Dermatitis treatment, natural remedy with herbs and supplements
October 27 2014 by
Ray Sahelian, M.D.

Dermatitis is a term meaning "inflammation of the skin". Dermatitis is usually used to refer to eczema, which is also known as eczema. Seborrheic dermatitis is a common skin inflammation characterized by a red, scaly, itchy rash primarily occurring on the face, scalp, hairline, eyebrows and trunk. The condition often recurs, requiring re-treatment over time. Cases of atopic dermatitis are on the rise among US children.
   Seborrheic dermatitis is a superficial fungal disease of the skin, occurring in areas rich in sebaceous glands. It is thought that an association exists between Malassezia yeasts and seborrheic dermatitis. This may, in part, be due to an abnormal or inflammatory immune response to these yeasts.

Natural treatment
JAMA Dermatol. 2013. Effect of nutrient supplementation on atopic dermatitis in children: a systematic review of Probiotics, Prebiotics, formula, and fatty acids. Department of Dermatology, University of California at Davis School of Medicine, Sacramento, CA. To identify whether nutrient supplementation with probiotics, prebiotics, formula, or fatty acids prevents the development of atopic dermatitis (AD) or reduces the severity of AD in newborns to children younger than 3 years. In the 21 studies, a total of 6859 participants received supplements, which included infants or mothers who were either pregnant or breastfeeding;4134 infants or mothers served as controls. Nutritional supplementation was shown to be an effective method in preventing AD (11 of 17 studies) or decreasing its severity(5 of 6 studies). The best evidence lies with probiotics supplementation in mothers and infants in preventing development and reducing severity of AD. Specifically, Lactobacillus rhamnosus GG was effective in long-term prevention of AD development. γ-Linolenic acid reduced severity of AD. Supplementation with prebiotics and black currant seed oil (γ-linolenic acid and ω-3 combination) was effective in reducing the development of AD. Certain types of nutrient supplementation are beneficial in preventing AD development and reducing its severity.

Q. Could tea tree oil be helpful in seborrheic dermatitis?
   A. Perhaps. Tea tree oil cream can be tried first before using pharmaceutical medications.

Daily vitamin D supplements might help children with eczema that gets worse in the winter. When eczema, a chronic inflammatory skin disorder, flares up in the winter it's known as winter-related atopic dermatitis, Massachusetts General Hospital, news release, October 2014.

Seborrheic dermatitis - Seborrhea
This is a common disorder for which curative treatment is difficult. This condition is a red, scaly, itchy rash most commonly seen on the scalp, sides of the nose, eyebrows, eyelids, skin behind the ears, and middle of the chest. Other areas, such as the navel (belly button), buttocks, skin folds under the arms, axillary regions, breasts, and groin, may also be involved.
   Seborrheic dermatitis is a subacute or chronic disease of the skin, affecting the seborrhea afflicted areas and presenting with erythema and desquamation. The inflammatory reaction towards the fungi Malassezia spp. is considered to have a basic etiologic connection with this disease. Taking into consideration the pathogenesis, treatment of the dermatitis should be directed towards eradication of Malassezia spp., reduction of the skin lipids, and suppression of the inflammatory response. A wide variety of agents presented in different forms -- ointments, shampoos and drugs -- can offer effective treatment alternatives.
  This chronic inflammatory disorder affects areas of the head and trunk where sebaceous glands are most prominent. Lipophilic yeasts of the Malassezia genus, as well as genetic, environmental and general health factors, contribute to this disorder. Scalp seborrhea varies from mild dandruff to dense, diffuse, adherent scale. Facial and trunk seborrhea is characterized by powdery or greasy scale in skin folds and along hair margins.

Seborrheic dermatitis treatment
Therapy options include application of selenium sulfide, pyrithione zinc or ketoconazole -containing shampoos, topical ketoconazole cream or terbinafine solution, topical sodium sulfacetamide and topical corticosteroids. Preliminary studies suggest that terbinafine may be effective.
   Barrier Therapeutics, Inc., a pharmaceutical company developing and commercializing products in the field of dermatology, makes Xolegel (ketoconazole, USP) Gel, 2% for the topical treatment of seborrheic dermatitis in immunocompetent adults and children twelve years of age and older. Xolegel, previously referred to by the Company as Sebazole, is a topical formulation of 2.0% ketoconazole, an antifungal agent, in a waterless gel for once-daily application. Xolegel is the first prescription gel formulation of ketoconazole in the U.S.

Fluconazole for seborrheic dermatitis
Fluconazole and its place in the treatment of seborrheic dermatitis -- new therapeutic possibilities.
Folia Med. 2006.
We compared two study groups of patients: Group I--27 patients with seborrheic dermatitis stage I, II and III, treated with fluconazole, 50 mg/day for two weeks. As topical therapy we applied clobetasol propionate 0.05% ointment. After the completion of the therapeutic course, 85% of the patients in this group were clinically cured and their symptoms faded away. Fifteen percent of the subjects in this group--mainly stage III seborrheic dermatitis patients, showed partial but significant clinical improvement. The specific fungal test for Malassezia spp. on Dixon agar was negative in 93% of the cases in this group. Group II--eleven patients with similar clinical indexes were treated with fluconazole 50 mg/day only, for the same time period. The therapeutic results in this group were also satisfactory--31.5% of the patients were cured and 68% showed clinical improvement. In 74% of the patients the specific test for Malassezia spp. was negative after treatment. Fluconazole treatment in patients with seborrheic dermatitis proves to be effective and safe.

Contact dermatitis
This condition accounts for 85-90% of all occupational skin diseases and, as a frequent cause of hand dermatitis.
     A Mayo Clinic team has compiled a top-10 list of the most frequent allergen that causes contact dermatitis. The allergens appear in a wide array of products. Patients underwent skin patch testing for up to 71 allergens. The investigators found that 71 percent of patients had at least one positive reaction and 52 percent had two or more positive results. The 10 most commonly identified allergens were nickel sulfate hexahydrate, balsam of Peru, cobalt chloride, neomycin sulfate, gold sodium thiosulfate, "fragrance mix," thimerosal, formaldehyde, benzalkonium chloride and potassium dichromate.

Atopic dermatitis - Atopica
Combination therapy with pimecrolimus cream 1%, a topical calcineurin inhibitor, and fluticasone propionate cream 0.05%, a mid-potency topical corticosteroid, does not lead to a synergistic effect in the treatment of atopic dermatitis.

Atopic dermatitis has been related to a deficiency of delta-6-desaturase, an enzyme responsible for the conversion of linoleic acid to gamma-linolenic acid (GLA), which is found in evening primrose oil.

Adv Ther. 2014 Feb. Gamma-linolenic Acid levels correlate with clinical efficacy of evening primrose oil in patients with atopic dermatitis. Evening primrose oil (EPO) contains high amounts of GLA. The open study included 21 patients with AD. EPO (4-6 g) was administered daily for 12 weeks.  The clinical disease activity under EPO treatment correlates with the individual increase in plasma GLA levels. Thus, the results of this pilot study indicate that an increase in plasma GLA might be used as predictive parameter for responsiveness of AD to EPO therapy.

Perioral dermatitis treatment
Perioral dermatitis is a unique skin disorder of childhood. Its exact origin is unknown; it is probably an idiosyncratic response to exogenous factors such as the use of a topical fluorinated corticosteroid or other substances on the face. It is uncommon but not rare. The age of affected children has ranged from 7 months to 13 years, with the median being in the prepubertal period. Boys and girls, blacks and whites are equally affected. Clinical features include the following: absence of systemic symptoms; periorificial distribution (perioral, perinasal, periorbital); skin lesions that consist of flesh colored or erythematous inflammed papules, micronodules, and rare pustules; and variable pruritus. Laboratory tests are negative.
   The prescription cream Elidel may benefit those who suffer with perioral dermatitis.

I have perioral dermatitis around my chin and mouth - and a little bit around my eyes. As I am allergic to tetracycline, which clears up this problem quickly, I dont know what to use. The metronidazole gel does not appear to work at all. I read your article on Epson salt - will this maybe work effectively on perioral dermatitis?
    I doubt it would since the Epsom salt helps with a fungal infection.

Dermatitis herpetiformis information
This is characterised by granular IgA precipitates in the papillary dermis. In contrast to other autoimmune blistering diseases, where tissue-deposited and circulating autoantibodies recognise the same target within the skin, in dermatitis herpetiformis a serum IgA reacting with a component of the healthy papillary dermis has not been detected. Recently, the antigenic specificity of pathognomic skin-bound IgA has been clarified: the immune precipitates contain epidermal transglutaminase, an enzyme not previously detected in the papillary region of normal skin. Furthermore, serum IgA in dermatitis herpetiformis has been found to bind epidermal transglutaminase. These findings may relate to the fact, that dermatitis herpetiformis is associated with gluten sensitive enteropathy, coeliac disease, which is characterised by IgA type autoantibodies to a closely related enzyme, tissue transglutaminase.

Nummular dermatitis
This is a chronic inflammation of the skin characterized by coin-shaped, vesicular, crusted, scaling, and usually pruritic lesions. The cause is unknown. Nummular dermatitis is most common in middle-aged patients and is often associated with dry skin, especially during the winter.

Dermatitis natural treatment questions
Q. I'm inquiring on any new meds or creams on seborrheic dermatitis. I've used everything from steroids to israel salts to even the immunomodulators. anything new homeopathic?
   A. This is not an area we have studied in depth. We will update our page on seborrheic dermatitis as we come across more info on natural and alternative treatments for this skin condition.

Q. This is in regards to a condition called perioral dermititis. It's a type of rash that occurs around the mouth (hence the name) but seems to have no identifiable cause, although a number of factors does influence it.  The incidence of perioral dermatitis rash is steadily increasing and researchers have looked to environmental factors to see if there's any correlation in this increase. Originally, I was prescribed a 1% strength topical corticosteroid as treatment (my doctor wasn't sure what it was then). It made a big difference. The problem with this is the perioral dermatitis will return when the corticosteroid is stopped & often much worse. This is what I found. Use of the topical cream needs to be continued indefinitely which is not recommended! I quit using it after a couple of months because of this concern. The rash worsened, as expected, but has not improved even after stopping it for a long time now. I use (with my dentist's approval) a 5:1 mixture of calcium carbonate - sodium bicarbonate to brush my teeth. I highly dislike the feeling that sodium lauryl sulphate causes in my mouth. I don't use face creams. Instead, I use a very tiny amount of shea butter warmed by rubbing between my fingers & spread across my still damp face after washing. My skin is neither dry nor oily - just right really. No use of cinnamon gum or candies either. I wash around my eyes with soap & water. Around my mouth, I use a wet washcloth with a drop of soap only. I wear foundation about twice per week but wash it off immediately when I come home. I've avoided using any since the rash has worsened. I have no allergies, no food, contact, or inhalant sensitivities that I'm aware of - never have had before & never have had any rashes either. My skin elsewhere is very good. I don't take any hormonal remedies, nothing else unusual or out of the ordinary. My diet is good too. I don't use ready made foods or refined products. My sugar intake is very low. It's just I think this is a topic that would be good to be addressed by Dr. Sahelian since it's more common than many suspect. Most women with it are embarrassed by its appearance & try their best to cover it or take whatever works. Doctors normally treat this with a 3-4 month course of antibiotics (even though no real causative agent has been found) & sometimes, topical antibiotics as well. Unfortunately, when treatment is finished, many have found that the rash will return in a few months. I prefer not to use antibiotics lightly & haven't needed them for many years as my health otherwise is excellent.
   A. If we come across any natural treatment for perioral dermatitis, we will mention them.

Q. I live in India. I am suffering from seborrheic dermatitis scalp since last 20 years. I have tried everything from shampoos to steroids. Still I am not able to get rid of this condition. I am male, 40 years. I was wondering can you suggest me any new drug I may try.