negative, Morbigan’s disease, ophthalmorosacea, rhinophyma and similar forms of disease of other localizations (gnathofima, metaphyma, otofima, blepharophyma) [3]. Thus, in addition to the classical forms of rosacea, modern dermatologists also distinguish isolated and atypical variants of the disease [4].

Rosacea begins with recurrent tidal erythema, provoked by meteorological, nutritional factors and stress. Erythema lasts from several minutes to several hours, then disappears without a trace. Such rather frequent relapses are replaced by remissions, the process can last from several months to several years. Further, stagnant erythema, edema, moderate infiltration appear on the skin of the cheeks, nose, forehead, chin, then multiple telangiectasias form, peeling of the skin – the erythematous-telangiectatic stage of the disease begins.With the progression of the process against the background of erythema, isolated or grouped long-term persistent papules and purulent pustules appear, patients are worried about itching, fever and burning – the disease goes into papular and pustular stages. In the acute course of the disease, pronounced edema and hyperemia develop, especially pronounced in the periorbital region. In advanced cases of the disease, deep inflammatory nodes and infiltrates are formed on the skin – this is the infiltrative-productive stage and rhinophyma [3, 5].Tumor growths are formed due to progressive hyperplasia of the sebaceous glands and connective tissue. In every third patient, rosacea occurs with eye damage in the form of blepharitis, conjunctivitis – ophthalmic rosacea develops [6].

The course of the disease is aggravated by the presence of an acne tick ( Demodex folliculorum ), which is found more often in rosacea than in healthy people. It is a carrier of microbes and viruses to the deeper layers of the sebaceous glands and hair follicles, enhances pustulation in the foci of inflammation [7, 8].In addition, the course of the disease is influenced by the physical influences of the environment – low and high temperatures and high humidity.

Seborrheic dermatitis is a chronic erythematous-squamous dermatosis, localized on seborrheic areas and occurring with frequent relapses. The peak incidence occurs in 20–40 years, men are more likely to get sick [3]. When the skin of the face is affected, the rash is located in the area of ​​the eyebrows, bridge of the nose, nasal and nasolabial folds, beard and mustache, rashes are often combined with damage to the scalp.The lesions are erythematous-squamous elements or plaques formed as a result of the fusion of yellowish-pink miliary papules covered with fatty scales. Due to peripheral growth and fusion with each other, plaques can acquire ring-shaped, garland-like outlines. Often, the disease is represented by a layering of fatty scales on an erythematous background [5]. Under the influence of psycho-emotional and physical stress, and sometimes for no apparent reason, the intensity of the color of the affected skin can change.With seborrheic dermatitis, the eyelids (marginal blepharitis) and the red border of the lips (exfoliative cheilitis) may be involved in the pathological process [2].

In the mechanisms of development of seborrheic dermatitis, the following factors play an important role: violation of the secretory function of the sebaceous glands, changes in the chemical composition of sebum, increased proliferation of fungi of the genus Malassezia , as well as immune and endocrine disorders (dysfunction of the endocrine glands – pituitary, thyroid and gonads, adrenal cortex), organic and functional lesions of the nervous system (especially its vegetative part), impaired digestion. The leading role of this or that factor is manifested in each specific case in different ways [8, 9].

Despite significant differences in the clinical picture, rosacea and seborrheic dermatitis have a number of common pathogenetic disorders. First of all, this is the presence of inflammatory changes in the skin, accompanied by a more or less pronounced violation of blood microcirculation and the connective tissue frame of the dermis, which leads first to transient and then to persistent dilatation of blood vessels; imbalance of cellular and humoral immunity, including a decrease in activity against bacterial allergens; decrease in the barrier-protective function of the skin; the presence of background diseases from various organs and systems, as well as metabolic disorders, vegetative and psychological status of the patient [1].

A cosmetic defect or long-term itching forms in the general clinical picture of these dermatoses pronounced mental disorders, which significantly reduce the quality of life and maladjust the patient socially and professionally. In complaints of patients, it is often not specific skin problems that are highlighted, but those psychosocial experiences that cause a lot of inconvenience. The feeling of one’s own inferiority, exaggerated by the attention of others, creates and deepens depressive symptoms in such patients, pushing them onto the path of social isolation.

Since rosacea and seborrheic dermatitis are diseases caused by both external and internal causes, the treatment of these dermatoses should be complex. Along with drug therapy, involving the use of antihistamines, desensitizing, sedatives, vitamins of group B, as well as C, E, A, aromatic retinoids, antimicrobial and antifungal drugs, etc., general strengthening recommendations, including adequate sleep, walking , rational sports and a diet with a predominance of dairy-plant foods, limiting the consumption of carbohydrates, animal fats, and extractives.

Having achieved a regression of the main manifestations of the disease, at the end of the main course of drug therapy, it can be quite difficult to maintain the process in a state of prolonged remission. To successfully achieve this goal, proper daily care with emollients, moisturizers and antiseptic agents is essential. There are a number of topical treatments available to help improve the appearance of the skin with rosacea and seborrheic dermatitis.

Means of the Sensibio series produced by the Bioderma laboratory, France, are effective external preparations and are intended for the treatment and daily care of sensitive skin with local and widespread forms of rosacea and perioral dermatitis, seborrheic dermatitis and after cosmetic manipulations.They can be used as monotherapy for the treatment of mild skin lesions and in combination with drug treatment for more severe manifestations of these dermatoses [7]. The advantages of the Sensibio series when applied topically are non-toxicity, good patient tolerance, low probability of interaction with other drugs and the absence of cases of overdose. The products also meet cosmetic requirements: they are odorless, easily absorbed by the skin, leaving no oily sheen, do not stain clothes, and can be applied under makeup.

Sensibio Forte cream contains active anti-inflammatory components of rhamnose (buckthorn extract) and glycyrrhetinic acid (licorice extract), which reduce the secretion of interleukin-8 and block the destruction of 17-hydroxycorticosteroids; enoxolone, which reduces the sensation of heat and burning; as well as restoring comfort to the skin, softening and moisturizing it sodium pyrrolidone carboxylate, allantoin and vitamin E.

Sensibio H₂O solution for gentle cleansing of the face and eyelid contour contains micelles of fatty acid esters, which promotes ideal skin cleansing, maintains its balance, refreshes and tones, and its cucumber extract has a soothing and anti-inflammatory effect.There are no alcohol and flavors in the solution. The liquid should be applied with light movements, if possible without rubbing, without stretching the skin.

Sensibio DS + cleansing gel contains the patented DSactive® complex, undecyl alcohol and decylene glycol, which help remove scales and suppress the growth of fungi of the genus Malassezia ; the patented complex of Toleridin, zinc, vitamin B₆ and azelaic acid, which have anti-seborrheic action; as well as suppressing inflammation and reducing skin redness glycyrrhetinic acid and kelp extract. Gel Sensibio DS +, eliminating the causes of seborrheic dermatitis, reduces the severity of its symptoms and has an anti-relapse effect [8].

We used the Sensibio series preparations as part of the complex therapy of 28 patients (15 in hospital, 13 outpatient) – 8 men and 20 women aged 18 to 46 years. Of these, 21 patients (3 men, 18 women) had rosacea, 7 (4 men, 3 women) had seborrheic dermatitis. The duration of the disease ranged from 1 month to 5 years.

Of the patients with rosacea, the erythematous-telangiectatic stage was in 10, papular – in 7, pustular – in 4 patients. 18 (85.7%) patients complained of burning sensation, sensations of heat and skin tightness, 3 patients (14.3%) had no subjective sensations. In 14 (66.7%) patients, deterioration from the skin process occurred against the background of insolation and thermal procedures.

9 patients with erythematous-telangiectatic and papular stages of rosacea had not previously received treatment for this disease. 12 patients with different stages of rosacea received previous drug therapy, including topically applied fluorinated glucocorticosteroids.

An acne mite ( Demodex folliculorum ) was found by us during microscopy of scraping from the skin of the face in 16 (76.2%) patients with rosacea, from eyelashes – in 8 (38%).

To identify and treat foci of chronic infection and concomitant diseases, patients were consulted by related specialists: gastroenterologist, endocrinologist, gynecologist, therapist, neuropsychiatrist.Some diseases of the gastrointestinal tract (gastritis associated with Helicobacter pylori infection; chronic pancreatitis; intestinal dysbiosis) were detected in all (100%) patients. Foci of chronic upper respiratory tract infection (chronic bronchitis, chronic tonsillitis) were detected in 3 (14.3%) patients, urinary tract infections (chronic cystitis, recurrent genital herpes) – in 2 (9%), endocrine and hormonal disorders (nodular goiter, autoimmune thyroiditis, hypothyroidism, impaired glucose tolerance) – in 10 (47. 6%), gynecological diseases / disorders (dysmenorrhea, uterine myoma) – in 6 (28.7%), functional disorders of the nervous system (neurotic and psychogenic reactions) – in 14 (66.7%) patients.

Taking into account the fact that the pathogenesis of rosacea is based on angioneurosis with a change in the tone of blood vessels of the skin under the influence of various exogenous and endogenous causes, we recommended that patients, if possible, exclude factors provoking the disease – overheating and hypothermia, insolation, stress, alcohol and coffee consumption, as well as limit the intake of carbohydrates, animal fats, extractives. All patients received sedatives as part of complex therapy.

The choice of therapy for rosacea was determined by the stage and form of the disease, as well as the identified concomitant diseases.When Helicobacter pylori infection was detected, patients were prescribed complex eradication therapy (amoxicillin, clarithromycin, omeprazole). With concomitant demodicosis, for 7–14 days, treatment with 10–20% emulsion or benzyl benzoate ointment was carried out, and Demalan ointment was applied to the eyelids along the eyelash growth line once a day.

The main emphasis in the treatment of the erythematous-telangiectatic stage of rosacea was made on local treatment. At the same time, the patients took metronidazole by mouth, 0.5–1.0 g per day for 4–6 weeks, Ascorutin, calcium preparations.As a means for washing and removing make-up from the skin of the face and eyes, we prescribed to patients the solution Sensibio N O, which has good cleansing and soothing properties. The patients alternated cold lotions with 1–2% resorcinol solution with the application of Sensibio Forte cream 2 times a day in the morning and in the evening for 5–10 days. After stopping the severity of the process, we recommended that patients continue to use Sensibio N O solution and Sensibio Forte cream in the morning and evening for 1–6 months as maintenance therapy.

In patients with papular and pustular rosacea, as part of general therapy, we prescribed metronidazole preparations 1.0 g per day for 6-8 weeks, vascular drugs, vitamins C and P (rutin), calcium and zinc preparations, as well as Bellataminal preparations. Atarax. For gentle cleansing of the irritated skin of the face and eyes, the patients used the Sensibio N O solution. To stop the burning sensation and reduce the edema, lotions with 1–2% resorcinol solution, with tea, chamomile infusion were prescribed 3-4 times a day.Sensibio Forte cream, as the main external remedy for returning comfort and relieving inflammation, was applied by rosacea patients to cleansed skin 2 times a day, morning and evening. Due to the pronounced anti-inflammatory effect of Sensibio Forte cream, comparable to the action of glucocorticosteroids, already in the first days of use, patients noted the disappearance of the burning sensation, heat and tightness of the skin; the intensity of hyperemia, edema, the number of papular and pustular elements decreased markedly. After stopping the severity of the process as a maintenance therapy, we recommended that patients continue to use Sensibio N O solution and Sensibio Forte cream for 1–6 months.

As a result of the therapy, clinical cure occurred in 6 (28.7%) patients with rosacea, in 15 (71.3%) patients – a significant improvement; the intensity of itching, burning, erythema, the number of papular and pustular elements decreased significantly.

In 7 patients with seborrheic dermatitis we observed, a widespread rash was localized on the face (cheekbones, wings of the nose, chin, eyebrows, forehead), in the sternum, on the scalp and was accompanied by slight itching. Elements on the skin were represented by pink patches with indistinct boundaries, the surface of which was covered with easily detachable oily scales.

All patients had previously received drug therapy, including some of them topically applied fluorinated glucocorticosteroids.

Various diseases of the gastrointestinal tract (gastritis, chronic pancreatitis, biliary dyskinesia, intestinal dysbiosis) were detected in 6 (89%) patients. Endocrine and hormonal disorders (thyroid disease, impaired glucose tolerance) occurred in 3 (42. 8%), gynecological disorders (dysmenorrhea) – in 2 (28.9%), functional disorders of the nervous system (neurotic reactions) – in 4 (57%) patients.

Since the disease had a chronic course and exacerbations were associated with stress, the consumption of spicy and fatty foods, sweets, alcohol, as well as the irrational use of cosmetics, we recommended a hypoallergenic diet, a rational mode of work and rest for all patients.

In the complex therapy of seborrheic dermatitis, we prescribed to patients preparations of sulfur, calcium, vitamins A, E, B, antihistamines, sedatives such as Bellataminal.To cleanse the skin, remove scales and reduce inflammation, the patients applied topically 2 times a day, morning and evening, the Sensibio DS + foaming gel, the active substances of which suppressed the reproduction of fungi of the genus Malassezia . For patients with persistent erythema that developed during the use of ointments containing fluorinated glucocorticosteroids, we first prescribed anti-inflammatory soothing cream Sensibio Forte 2 times a day for 10-15 days until the symptoms of edema and irritation were eliminated. After stopping the severity of the process and discontinuing drug therapy, we recommended continuing the use of the Sensibio DS + cleansing gel twice a day for 1-2 months as a maintenance therapy.

As a result of the therapy, in 6 (89%) patients with seborrheic dermatitis, clinical cure occurred, and in 1 patient – a significant improvement, the intensity of erythema and desquamation significantly decreased.

Treatment with the Sensibio series in patients with rosacea and seborrheic dermatitis lasted an average of one to three months.Clinical cure was achieved in 12 patients, significant improvement in 16. We obtained the best results in the treatment of patients with seborrheic dermatitis. We did not observe cases of intolerance or undesirable side effects from the use of Sensibio N O cleansing solution, Sensibio Forte cream and Sensibio DS + cleansing gel in patients.

Thus, the Sensibio series preparations are effective external agents that can be used both as monotherapy and in combination with other drugs for the treatment of acute inflammation in severe erythema in the case of local and widespread forms of rosacea and seborrheic dermatitis, as well as for daily skin care of patients.

Sensibio Forte

Reduces the hyperreactivity of inflamed skin, soothes it, restoring the feeling of comfort. Has an intense moisturizing effect. Restores the protective functions of the skin. Does not contain fragrances. Can be used in men, women and children for the care of sensitive, irritated skin, including irritation after hair removal, shaving, peeling, laser exposure (treatment).

Sensibio H O

Qualitatively and quickly cleanses the skin of the face and eye contour by microemulsifying impurities and makeup, while maintaining the hydrolipid balance of the stratum corneum.Soothes and moisturizes the skin. Does not contain alkali, alcohol, phenoxyethanol and fragrances; pH neutral. Designed to cleanse fragile, thin, sensitive skin prone to redness.

Sensibio DS +

Designed for specific care of sensitive skin with irritation, redness and peeling, mainly in seborrheic zones: wings of the nose, eyebrows, forehead, chin. Contains the patented DSactive® complex, which has 2 main actions: it limits the reproduction of microflora (fungi of the genus Malassezia ) and prevents relapses by reducing the secretion of sebum – the source of reproduction Malassezia .Differs in excellent tolerance and non-comedogenicity. The lightweight, non-greasy texture provides the skin with perfect comfort.

90,000 Rosacea, perioral dermatitis


Rosacea – persistent damage to the vessels of the facial skin. It is manifested by reddening of the skin of the cheeks, nose, forehead and chin, rashes of bright pink color, spider veins, pustules. In the later stages, the development of irreversible thickening and infiltration of the skin of the nose, forehead, earlobes, eyelids, chin is possible.It leads to a deterioration in the appearance of the skin, sometimes pronounced cosmetic defects, changes in appearance, psycho-emotional problems. With damage to the eyes, keratitis and corneal ulceration develop.

Earlier, the development of rosacea was prescribed for the presence of demodicosis, but these two diseases are different in their etiology, although each of them complicates the course of the other. In the pathogenesis of the development of rosacea, there is an increased sensitivity of the vessels of the skin. If there is a genetic predisposition or the vessels are fragile and brittle, then in response to such stimuli as sudden changes in temperature, dry and hot air, the vessels expand, which is not observed in the bulk of people.

The incidence of rosacea in people with a history of gastritis is much higher than in those with Helicobacter pylori, the bacterium that causes gastritis, has not been detected. Rosacea of ​​a medicinal nature is observed with prolonged use of corticosteroid ointments, skin arteries become thinner, become more fragile and sensitive to minor temperature changes.

Risk factors for the development of rosacea

The incidence of rosacea is approximately the same in both sexes, but women during menopause are more susceptible to rosacea, as the hormonal background and properties of blood vessels change. Blondes and redheads with thin, sensitive skin prone to redness are at risk for rosacea. Allergic and contact dermatitis can provoke rosacea, since the vessels are often dilated and in the future, their return to their previous state is no longer possible.

Genetically, the inhabitants of northern peoples are more prone to rosacea, living in a sharply continental climate and in northern countries also increases the risk of rosacea.

Diseases and disorders of the endocrine system, diseases of the gastrointestinal tract and disorders of the immune system, especially when combined with each other, lead to rosacea.The pathogenesis of rosacea is not fully understood, but most dermatologists agree that being in hot or cold rooms, wind, eating excessively burning food, alcohol and spices provoke rosacea.

Prevention of rosacea

Since rosacea is a chronic disease, after removing the excess capillary network, after a while it will reappear. Therefore, the prevention of rosacea consists in periodic visits to the beautician’s office to eliminate newly appeared hypertrophied vessels. But, if between the procedures to avoid overheating and hypothermia of the skin, as little as possible to be in the open sun, adjust the diet and use cosmetics that contain horse chestnut extract and other substances that strengthen the vascular wall, then you will need to repeat the procedures no more than once every 2 -3 years.

Perioral dermatitis

Perioral dermatitis – a chronic inflammatory lesion of the skin around the mouth in the form of separate or grouping red papules located on the background of normal or reddened skin.

The most common perioral dermatitis occurs in women aged 20 to 40 years. Recently, there has been an increase in the incidence of this type of dermatitis among children.

Causes of perioral dermatitis

The exact reasons for the development of perioral dermatitis are not yet known. In many cases, the disease occurs in patients after long-term use of topical drugs containing corticosteroids.

The development of perioral dermatitis can be triggered by severe chapping of the facial skin, increased sun exposure, the use of fluoride-containing toothpaste and decorative cosmetics such as makeup base and foundation.In women, a connection between the disease and hormonal changes was noted: the appearance of rashes during pregnancy and against the background of various gynecological diseases, an increase in the manifestations of dermatitis before the onset of the menstrual cycle. In some cases, perioral dermatitis occurs with the use of oral contraceptives.

Symptoms of perioral dermatitis

Rashes of perioral dermatitis are single or grouped typical spherical papules. They are colored red or reddish pink and are located against the background of reddened or unchanged skin.The rash can be accompanied by discomfort, a feeling of tightness in the skin, burning or itching. But in about 25% of cases, patients do not notice any subjective sensations.

Rashes with perioral dermatitis are located on the chin, under the nose, in the area of ​​the nasolabial folds, in the corners of the mouth. Occasionally, a periorbital form of the disease occurs with lesions of the skin of the corners of the eyes, lower and upper eyelids, and the bridge of the nose.

90,000 How to distinguish rosacea from other dermatitis?

Rosacea (rosacea) is a skin pathology, clinically manifested by persistent erythema and telangiectasias, later papules and pustules.The causes of the development of the disease have not been identified, but, as a rule, it is a complex of hereditary and external factors. The course of the disease is complicated by alcohol, spicy food, ultraviolet light, Demodex mite, intestinal bacteria Helicobacter Pilori.

Risk Factors:

  • demodicosis;
  • age group from 30 to 50 years old;
  • I-II phenotype (residents of the Scandinavian countries), but granular roseola is more common in representatives of the Mongoloid and Negroid races;
  • female

Differentiated Diagnostics

Today there is no single test for diagnosing rosacea. The attending physician in the clinic of dermatology first differentiates diseases that are similar in terms of symptoms. When examining the patient, erythematosis, mycosis, carcinoid syndrome, acne, tubercular syphilis, folliculitis, etc. are excluded. Laboratory tests are prescribed, primarily general and biochemical blood tests, lipid profile, skin histology.

At least two signs of rosacea from each group of signs must be present:

  • primary – erythema, telangiectamias, papules and pustules;
  • secondary – burning, soreness, edema, lesion of the central part of the face, inflammation of the eyelids and conjunctiva, phymatous changes.

Clinical stages

Traditionally, there are four clinical stages of development of rosacea. Each form of the disease is similar to several ailments, but has nothing to do with the removal of flat warts. With this diagnosis, unlike rosacea, it is much easier to recover.

  • Erythematous stage has symptoms of carcinoid syndrome (especially in combination with hot flashes), seborrheic dermatitis, telangioectatic mastocytosis, photodermatosis. However, pustules only develop with rosacea.
  • The appearance of papules and pustules on the central part of the face indicates possible perioral dermatitis, red granularity of the nose, acne.
  • Ophthalmic rosacea occurs in 50% of patients and is treated jointly by a dermatologist and an ophthalmologist. In advanced and difficult cases, the help of other specialists is needed. With rosacea, along with ophthalmic problems, pink acne is also present.

Every second person succeeds in completely defeating the disease.Early diagnosis increases the chances and shortens the duration of treatment, which often reaches ten years.

Rosacea on the face – treatment at ON CLINIC Ryazan

An inflammatory disease provoked by angioneurotic pathologies that affects the skin of the face and belongs to the category of chronic is rosacea. This diagnosis is more common in women than in men, and it causes them a lot of suffering due to the unaesthetic appearance of the face. Very noticeable rashes on the skin of a deep pink color, rosacea – dilated capillaries under the skin, as well as pustules and the so-called vascular “stars” on the face attract the attention of others, and the patient himself may even be unpleasant to look in the mirror.

If the patient does not consult a dermatovenerologist for treatment, then the disease can progress – the skin thickens, and its infiltration also occurs. Rosacea on the face can cause keratitis and painful sores on the cornea of ​​the eyes.

Rosacea, rosacea, and rosacea, as rosacea symptoms are often called, are chronic conditions that affect about one in ten people. Despite the fact that it more often affects the fairer sex, it is noticed that in men this disease progresses faster.Among them, inflammatory processes on the skin and in the subcutaneous tissue, provoked by various infections, are not uncommon.

Causes of rosacea development

The root cause of rosacea on the face can be contact and allergic types of dermatitis. However, the disease can be triggered not only by skin diseases – various abnormalities in the work of the endocrine, digestive or immune systems, as well as the diagnosis of VSD, which is common today, can eventually lead to the development of rosacea in adults.The first symptoms of the disease can appear under the influence of temperature changes, when eating very hot or overly spicy and spicy foods and alcoholic beverages, as well as because of cold, heat or strong winds.

If there is an increased activity of the demodex mite on the skin of the patient’s face, then this aggravates the course of rosacea – some researchers believe that it is this microscopic size of the parasite that leads to the appearance of this disease. Finally, the so-called steroid type of the disease is caused by prolonged use of corticosteroids externally without the supervision of a doctor.

Symptoms of rosacea

At an early stage of this disease, all its manifestations are limited by the fact that from time to time, not very pronounced redness appears on the cheeks, forehead, nose and chest of the patient – this can be triggered by the use of a hot dish, moving from the cold to a warm room, as well as stress, emotional and physical excessive stress, taking certain pharmaceuticals, using certain types of decorative and care cosmetics. Often, rosacea begins to manifest itself in women during menopause. Over time, the disease progresses, redness on the skin occurs more and more often. Persistent, bright red spots that persist and visible spider veins may appear on the face. All these aesthetic inconveniences can be accompanied by facial swelling, dry skin and burning sensation.

The next stage of the disease is characterized by the appearance on the skin of abscesses and pimples, which are located in groups.The skin on the patient’s face becomes hypersensitive to the sun’s rays. This leads to clogged pores as well as comedones.

If rosacea is not treated, it continues to progress: the lesion spreads to the entire face, as well as the scalp, to the chest, and in some cases to the back. Thickening of the skin is possible – it acquires a bumpy structure.

If rosacea affects the skin of the nose in men, it can cause the nose to become pineal and bluish in color.This pathology is called “rhinophyma” and is also manifested by the appearance of deep grooves, which, as it were, divide the nose into segments, which hypertrophy over time. Despite the fact that this tumor-like tissue change is not dangerous, it greatly reduces the patient’s quality of life, disfiguring his face.

In some cases, in patients with rosacea, the eyelids and skin around the eyes are affected. Symptoms of such a lesion are a feeling of grit and grit in the eyes, frequent blinking and dryness of the cornea.A complication such as keratitis can develop, in which the cornea of ​​the eye is seriously affected.

Diagnostics and treatment of rosacea in ON CLINIC Ryazan

It is enough for an experienced dermatovenerologist to examine the patient in order to diagnose him. If purulent acne is poured on the skin, then bacterial culture is also prescribed for the study of microflora.

At an early stage, this disease is easily treated. If the disease has gone far, then a much longer treatment will be required to eliminate all its manifestations.The doctor prescribes an individually tailored treatment regimen for a patient with rosacea , which may include:

  • topical antibiotics;
  • oral antibiotics;
  • compresses and applications with herbal infusions and metronidazole;
  • laser treatment;
  • cryotherapy;
  • photocoagulation.

If you do not deal with the treatment of rosacea or make a choice in favor of self-medication, then this can provoke the appearance of purulent abscesses, the only way to get rid of which is surgical intervention followed by the installation of drainage.There is only one way to avoid this – at the first signs of the disease, contact a qualified specialist. In our medical center, the dermatovenerology department works seven days a week. Our doctors have extensive experience in successfully treating rosacea, acne, dermatitis, psoriasis and other skin conditions.

Cream for sensitive skin against redness, rosacea, rosacea METRORUBORIL® A.Z. IsisPharma 30 ml

Type, structure, volume

The remedy.Cream 30 ml.


RUBORIL® is a complex of care products for sensitive, inflamed skin prone to rosacea, redness, rosacea. The combination of soothing and protective ingredients helps to restore the skin to its natural balance, this is confirmed by laboratory and clinical studies. For best results, ISISPHARMA recommends the complete RUBORIL® range of products to cleanse, care and then protect your skin.

METRORUBORIL® A.Z is a cream that reduces redness and inflammation. It improves microcirculation in the skin, moisturizes, soothes and brightens your face.

METRORUBORIL® A.Z improves capillary blood flow, strengthens the vascular wall, relieves tissue edema. The high concentration of synergistic active ingredients reduces inflammation (papules and pustules). In clinical studies, all observed after 4 weeks of application noted a significant reduction in redness.The complex of active ingredients acts at all stages of redness formation. Clinically proven effectiveness.




Azelaic acid 15% – relieves redness, soothes the skin, strengthens the vascular wall, moisturizes.It has a pronounced anti-inflammatory effect in rosacea and rosacea. Protects the skin from external influences and improves overall condition;

ß-CALM® complex – reduces redness within 4 weeks. These are 4 active ingredients to enhance the protective function of the skin and eliminate the cause of redness:

Yeast extract + plant extracts: protect and strengthen the capillary walls, improve microcirculation;

Vitamin B3: enhances the protective function of the skin, has an anti-inflammatory effect;

Betaine: maintains the natural moisture of the epidermis;

Betaglycyrrhetinic acid 1%: anti-inflammatory.

Vegetable glycerin 2% – softens and soothes.


Improves capillary blood flow, strengthens the vascular wall, relieves tissue edema. The high concentration of synergistic active ingredients reduces inflammation.


Apply twice a day (morning and evening) on ​​clean, dry skin on local inflammations, extending widely beyond their borders.Use RUBORIL® Expert M or RUBORIL® Expert S for basic care and RUBORIL Expert UV protection SPF50 +


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ISISPHARMA (France) is an international expert in restoring and maintaining the natural physiological balance of the skin. The brand specializes in the development and implementation of innovative products in the field of dermatology and aesthetic medicine.All products are manufactured in France according to GMP standards, which gives confidence in the quality and safety of each brand product.

How much does it cost to treat seborrheic dermatitis on the face


cured seborrheic dermatitis

My skin problems started after the baby was born.

During exacerbations, I cried in pain if the wind touched my face in the street.

Sometimes the skin on the nose, cheeks, part of the forehead and chin suddenly began to itch, redden, swell, then cracked and covered with a yellowish crust.Then the crusts disappeared and everything gradually returned to normal, but the wings of the nose and part of the cheeks were always reddish.

I was diagnosed with seborrheic dermatitis. I went to the doctors for a long time and chose the treatment, now my condition has improved and exacerbations have become less frequent.

See your doctor

Our articles are written with a passion for evidence-based medicine. We refer to reputable sources and go for comments from reputable doctors. But remember: the responsibility for your health lies with you and your doctor.We do not write prescriptions, we make recommendations. It is up to you to rely on our point of view or not.

What is seborrheic dermatitis and how does it manifest

Seborrheic dermatitis is a chronic skin disease, often manifests itself on the scalp and face, but sometimes rashes can also be on the back, chest, armpits and groin. Seborrheic dermatitis on the scalp can be called dandruff, where it often looks like dry and flaky skin. On the face, it usually manifests itself in areas of peeling and inflammation, and the skin can also redden, swell, and itch.

Seborrheic Dermatitis – Mayo Clinic blog article

My dermatitis affects areas of the face where there are sebaceous glands: in the nose, on the adjacent areas of the cheeks, eyebrows, on the forehead at the hair roots. There, the skin is very red and itchy. But on the scalp there is just a slight peeling.

It is impossible to get seborrheic dermatitis from another person – it is a non-infectious disease. Its exact reasons are unknown. It is believed that the disease may be associated with increased multiplication of one of the types of yeast that normally live on the skin, or with impaired functioning of the immune system.

Seborrheic dermatitis can start in anyone, but is more common in people with neurological and mental illness, certain endocrine diseases, and immune disorders, such as HIV or certain cancers. It can also develop due to inappropriate skin care products, cold dry weather, and hormonal changes. Apparently, the latter provoked my first attack of dermatitis after childbirth.

With such a reddening of the skin, an exacerbation of the disease begins, then the face becomes covered with yellow crusts

Rashes with seborrheic dermatitis can appear and disappear.I have them after washing with plain water, because of a medical mask and sunglasses, especially in the heat: the skin sweats more and dermatitis appears faster. And also, when I often treated my teeth, exacerbations began after visits to the doctor – apparently due to the dentist’s medical gloves.

At the beginning of the disease, I had exacerbations about once a week. For example, on Monday, redness begins, on Tuesday the skin swells and peeling spots appear, everything itches, on Wednesday-Thursday the skin burns, swells, the rashes grow.On Friday-Saturday everything goes downhill, and after three or four days it starts again. And so for several years.

Treatment helps to reduce or sometimes eliminate itching, burning and redness. Therefore, now the situation is better: the last exacerbation was two weeks ago, I caught him “on the way” – the skin only slightly reddened and returned to normal without itching, crusts and inflammation.

Seborrheic dermatitis and dandruff are not exactly the same

Anna Trushina

Dermatologist, Rassvet Clinic

Dandruff is usually called peeling scales of the skin on the scalp visible to the naked eye.Indeed, this is often a manifestation of seborrheic dermatitis. However, dandruff can have other causes as well. For example, the usual dry skin or flaking due to contact dermatitis – irritation due to various external influences: inappropriate shampoos or other care products, styling products, hats and jewelry. Still similar symptoms sometimes occur with other chronic skin diseases, in particular with psoriasis of the scalp.

How I was diagnosed

With the first symptoms I went to a therapist.She suspected systemic lupus erythematosus, an autoimmune inflammatory disease. With it, a rash in the form of red and pink plaques is located on the face in the form of a butterfly. Outwardly, it really looked like the rash on my face. The therapist ordered blood tests, but they did not confirm the diagnosis, and I was sent to a dermatologist. Then I lived in a small town, there were only four dermatologists: two in state clinics and two in paid ones.

Three dermatologists gave me different diagnoses.

Rosacea is a chronic skin disease in which the skin of the face turns red, swells, and areas with visible vessels appear on it.

Psoriasis is also a chronic skin disease, when dry red spots with white scales and severe itching appear.

Eczema is another chronic skin disease with similar eruptions.

Some of the symptoms of these diseases were similar to mine, but I saw that dermatologists had doubts.They prescribed antihistamines for itching, as well as Betadine, an antiseptic. It all helped so-so.

Only a fourth dermatologist suggested seborrheic dermatitis. He sat me down in front of him, opened a medical directory, found similar diseases and clarified my symptoms. Then he ruled out what did not fit other diagnoses, such as rosacea or rashes in the form of dry plaques, and eventually came to the idea that I have seborrheic dermatitis. Two years later, we moved to a larger city, and two more dermatologists there confirmed his findings.

Betadine comes in the form of a solution and ointment. He did not help me, since the doctors did not immediately make the correct diagnosis. Source: Eapteka

How to diagnose seborrheic dermatitis

Anna Trushina

Dermatologist, Rassvet Clinic

The doctor makes the diagnosis based on examination and questioning of the patient. Sometimes a dermatoscopy of the skin helps in making a diagnosis – its examination under magnification using a special instrument. Dermatoscopy may be useful in some cases to distinguish seborrheic dermatitis from other skin conditions that may be similar in appearance to it.This is, for example, psoriasis or systemic lupus erythematosus.

How I treated seborrheic dermatitis

Treatment of seborrheic dermatitis does not eliminate the cause, but relieves symptoms: removes scales, reduces itching, swelling and redness, soothes inflammation. Doctors usually prescribe topical medications such as antifungals and corticosteroids, hormonal medications that reduce inflammation. For the treatment of dermatitis on the scalp, they are used in the form of shampoo, and on the face and body, in the form of creams and ointments.

Seborrheic Dermatitis – MSD Physician’s Manual

For seborrheic dermatitis on the head, antifungal shampoos with ketoconazole or climbazole, for example, Nizoral, which contains ketoconazole, may be prescribed. You need to wash your hair twice a week, but not constantly, no more than a month. Then, once every two to four weeks, they are used for prophylaxis, constantly using the usual shampoos.

I used Nizoral on the advice of a doctor – he didn’t ruin my hair, it was just a little rougher than usual.And dandruff and itching disappeared, which made me happy. For shoulder-length hair, a bottle was enough for me for almost two months – about ten times.

Antifungal shampoos with ketoconazole cost from 300 R, “Nizoral” is one of the most expensive, its price is about 700 R. At first I used it constantly, now about two to four weeks a year, when there is a need, since seborrheic dermatitis the head hardly bothers me.

Antifungal shampoo should be used consistently to prevent flare-ups.Source: Eapteka

In case of exacerbation of dermatitis on the skin, corticosteroid ointments, such as hydrocortisone, may be prescribed. They are prescribed for a short time, usually no more than two weeks, only to quickly relieve inflammation. My dermatologist strictly ordered the use of such an ointment for no more than five days. After the second day of application, it became noticeably better, I liked the effect, and I decided to smear it longer. After about eight days, the cream seemed to stop working: the area of ​​redness increased, itching and burning became stronger.I got scared and threw out the ointment. It costs about 30 R.

Doctors can also prescribe shampoos and creams with zinc pyrithione – this is an antifungal agent. The first dermatologist to diagnose me prescribed Cynovit cream. In its composition, in addition to zinc pyrithione, there is also climbazole – also an antifungal agent, as well as urea, which moisturizes and exfoliates the skin. This cream dried out my skin and dealt with redness and flaking pretty well. But he had a drawback: it was poorly absorbed.It had to be applied in a thin even layer, white flakes always remained on my face, so I smeared them on when I did not plan to leave the house. Such a cream cost about 400 R.

I was also prescribed “Magne B6” from the drugs – the doctor said that with its lack, seborrheic dermatitis may occur. I drank Magne B6 Forte for about a month, it cost 650 R. I don’t remember that it had any effect on dermatitis, but I was not so irritable, I became calmer and more collected.

Hydrocortisone ointment should only be used as directed by a physician and only for a short time.Source: Asna Cynovit cream worked well against rashes, but I didn’t like that it remained on my face. Source: Eapteka

Is it necessary to drink vitamin or mineral supplements with seborrheic dermatitis

Anna Trushina

Dermatologist, Rassvet Clinic

Seborrheic dermatitis is a chronic inflammatory skin disease not associated with a deficiency of vitamins and trace elements, therefore in its treatment they are not used. The practice of prescribing supplements has probably been around since the days when less was known about how and why this disease occurs.

How do I care for skin with seborrheic dermatitis

For seborrheic dermatitis, you can use medicinal cosmetics to treat skin with seborrheic or atopic dermatitis – as a rule, they are gentle and less irritating to the skin. I bought creams “Boro Plus”, “La-Cree”, on the advice of one of the doctors – “Emolium”, but they only reduced itching, the skin was not completely cleared of scales. And they did not help much against inflammation. Doctors also recommend Uriage or La Roche-Posay pharmacy cosmetics.

My dermatologist also advised me to try medicinal cosmetics and choose the one that works. I started with La Roche-Posay products and have been using them for several years. This cosmetics has several series. Suitable for seborrheic dermatitis is called Lipikar.

Most often I buy a small set: it contains Lipikar Syndet AP + cleansing gel and Lipikar Baume AP + after cleansing balm. The set contains 100 ml gel and 75 ml balm. I use more gel for washing, so often the balm remains, and I buy a new set again.

Five years ago, I bought such sets for 375 R. Now they cost 700 R. If you buy separately, then 200 ml gel on the official website costs 1063 R, and 75 ml balm – 654 R. When I finish this set, I will buy only gel 200 ml. This will be more economical, because I already have two tubes of balms: if I buy another set, I will not be able to use them up to the end.

1300 R

I spend on care products for the year

One kit is enough for about six months if used every day morning and evening, but I usually wash only once a day.If an exacerbation has begun, then twice a day is about three to four days a month. Because of this, I buy kits about once every nine months. On average, two sets of cream and gel are enough for me for a year, this is about 1300 R.

The set that I use for skin care

I don’t use any other skin care cosmetics: it’s difficult for me to find something, I’m afraid it will worsen my skin condition. About seven years ago I tried face scrubs, for example, “Clean Line” with apricot pits: my face began to redden and become inflamed.I realized that I shouldn’t irritate the inflamed skin even more, and refused them. I also tried the usual moisturizer from Nivea, there was no irritation from it, but there was no effect either. One day my daughter gave me disposable Korean face masks – I only used one because my face was combed after it.

I also rarely use decorative cosmetics: in my everyday life I’m used to not applying anything superfluous to my face, so I don’t put on makeup. I apply foundation only to important meetings, so the skin tolerates it normally.I also sometimes use lipstick, eyebrow pencil, and mascara without problems.

What diet do I follow to improve my skin

Evidence-based doctors believe that healthy skin just needs a balanced and healthy diet. To date, there are no convincing data on the benefits of a particular diet in relation to seborrheic dermatitis.

But various dermatologists advised me not to eat fried, fatty, spicy, sweet, not to drink alcohol. I don’t drink alcohol anyway, I rarely eat fatty and fried foods, so I can’t say if avoiding these foods affects rashes.But I really love chocolate, yeast baked goods, sweet creams. And I notice that if I refuse them, then the condition of the skin improves. A couple of chocolates and sandwiches a day do not affect the situation, but when someone has a birthday in the family and I eat pizza and cakes, after two or three days, redness, itching and crusting will appear on the skin.

So the rule is simple: no more than three sweets a day, or one slice of cake, or three slices of yeast bread.

How I live with seborrheic dermatitis now

I have a simple skin care regimen.In the morning I wash my face with plain water. If I feel irritation or itching, then I wash my face with La Roche-Posay gel in the morning and in the evening, then I apply a balm of the same brand.

Every year the periods between exacerbations are longer: at first they were days, now weeks. The intensity of the rashes and their area also decreased. Previously, rashes were on the wings of the nose, forehead, cheeks, corners of the mouth, now it is a couple of stripes on the wings of the nose, nasolabial folds and slightly near the corners of the lips. If there is more dandruff on my head, I use Nizoral in a short course, I buy about one bottle for 700 R per year.I do not use any medicines, only care is enough for me now.

I also try to wear medical masks less often so as not to provoke irritation, I take off my glasses if my eyes can tolerate the sun, I try to touch my face less.

Five years ago, there were always noticeable rashes on my skin.Now it is difficult to guess about my skin problems, it only sometimes turns red


  1. Seborrheic dermatitis is a chronic skin disease when redness, irritation, inflammation, itching, plaques appear on it.It can be on the face, back, chest, on the forehead near the hair.
  2. It is easy to confuse dermatitis with other conditions such as rosacea, eczema or psoriasis, so you need a good dermatologist who can diagnose it.
  3. Topical corticosteroids, which reduce inflammation, and antifungal agents are helpful. But they cannot be used for a long time.
  4. It is important to choose your skin care so that cosmetics do not aggravate skin irritation.
  5. There is no confirmed evidence that diet definitely affects the skin condition in seborrheic dermatitis, but a healthy and nutritious diet will definitely improve well-being.

Have you also had an illness that affected your lifestyle or attitude? Share your story.

Treatment of seborrhea of ​​the scalp – Publications – An-Tek laboratory

Seborrhea of ​​the scalp is a skin disease that occurs in areas rich in sebaceous glands. It manifests itself in inflammation of the scalp and other areas and can proceed both in a mild form and develop to severe forms of dermatitis. Seborrhea occurs as early as adolescence and is most common in adolescents and the elderly.Men are more likely to suffer from seborrhea than women.

Until now, scientists are discussing the causes of the development of seborrhea. Although seborrhea affects the scalp rich in sebaceous glands, it is not a disease of these glands. In patients with seborrhea of ​​the head, the microflora of the skin and the balance of bacteria living on it are disturbed. The predominance of certain types of rain fungi that inhabit the skin can lead to a violation of the lipid composition of the skin and the development of irritation. Seborrheic dermatitis is not only an aesthetic problem.With dermatitis, the skin becomes inflamed, itchy, and keratinized faster. The scalp becomes crusted, seborrhea becomes visible visually and requires special treatment.

Seborrheic dermatitis: contributing to development

Seborrhea affects the head and other parts of the body more often if there are concomitant conditions:

  • increased skin oiliness;
  • life with stress;
  • lack of sleep;
  • facts of seborrhea of ​​the head in relatives;
  • lymphoma, HIV and other diseases causing a state of immunosuppression;
  • diseases of the nervous system;
  • mental disorders.

Seborrhea often develops in the presence of these factors, but the reasons for the development of the disease are not fully understood. Seborrheic dermatitis is not a disease of the sebaceous glands, although it develops in areas of the head saturated with them.

Yeast-like fungi of the genus Malassezia play a significant role in the development of the disease (they inhabit the skin of most healthy people, but in some cases can cause rashes and irritation), the peculiarities of the lipid composition of the skin surface, as well as the peculiarities of the immune response to Malazessia fungi and their metabolic products.Regardless of the reasons for the development of dermatitis, special measures are required to influence the scalp. The duration of such treatment can be from two months to six months, and after defeating dermatitis, supportive therapy is needed for the epidermis of the head, which will prevent the re-development of seborrhea on any part of the body or head.

Features of the course of seborrhea

Does seborrheic dermatitis only affect the head? No, this disease can occur on different parts of the human body.Treatment methods will differ depending on the location of the areas affecting the head, chest, back or other areas of the body.

Seborrheic dermatitis, which develops on the head or other parts of the body, is characterized by a course with periods of exacerbation and remission. Its treatment should take place in several stages and include supportive therapy for seborrhea. The entire treatment regimen should be coordinated with a doctor in order to achieve maximum results and normalize the condition of the scalp as soon as possible, as well as prevent the development of seborrhea and dermatitis.

In the treatment of all forms of seborrhea, special care products are used, as well as oils or creams to soften the crusts. It is important to stop itching so that there is no desire to scratch the scalp and thereby further exacerbate seborrhea. Scratching can open a gateway to secondary infection, and the scalp will have to be treated for multiple conditions at once.

Head and hair care products as treatment for dermatitis

Means for the care of the scalp, body, hair with seborrhea should solve the following problems:

  • relieve itching and soothe the scalp;
  • suppress the growth of fungal flora on the head;
  • Provides gentle, gentle cleansing of the scalp.

In some cases, treatment is supplemented with oral agents – antifungal drugs and others. Treatment with topical corticosteroids is also possible, but this treatment is used for a short time and only as directed by a physician.

Diagnosis of dermatitis

In An-Tek Laboratory, before the treatment of skin dermatitis, the patient undergoes diagnostics. A trichologist will assess the condition of the skin on the head, especially its hairy part, with the help of a trichoscope, he will study the structure of the hair, its thickness and other characteristics.With seborrhea, a clinical picture is enough for a diagnosis: when prescribing treatment, the doctor will make sure that the patient really has seborrhea, and not other diseases with similar symptoms – rosacea, lichen, psoriasis, eczema and others.

The first recommendation to the patient is to use a special shampoo for the head, indicated for the treatment of seborrhea and dermatitis. However, this remedy alone may not be enough to return the skin to its normal state. In this case, the doctor will resort to active treatment of general action.Seborrhea responds well to the use of local remedies, but an integrated approach is always more effective.

Scalp care for seborrhea

What rules should be followed during the treatment of seborrhea? The doctor always gives individual recommendations for scalp care, but the general list can include:

  • observance of the principles of healthy eating not only during the period of exacerbation of seborrhea, treatment or during the period of remission of seborrhea, but also on an ongoing basis;
  • Daily use of a gel for skin and hair to reduce oiliness and remove keratinized particles;
  • cleansing dry scalp three times a week;
  • ensuring optimal humidity and air temperature in the apartment.