Seborrheic Dermatitis

Seborrhea – Keratinization Disorders

Seborrhea is a clinical syndrome that can present in several different forms.  It can be seen as excessive flaking and extremely dry skin, or odiferous greasy scale and yellow brown adherent oil deposits or a combination of the two.  In addition there may be circular scaling and reddened or pigmented areas of inflammation.  Many of the symptoms are worse in the folds of the skin, especially on the feet, underneath the body, and the neck.  The odor associated with this can be worsened by secondary bacterial or yeast infections.  Many patients have ear problems.

Seborrhea is sometimes secondary to some underlying problem.  These include hormonal imbalances (hypothyroidism, Cushings, Diabetes, etc.), allergies, parasites (internal and external), fungal infections, dietary abnormalities, environmental factors (temperature, humidity changes) and obesity.  Seborrhea occasionally can have no underlying problem associated with it.  This is primary (genetic) or IDIOPATHIC SEBORRHEA.

The treatment for seborrhea is to diagnose and treat the underlying disease if possible.  If the underlying disease cannot be found or is not treatable, or it is primary idiopathic seborrhea, then the objective is control of the skin problem.  There is, unfortunately, no cure for idiopathic seborrhea.  However, synthetic vitamin A derivatives, called retinoids, or oral cyclosporine may be helpful in controlling clinical signs in some cases in Cocker Spaniels.

The main method for controlling symptoms is by the use of antiseborrheic shampoos.  Several shampoos may need to be tried before the best one(s) for your pet is selected.  Sometimes two different shampoos may be needed.  Medicated shampoos are most effective when they are kept in contact with the skin for 5 to 15 minutes (the thicker the skin; the longer the penetration time needed).  Gentle massaging during this time is useful.  Be sure to avoid the tendency to under treat the affected areas on the feet and in the skin folds while over treating the middle of the back.

To prevent reoccurring infections bathe and apply topical therapy (ointments, powders, sprays, or water barriers) to the four (see diagram below) most common sources of bacteria and yeast on the dog’s skin;

  1.  Lower lips and chin.
  2. Ears
  3. Paws
  4. Perianal area (bottom); including the male prepuce (sheath) and female vulva.

Treatment Instructions
When only one shampoo is indicated:  Apply the shampoo daily or every other day with cool water until your dog feels, looks and smells better, and stops itching; let the shampoo soak; and then rinse it off well.  Your dog may air dry, towel dry or blow dry keeping the skin cool to prevent itching.  As your dog improves you can increase the interval between baths until he/she can go between baths without smelling or itching.  Generally, seborrheic dogs will require regular weekly bathing for control of their skin condition.  Alternatively, you may be able to control certain effected areas of the skin by using “spot” or “selective” bathing of only the most likely areas of involvement.

When two shampoos are indicated:  Apply the first (#1) shampoo; let it soak, and then rinse it off; then apply the second (#2) shampoo, let it soak, and then rinse it off (both used at the same bath time).  Do this daily or every other day with cool water until your dog feels, looks and smells better, and stops itching; let the shampoo soak; and then rinse it off well.  As your dog improves you can increase the interval between baths until he/she can go between baths without smelling or itching.

The shampoos are designed to remove scale, crusts, dead hair, debris, bacteria and yeast; therefore you can expect your dog’s skin to look worse, or even feel worse, before getting better.  You may opt to shorter your dog’s hair to facilitate bathing, drying, healing, and flea control.  For regular maintenance it is best to keep the lower lips, ears, paws and anal area short.

The rule of thumb is, “KEEP THE WET AREAS DRY; AND THE DRY AREAS WET.”

To reduce the impact of increased scaling caused by bathing you can apply various humectants or moisturizing treatments after each bath.  Products like Humilac, Skin-So-Soft, Alpha Keri Bath Oil, etc. can be used.

To modify your dog’s skin oils you can add Omega 3 fatty acids (fish oils) to his/her diet in the form of 1)  Fish (Salmon, Sardines, Tuna, Herring, or Mackerel);  2)  Dog food that contains fish or fish oil supplements; and/or;  3)  Commercial fish oil supplements (Vitamin Mineral Supplements with fish oils).  The amount of fish oil varies with the source.
Bacterial and/or yeast infections are common, and related to the amount of oil on your dog’s skin.  The goal is to use regular maintenance techniques to prevent the need for antibacterial or antifungal oral therapy, but if infection is present it should initially be eliminated with the use of oral treatments.  Probiotics (Lactobacillus, Acidophilus, yogurt, cottage cheese, etc.) are often recommend to restore the normal bacterial flora of the intestine, since antibiotic or antifungal therapy may be needed for a prolonged period of time.