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Pediatrics - Seborrhea, Cradle Cap

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Introduction

Seborrhea, also called Seborrheic Dermatitis, is a common skin condition.  When it occurs on the scalp it is called dandruff.  Seborrhea on a baby’s scalp is called cradle cap. 

Seborrhea describes red scaly itchy skin.  The affected areas produce white or yellowish flakes.  Seborrhea can develop on the scalp, face, or skin folds on the body.  It is a life long condition that can be controlled with treatment. 

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Anatomy

The skin covers the body and protects it from the environment.  The skin is composed of three major layers, the epidermis, dermis, and subcutaneous tissue.  The epidermis is the outermost layer of the skin.  It protects the inner layers of skin.  The cells at the bottom layer of the epidermis continually move upward to the outer layer.  They eventually wear off and are replaced by the next layer of cells.
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Causes

The exact cause of seborrhea is unknown.  Researchers believe it is caused by a fungal exposure in persons with oily skin or decreased immune systems.  People that are susceptible to seborrhea develop an inflammatory skin response to the fungus.  The skin becomes flaky and sheds in an attempt to rid itself of the fungus. 
 
Seborrhea appears to run in families.  There may be a hereditary factor to its appearance.  It appears to be associated with stress, fatigue, obesity, acne, weather extremes, and poor hygiene.  Soaps and shampoos that contain alcohol can contribute to the condition.  Some neurological conditions, such as Parkinson’s Disease, stroke, and traumatic brain injury, and some medical conditions, such as HIV and AIDS, are associated with seborrhea.
 
Seborrhea develops on the outer layer of skin in areas with increased oil production.  Common affected areas include the scalp, eyebrows, nose, and ears.  It tends to develop in skin folds in the armpits, underneath the breasts, and in between the legs.  
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Symptoms

Seborrhea appears as a scaly itchy red area on the outer layer of the skin.  The skin develops white or yellow colored flakes that come off.  The affected areas may bleed or become infected from prolonged scratching.  It commonly occurs on the scalp, eyebrows, nose, and ears.  It also develops in skin folds in the armpits, underneath the breasts, and in between the legs. 
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Diagnosis

Your doctor can diagnose seborrhea by examining your child’s skin.  You should show your doctor the affected areas on your child’s body.  Tell your doctor about your child’s risk factors and symptoms.
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Treatment

Seborrhea can be treated at home with good hygiene practices using products designed to treat the condition.  Your child should thoroughly clean and wash his or her hair and body daily.  Your doctor can recommend over-the-counter soaps, lotions, and shampoos to improve your child’s symptoms.  Your child should avoid hair and body products that contain alcohol.  In some cases, doctors may prescribe antifungal lotions or corticosteroid preparations. 
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Prevention

Seborrhea is a life long condition.  The condition may come and go.  Your child may help reduce symptoms by keeping his or her scalp, face, and body very clean.  Use products or prescriptions especially formulated to treat seborrhea.  Read the content labels for soap, lotions, make-up, and shampoo.  Avoid products that contain alcohol.  Treatment for underlying medical conditions may improve the condition.
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Am I at Risk

Is My Child at Risk?

Risk factors may increase your child’s likelihood of developing seborrhea.  People with all of the risk factors may never develop the condition; however, the chance of developing seborrhea increases with the more risk factors your child has.  You should tell your doctor about your child’s risk factors and discuss your concerns.

Risk factors for seborrhea:

_____ Seborrhea is more common in men than women.  In men, it may develop in moustache and beard areas.
_____ Seborrhea appears to run in families.  If a child’s parents or siblings have seborrhea, a child has an increased risk for developing it.
_____ Oily skin is associated with seborrhea.
_____ Obesity appears to increase the risk of seborrhea formation, particularly in skin folds.
_____ Using soap and shampoo products that contain alcohol appear to increase the risk of developing seborrhea.
_____ Neurological conditions, such as Parkinson’s Disease, stroke, and traumatic brain injury, are associated with seborrhea.
_____ Medical conditions that depress the immune system, such as HIV and AIDS, are associated with seborrhea.
_____ Skin disorders, such as acne, increase the risk of seborrhea.

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Complications

Itching and scratching can cause bleeding and bacterial or fungus infections.  Contact your doctor if your child’s affected areas appear infected.  You should also contact your doctor if over-the-counter products do not relieve your child’s symptoms.
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Advancements

There are more and more over-the-counter products for seborrhea than ever.  Check out the soap and shampoo aisles of your drug store, grocery store, or variety stores.  Hygiene product labeling has also improved.  Look for products that do not contain alcohol.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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