Seborrheic dermatitis in men: causes and consequences

Tatyana Protsenko – Doctor of Medical Sciences, Professor, Honored Doctor of Ukraine, Academician of the Academy of Sciences of Higher Education of Ukraine, Academician of the International Academy of Education and Science, Member of the European and American Academy of Dermatology and Venereology (Ukraine)

Causes and consequences

Seborrhea was known as an independent skin disease in ancient times. The name comes from the merger of two words: Latin sebum (fat) and Greek rrhea (flow). Seborrhea is a hereditary disease associated with impaired functioning of the sebaceous glands, quantitative and qualitative changes in the sebum they produce. Since the functions of the sebaceous glands are controlled by sex hormones, mainly androgens, seborrhea in men has its own characteristics that must be taken into account both when treating the disease and developing cosmetic care.

The peculiarities of the manifestations of seborrhea in men are also due to the differences in male and female skin, which begin to appear, as a rule, from 12–14 years of age. After puberty, due to the secretion of sex hormones (androgens), these differences become pronounced and significant for the implementation of high-quality cosmetological care. They are manifested in structural and anatomical, biochemical, mechanical and functional features, response to exogenous factors, sensitive function, skin color, hormonal influence, and characteristics of the pilosebaceous structures.

These differences are especially pronounced at the age of 20–69 years, when the highest androgen-induced activity of the sebaceous glands is noted, while there is no correlation between the blood testosterone content and the level of sebaceous secretion. Overproduction of sebum is accompanied by changes in its physicochemical properties, decreased bactericidal activity, increased viscosity, etc., which often leads to the development of seborrheic dermatitis. A decrease in the bactericidal capacity of sebum activates the opportunistic flora of the pilosebaceous follicles - yeast-like lipophilic fungi: on the scalp - Pityrosporum ovale, on the face and torso - Pityrosporum orbiculare. These microorganisms, which are normally concentrated around the sebaceous hair follicles, begin to use the altered secretion of the sebaceous glands as a source of fatty acids necessary for growth and reproduction. With further development of the process, the deep flora of the pilosebaceous follicles - Propionbacterium acne - is also activated, which can lead to the appearance of inflammatory follicular papules, pustules and the onset of acne.

The development of pathological changes in the skin is also promoted by stress, decreased immunity, metabolic disorders that always accompany diseases of the digestive system (gastritis, colitis, dyskinesia, constipation, etc.), endocrine diseases (diabetes mellitus, impaired carbohydrate tolerance, etc.). Recently, great importance has been attached to nutritional problems, including poor nutrition, debilitating diets or abuse of vitamin supplements.

Taking into account the hormonally determined differences in the structure and functioning of skin structures, seborrheic dermatitis and acne in men are more severe, more difficult to treat, and recur more often. That is why a well-designed program of cosmetic care and/or rehabilitation after treatment can not only increase its effectiveness, but also prevent the development of relapses or even the onset of these diseases.

Characteristic picture

The clinical manifestations of seborrhea are quite characteristic: the skin becomes oily, shiny, has a dirty gray color and enlarged pores. Depending on their characteristics, oily (liquid and thick), dry and mixed seborrhea are distinguished. In men, thick seborrhea is more often observed, in which the skin thickens, becomes dull, has a grayish color, and the secretion of the sebaceous glands acquires an unpleasant odor, which must be taken into account when carrying out cosmetic procedures. Often scales, redness, itching appear and seborrheic dermatitis debuts. Characterized by damage to the scalp, which does not extend beyond the boundaries of hair growth, nasolabial folds, glabellar and postauricular areas, as well as seborrheic areas of the body. In severe cases, seborrheic dermatitis can have a generalized distribution, including erythroderma.

Cosmetic care

Management of men with seborrhea should include not only cosmetic care, but also mandatory correction of the functioning of the digestive organs: a balanced diet, vitamins and microelements, a sufficient amount of fluid per day (at least 2 liters).

Cosmetological recommendations should ensure adequate cleansing of the skin and the use of moisturizers with antibacterial action. For this purpose, medicinal cosmetics can be prescribed, which are widely available in Ukrainian pharmacies, are comfortable to use and are acceptable for men.

Active components in dermatocosmetics (α- and β-hydroxy acids and other keratolytics, plant blockers of the enzyme 5-α-reductase, zinc gluconate, copper, etc.) allow you to delicately and adequately cleanse the skin, preventing the development of blockage of the sebaceous glands, and in the future - open and closed acne, ingrown hairs, especially in the shaving area, prevent microbial inflammation and the subsequent development of seborrheic dermatitis. It is thanks to a certain therapeutic effect that this cosmetics is sometimes called “anti-acne”. As a rule, such products provide not only complete cleansing of the skin, but also keratoregulating, sebostatic and anti-inflammatory effects.

Prevention comes first

In order to prevent the development of aesthetic problems and dermatological diseases, it is necessary to begin intensively caring for the skin at an early age of puberty (from 12 years old), teaching the teenager, first of all, to regularly (morning and evening), fully and adequately cleanse it. A gel or soap as part of a dermatocosmetics line is quite suitable for this. In the late puberty period (16–19 years), it is necessary to supplement care with the use of moisturizing aftershave creams with anti-inflammatory keratoregulating components, thermal water after shaving, and, if necessary, external medical preparations. Recommendations from a specialist in aesthetic medicine (esthetician, cosmetologist, dermatologist) are also of great importance. After 19 years, if skin problems persist, seborrheic dermatitis or acne develops, a consultation with a dermatologist is indicated, who, along with external therapy, prescribes a medical examination and, if necessary, systemic therapy. Early detection of dermatological pathology, its timely treatment and well-developed skin care at any age is the key not only to health and beauty, but also to social and professional success.

Source: KOSMETIK international journal, No. 2(32), 2008, pp. 20-21