Evaluation of clinical and lifestyle factors associated with disease severity in adult patients with scalp seborrheic dermatitis: a retrospective analysis

Abstract

Introduction: Scalp seborrheic dermatitis (SSD) is a prevalent and chronic dermatological condition. Although various mechanisms have been proposed, its precise etiology and exacerbating factors remain unclear. This study aimed to identify the factors influencing clinical severity in individuals with SSD; to assess the associations between severity and variables such as gender, age at disease onset, treatment history, and the presence of comorbid systemic or dermatological conditions; and to determine potential triggering factors. Methods: A total of 198 adult patients diagnosed with SSD were included in this retrospective study. Collected data included demographic characteristics, smoking and alcohol use, Fitzpatrick skin type, age at disease onset, duration of the most recent flare, frequency of hair washing, and the season during which the patient presented. Clinical severity of SSD was assessed by a dermatologist. In addition, the presence of systemic and dermatological comorbidities, as well as patient-reported triggering factors, was documented. Results: A statistically significant difference in SSD severity was observed between sexes, with higher severity noted in male patients (p = 0.006). No significant associations were found between SSD severity and age, Fitzpatrick skin type, smoking or alcohol use, season of presentation/flare up, or the presence of systemic diseases. However, SSD severity differed significantly based on the presence of onychomycosis (p = 0.001). Conclusions: The significant association between the frequency of onychomycosis and the severity of SSD highlights a potential link involving shared immunologic, microbial, and skin barrier dysfunctions underlying both conditions.