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How to manage Seborrhoeic dermatitis?

Q: I am 27 and my doctor here said that I am affected by seborrhoeic dermatitis majorly affecting my chin and around the nose area there is redness and rashes and these keep switching on and off and from the past 2 years I had been using Elocon ointment but even if I didn't apply the ointment for a day the rashes would appear again. All through my pregnancy last year, I applied the same and before my delivery I stopped the ointment because of which my face was badly affected by rashes spreading all over the face. A dermatologist here suggested Nizral ointment, metrogyl gel, sisomicin sulfate and occupal D (around eyes). The problem subsided somewhat temporarily but again after a few days my skin appeared rough, dry, flaky (esp on my cheek bone area around eyes, nose and mouth and chin) and small rashes appear here and there (around nose) and the skin around the eyes have wrinkled and darkened. Any moisturiser (because of winters the skin becomes dry and tight) I apply only aggravate the dryness and the skin become more flaky. I'm a lactating mother and my baby is 10 weeks old and he is also suffering from rashes (on face, back, scalp, chest and a few around his waist) generally called infantile eczema. Any oils or creams are not suiting him, on applying closone-G the rashes disappear and on stopping it they again appear. I apply oilatum cream and oilatum soap and johnson baby powder and a message of olive oil suited him earlier but after a few days I tried changing his oil (baby oil johnson) but that aggravated the problem and now even with olive oil the rashes appear. The skin on his cheek is rough and if apply any cream other than closone G rashes appear. These rashes (on not applying closoneG) become small very tiny boils that weep after some time and he keeps rubbing his hand all over his face and eyes and head. Please help.

A:Seborrhoeic dermatitis is a common skin condition affecting millions. It shows up as flaking skin, or reddish patches. Unlike people with dry skin, the skin in people with seborrhoeic dermatitis is usually oily. It can be unsightly, itchy and, since it is often on the face, may cause embarrassment. It is not contagious. Scales form on reddened skin. In adults seborrhoeic dermatitis usually affects the scalp, eyebrows, ear canals, sides of the nose, and behind the ears. It sometimes affects the armpits, chest and in the groin area. Most people with it complain of dandruff, especially on the back and sides of the scalp. Stress, fatigue (pregnancy / lactation in your case), weather extremes, oily skin and infrequent shampooing or skin cleaning & severe medical illnesses make it worse. Seborrhoeic dermatitis may start in infancy as cradle cap. It affects the scalp as thick, crusty, yellow scales. Children outgrow it by age 3 and older do not normally get seborrhoeic dermatitis. Cradle cap is not contagious, it is not caused by poor hygiene, it is not an allergy, and it is not dangerous. Cradle cap usually does not itch, but it may. If excessive scratching occurs, it can cause additional inflammation, mild infections or bleeding. The problem in seborrhoeic dermatitis is in the oil (sebaceous) glands and hair follicles. People with seborrhoeic dermatitis produce too much sebum (the natural skin oil). Later, pityrosporum yeast, grows excessively in the sebum, sometime along with bacteria, making the dermatitis more persistent. Basic treatment consists of using shampoos containing zinc pyrithione , selenium sulfide or ketoconazole. You may need to try several shampoos to find the one that works best for you, and then rotate between several medicated and non-medicated shampoos to maintain effectiveness. Its important to massage the shampoo onto the scalp and other affected areas and leave it in place for a few minutes before rinsing thoroughly. Other shampoo ingredients that are sometime helpful are salicylic acid, coal tar, and sulfur. If shampoos aren't working, the next step is to rub on a steroid lotion once or twice a day. If you're still having trouble, a coal-tar preparation or overnight medication under a shower cap may be needed. You can use bland emollients or a suitable low potency steroid (let me suggest you desonide lotion twice daily) for you and your baby. Sodium sulfacetamide-sulfur lotion too can be used if you are not allergic to sulfa products. Please consult a local dermatologist before acting on my information as only he shall be able to give you the right picture.

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