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Red, Scaly Skin

Understand It Better — Take Better Care of It

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Redness and scales on the face, body and scalp can be linked to two specific chronic diseases that affect sensitive and reactive skin: seborrhoeic dermatitis and psoriasis.

Summary
  1. What are the signs of seborrhoeic dermatitis?
  2. Who is affected by SD?
  3. What causes SD?
  4. What are the signs of psoriasis?
  5. Who is affected by psoriasis?
  6. What causes psoriasis?

What are the signs of seborrhoeic dermatitis?

Seborrhoeic dermatitis is an inflammatory scaly condition primarily affecting the face and scalp.
The affected areas of the face are primarily the oily areas (rich in sebaceous glands) on either side of the nose, the nostril folds, the nasolabial folds, the area between the eyebrows and the eyebrows themselves, and the external ear canals. The scalp is the primary area where the disease is found and it triggers inflammatory dandruff that extends beyond the scalp. Other hairy areas may be affected such as the eyelids (causing blepharitis) and the pubis, as well as the beard or chest region in men.
On the scalp, the scales are generally yellowish and oily and do not stick to the scalp. It is possible that they will extend beyond the hairline onto the forehead. For more information, visit the hair and scalp “dandruff and scales” section here.
Seborrhoeic dermatitis progresses in episodes interspersed with periods of total or partial remission. Inflammatory flare-ups may be determined by the seasons and stress. Clinical signs often increase in the winter.
The symptoms vary but there is often itching or a burning sensation.

Who is affected by SD?

It is a frequent condition in adults (it affects 3% of the population), especially young adults, but it also commonly affects infants (71% of them), although only temporarily. “Cradle cap” in infants is one sign of seborrhoeic dermatitis.

What causes SD?

While some specific conditions promote the sudden onset of seborrhoeic dermatitis, symptoms usually appear in healthy young adults.
Several factors are to blame:
. The amount of sebum;
. Malassezia yeast (fungi) on individuals’ skin (saprophytic flora); The immune response of the affected person to yeasts that irritate and inflame the skin.

The chronic, recurring nature of seborrhoeic dermatitis which causes redness on the face with or without scales and/or dandruff is a significant source of discomfort for affected people. This discomfort is both social and functional (itching, burning sensations, etc.).

What are the signs of psoriasis?

Psoriasis is a chronic, non-contagious skin condition that affects 2 to 3% of the population. It may appear at any age. Specific triggering factors can reveal a genetically predisposed profile and cause lesions to appear.
Psoriasis patches are red (erythematous) and covered with thick whitish scales. They are very clearly defined compared to healthy skin. The areas most traditionally affected are the elbows and knees (areas that are impacted by microtraumas), but any part of the tegument may be affected. The scalp is one area frequently impacted (particularly the occipital area). When psoriasis reaches the skin folds (groin, armpits, etc.), this is called inverse psoriasis, which is much less scaly. The nails are sometimes affected as well in various ways (thickening, pitting, deformations).
Sometimes psoriasis appears on the skin as very small “drop-like” patches or pustules with erythema (redness).
Itching or even burning sensations may be felt in the skin folds. Psoriasis can have a major impact on quality of life, especially if it is widespread or found on particularly embarrassing or hidden areas.
It affects the skin but can also cause rheumatic problems. It affects around 25% of people with a skin condition. This psoriatic rheumatism can be axial (spine) or peripheral (particularly the phalangeal joints).

Who is affected by psoriasis?

Psoriasis affects men and women of all ages. However, it begins before the age of 20 in one third of cases and frequently appears between the ages of 20 and 40.

What causes psoriasis?

The family is affected in 30 to 40% of cases. Transmission involves several genes (multi-gene) and is not systematic.

Locally on the skin, accelerated epidermal renewal causes patches to appear. With this predisposed susceptibility, certain triggering factors are clear:
. Climate changes (cold periods in particular);
. Infectious factors (rhinopharyngeal in particular);
. Psychological stress: the skin is under the influence of neuromediators and it is “too reactive” here;
. Local traumas (burns, rubbing and more pragmatically, scratching);
. Certain medicines (synthetic antimalarials, certain medicines for hypertension, lithium salts, some specific eye drops, etc.).
Doctors are familiar with these medicines and there is no need to stop a beneficial treatment if its responsibility has not been proven.

Certain diseases and toxic habits, while not systematic, are often found in psoriasis patients: metabolic syndrome (several signs including being overweight, hyperlipidaemia, hyperglycaemia and high blood pressure), excessive alcohol consumption and smoking.