Psychosomatics of seborrheic dermatitis
Seborrheic dermatitis is a common skin condition: dandruff, greasy yellow scales, mild redness and itching on the scalp, eyebrows, around the nose, behind the ears and on the chest. It is not contagious and is not caused by poor hygiene. The exact cause is unknown; oil glands, Malassezia yeast on the skin and genes play a part, and stress and tiredness can make flare-ups worse. It comes and goes, and medicated shampoos and creams keep it under control. The Ladder method adds questions about overload.
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When to see a doctor
A dermatologist or GP makes the diagnosis by how the skin looks; tests are rarely needed. The NHS advises seeing a doctor if dandruff has not cleared after 4 weeks of medicated shampoo, your scalp is very itchy, red or swollen, or your face and body are flaking.
In the Ladder method
In the Ladder method seborrheic dermatitis is not explained as "you don't look after yourself", and you are not to blame for your skin flaking. It is a common skin condition, not untidiness. MedlinePlus lists stress and tiredness among the risk factors, so questions to yourself belong alongside treatment, not instead of it.
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In the method the scalp and face fit the image of what is on show and what overloads your head: endless tasks, thoughts, other people's judgements. It is an image, not the cause, and it does not replace an examination by a doctor.
On the ladder this shows up as the steps "what if they notice" and "my head is always full of tasks". You can work through them while you are being treated.
These are questions for reflection, not an explanation of what causes the condition and not a treatment.
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How it shows up
Book a doctor’s appointment if you notice:
- Dandruff, white dry or yellow greasy scales
- Flaking and redness on the eyebrows, around the nose, behind the ears
- Itchy scalp
- Oily patches of skin
- Flaking in the middle of the chest
- Worse in winter and under stress
What medicine knows
Seborrheic dermatitis is long-term inflammation of the skin where there are many oil glands: the scalp, eyebrows, eyelids, creases of the nose, behind the ears, the middle of the chest. MedlinePlus describes scales, white and dry or yellow and greasy, oily patches of skin, mild redness and itching. Dandruff is its mild form on the scalp.
The exact cause is unknown. MedlinePlus names a combination of factors: oil gland activity, Malassezia yeasts that live on everyone's skin, changes in the skin barrier and genes. Risk factors include stress and tiredness, weather extremes, oily skin, alcohol, obesity and some nervous system disorders.
The NHS stresses that dandruff is not contagious and is not caused by poor hygiene. What helps: a shampoo with ketoconazole, coal tar or salicylic acid for up to 4 weeks, and you may need to try more than one. In severe cases a doctor prescribes stronger treatments for the scalp and face.
Seborrheic dermatitis comes and goes, but it can be kept under control (MedlinePlus). Many people feel better in summer and in the sun. Similar patches occur with psoriasis, eczema and fungal infections, so if it does not clear up, a doctor confirms the diagnosis.
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Frequently asked questions
Can seborrheic dermatitis be caused by nerves?
Nerves alone do not cause it: the cause is a combination of oil glands, Malassezia yeasts, the skin barrier and genes. But MedlinePlus lists stress and tiredness among the risk factors, and they can make flare-ups worse.
What does seborrheic dermatitis mean in psychosomatics?
There is no proven "meaning". In the Ladder method a flaky scalp becomes a reason to ask yourself what overloads your head and whose judgement you fear. It is a question to yourself, not a diagnosis.
Will seborrheic dermatitis go away for good?
It comes and goes, but it can be kept under control with medicated shampoos and creams (MedlinePlus). If a shampoo has not helped in 4 weeks, see a doctor (NHS).
Related topics
Psychosomatics does not replace tests and treatment. Only a doctor can make a diagnosis.