JMIR Publications

ABSTRACT

Background:

Pathogenesis of seborrheic dermatitis (SD) involves lipid secretion by sebaceous glands, Malassezia colonization and an inflammatory response with skin barrier disruption. Each of these pathways could be modulated by diet, obesity, and nutritional supplements. Current treatment options provide only temporary control of the condition; thus, it is essential to recognize modifiable lifestyle factors that may play a role in determining disease severity.

Objective:

To summarize published evidence on diet, nutritional supplements, alcohol, obesity, and micronutrients in SD patients and to provide useful insights into areas of further research.

Methods:

A literature search of Scopus, PubMed, and Medline (OVID interface) for English language articles published between 1993-2023 was conducted on 16th April 2023. Case-control studies, cohort studies, and randomized controlled trials with 5 or more subjects conducted on adult participants (>14 years) were included, case reports, case series and review papers were excluded.

Results:

13 studies, eight case-control, three cross-sectional and two randomized control trials, involving 13,906 patients were included. SD patients had significantly increased copper, manganese, iron, calcium, and magnesium concentrations and significantly lower serum zinc and vitamin D and E concentrations compared to controls. Adherence to the Western Diet was associated with a higher risk for SD in female patients and an increased consumption of fruit was associated with a lower risk of SD in all patients. The prebiotic Triphala improved patient satisfaction and decreased scalp sebum levels over eight weeks. Most studies find associations between regular alcohol use and SD but the association with BMI and obesity on SD severity and prevalence is mixed.

Conclusions:

This review sheds light on specific promising areas of research that require further study, including the need for interventional studies evaluating serum zinc, vitamin D, and vitamin E supplementation for SD. The negative consequences of a western diet, alcohol use, and obesity, and the benefits of fruit consumption are well known; however, to fully understand their specific relationships to SD, further cohort or interventional studies are needed. Clinical Trial: This protocol was registered and can be accessed at Prospero with the registration number CRD42023417768.