Difference Between Sebborhoeic dermatitis And Rosacea

Seborrhoeic dermatitis and Rosacea are both inflammatory disorders of the skin which causes redness, lesions and itching. Most of the times Seborrhoea dermatitis and Rosacea occur together. Apart from inflammatory similarities both these disorders are quite different from each other.

The main features of Rosacea include a redness and flushing of the skin accompanied by a stinging and burning sensation. The blood vessels are distinctly visible under the surface of the skin, portraying potent vasodilatation. The nose looks red and protruded. Papules or Pustules which are very similar in appearance to acne appear on the skin. Certain foods and drinks like coffee, alcohol and histamine containing histamines may cause Rosacea.  Rosacea affects all age groups and is categorized into four types. These are:

1. Erythematotelangietatic rosacea: Permanent redness with flushing, skin is very dry and individuals have a sensitive skin

1. Papulopustular rosacea: Permanent redness with pus filled papules.

1. Phymatous rosacea: Most common and featured by red and protruded nose.

1. Ocular rosacea: Inflammation on eyelids and sensitivity of eyes to light, blurred vision.

Treatment with steroids is discouraged and antibiotics like ivermectin, doxycyclines are encouraged. Treatment with steroids will lead to an infection caused by Demodex mites as steroid treatment will lower the immunity, hence aggravating Rosacea. Laser therapy seems beneficial in rosacea and application of alpha-hydroxy acid helps to relieve redness and irritation.

On the other hand seborrhoea affects the skin of the face, scalp and other areas of the body like pubis and groins. The main features of seborrhoea are itching and burning sensation of the affected areas. Appearance of yellow or greasy patches on the skin is a distinct character of seborrhoea.. Presence of dandruff flakes on the scalp is also a common feature of seborrhoea.  Sebborhoeic dermatitis is mostly prevalent on inside of the ears, on forehead and on the eyebrows and around the nose. The disorder is associated with the dysfunction of the sebaceous gland. The main causes are cold stress and hormonal imbalance.

The chief causes are fungal strains of Malassezia and nutritional deficiency of zinc. Malassezia hydrolyze human sebum which releases a mixture of saturated and unsaturated fatty acids. Saturated fatty acids are taken up by Malassezia while the unsaturated fatty acids enter the stratum corneum of the skin. Due to their non-uniform structure they degrade skin’s barrier function leading to irritation response and inflammation.

Lack of Vitamins (B12, B6 and A) and persistence of immunodeficiency diseases like HIV and neurological disorders like Parkinsonism also leads to Sebborhoeic dermatitis. Management includes treatment with antifungal, keratolytics and steroids. Photodynamic therapy with UVA and UV-B laser inhibits growth of Malassezia species. Brief comparison of Sebborhoeic dermatitis and Rosacea are explained below:

Features	Rosacea	Sebborhoeic dermatitis
Identity	inflammatory disorders of the skin	inflammatory disorders of the skin
Common symptoms	redness, lesions and itching	redness, lesions and itching
Clinical Presentation	redness and flushing of the skin accompanied by a stinging and burning sensation	itching and burning sensation of the affected areas
Distinct Clinical presentation	Protrusion of the nose	Appearance of yellow or greasy patches on the skin
Common causes	Certain foods and drinks like coffee, alcohol and histamine containing histamines may cause Rosacea.	main causes are cold stress and hormonal imbalance. The chief causes are fungal strains of Malassezia.
Age groups affected	All	All
Categorization	Four types :Erythematotelangietatic, Papulopustular, Phymatous andOcular rosacea	Not categorized
Treatment with steroids	Not recommended	Recommended
Probability of growth of Demodex Mites	Yes	No
Nutritional causes	Lack of Zinc	Lack of Vitamins (B12, B6 and A)
Antibiotics/Medications	Doxycylines	with antifungal, keratolytics and steroids
Surgical intervention/Phototherapy	Laser therapy	Photo-irradiation of Malassezia.
Aggravated by Immunodeficiency	No	Yes
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