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Seborrheic Dermatitis in Older Adults: Pathogenesis and Treatment Options

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Abstract

Seborrheic dermatitis is a common and chronic skin disease, which is particularly prevalent in older adults. While a specific cause of seborrheic dermatitis remains largely unelucidated, the currently understood pathogenesis of seborrheic dermatitis revolves around the presence of Malassezia yeast colonies and an inflammatory response in the affected individual. Keratinocyte proliferation resulting from inflammasome response in the host skin leads to the clinically relevant symptoms of seborrheic dermatitis. The increasing number of older adults as a percentage of the population in the USA will lead to an even higher prevalence of the disease in the ensuing decades. Fortunately, there are multiple treatment options based on individual patient situations and preferences. Topical treatment is the gold standard, but oral therapy may be required in certain cases. In order to maximize effectiveness and minimize adverse pharmacologic effects, effective treatment for older adults must take into account changes in lifestyle and metabolism that occur with aging.

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Authors and Affiliations

  1. University of Alabama at Birmingham, Birmingham, AL, USA

    Josiah Sowell

  2. Department of Dermatology, University of Alabama at Birmingham, 1720 University Blvd, Suite 500, Birmingham, AL, 35294, USA

    Sandra M. Pena & Boni E. Elewski

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  1. Josiah Sowell
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  3. Boni E. Elewski
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Correspondence to Sandra M. Pena.

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SMP and JS have no conflicts of interest to declare. BEE has received consulting fees or honorarium from Arcutis, Boehringer Ingelheim, Bristol Myers Squibb, Amgen (previously Celgene), LEO, Eli Lilly, Menlo, Novartis, Pfizer, Sun Pharma, UCB, Valeant (Ortho Dermatologics), and Verrica; and has received research funding to her university from AbbVie, Anaptys-Bio, Boehringer Ingelheim, Bristol Myers Squibb, Amgen (previously Celgene), Incyte, LEO, Eli Lilly, Menlo, Merck, Novartis, Pfizer, Regeneron, Sun Pharma, Valeant (Ortho Dermatologics), and Vanda.

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JS performed the literature search, data analysis, and initial draft of the work. SMP and BEE critically revised the work.

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Sowell, J., Pena, S.M. & Elewski, B.E. Seborrheic Dermatitis in Older Adults: Pathogenesis and Treatment Options. Drugs Aging 39, 315–321 (2022). https://doi.org/10.1007/s40266-022-00930-5

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