cea and seborrheic dermatitis

[Guest guest]

I addressed someone's question about the connection between rosacea

and seborrheic dermatitis early Sunday evening, in addition to a

handful of other public posts, only some of which have been publicly

posted.

I talked about the four major conditions that I think of when dealing

with a local facial skin problems: acne, rosacea, seborrheic

dermatitis, and eczema (atopic dermatitis). Dermatologists may look

at this differently, but from my perspective they represent the

various ways normal skin responds when irritated or " upset. " I see

all four existing separately or together in various combinations,

waxing and waning independently or together.

Specifically, this response includes inflammation of the skin and/or

pores, edema of the skin and/or pores, increased proliferation of

cells and sebum, and impairment of the epidermal protective barrier,

the latter resulting in a loss of moisture (dry skin) and increased

absorption of whatever is on the skin (irritation leading to

inflammation and further barrier impairment). Each of the conditions

has a predominant presentation but there's overlap in each's

presentations, in addition to multiple conditions occurring at the

same time.

The skin can also develop problems on top of any of these --

superinfections, allergic reactions, etc. That's why diagnosis can be

challenging at times, and may not be fully possible on the first

visit. Also, as the skin changes with treatment, new reactions may

develop. That's not bad or unexpected, it's just characteristic of

human skin on the planet Earth.

(Flushing appears to be a vascular, not a skin problem. Depending on

the person, it may or may not trigger skin inflammation and edema,

but flushing itself is not a skin reaction, even though it is part of

many people's rosacea. That's why it doesn't respond to basic skin

care or treatments for inflammation or increased cell/sebum

production)

Those seeking a direct link between rosacea and seborrheic dermatitis

might think about the analogy of an angry/upset spoilt child. Such a

child might cry, might pout, might throw a temper tantrum. Each

spoilt child will react with their own unique response or combination

of responses. It doesn't really help to talk about the relationship

between crying and throwing a tantrum, for example, or why one child

becomes sullen and another does not, or even why the spoilt child

became angry, as such children become angry sometimes for the

slightest reasons, and other times will laugh it off. The key is,

once the child has reacted, the behavior itself needs to be managed,

in the present, whatever it is. Can future outbursts be prevented?

Maybe, but the answer isn't likely to be simple or work all the time,

on spoilt children or on those with chronic skin problems.

Marjorie

Marjorie Lazoff, MD