Dandruff, a Seborrhea Symptom of Parkinson's Disease

I have Parkinson's and that's not snow

I noticed recently that I had dandruff, something I have not had since I was a teenager when my skin was much more oily.

What I noticed a few months ago was that my scalp seemed very dry. I had white flakes forming in my scalp and falling down onto my head, face, neck and chest. Several weeks ago at my request Marge picked up some special shampoo for me that contains salicylic acid. I used it as directed, but it didn't help. Luckily I already had a dermatologist appointment coming up.

The dermatologist told me I had seborrheic dermatitis (dandruff) which can be caused by Parkinson's disease and other neurologic conditions although the exact causative relationship is not understood. It is not contagious.

It can be unsightly as it sometimes forms reddish patches on the face. It also effects the eyes, eyebrows, creases of the nose and lips, behind the ears as well as the ear canals and can form in the groin and armpit areas. The flakes form in the reddish areas and can be white or yellowish. In infants seborrhea is known as cradle cap. It does not appear to be a function of poor personal hygiene. Additional symptoms include itching, which I do not have and hair loss - more of which I do not need.

Treatment is determined by where you have it and how old you are. My dermatologist suggested starting with baby shampoo, which Marge had already gotten for me a week earlier. If that does not work after a few weeks I will switch to an over-the-counter dandruff shampoo.
The next option would be tar based shampoos, or a medicated shampoo like Nizoral. If all else fails there are steroid cremes that can be obtained with a doctor's prescription.

I noticed that some of the flakes are gathering in the corner of my right eye. My doctor said I needed to clean that out every morning with a soft brush. No rubbing.

Marge sees an improvement and says my scalp is not nearly as dry. I'm not so sure.

So what else do we know about Seborrheic dermatitis? There is a difference between Seborrhea which is scalp scaling without redness and Seborrheic dermatitis which has both redness and scaling. It is a chronic inflammatory skin condition which occurs in areas of the body where sebaceous glands are located.

There is a type of yeast, pityrosporum, which likes to grow in sebum. One bit of advice we read was that this yeast does not like sunlight. Another yeast, malessizia which may irritate the skin also. It is important not to irritate the skin further in order to avoid bacterial infection. Seborrhea may flare seasonally due to lack of sunlight exposure.

In PD patients at least one study observed an increase in the sebum excretion rate. Again there were mized opinions about whether the cause was hyperactivity of the parasympathetic system; a role of androgens or testosterone or MSH-hormone. In other words is there a relation to the sex hormones? What is known is that more men than women get seborrhea.

references and further reading:
http://www.springerlink.com/content/rn9463574362l734/
http://www.aocd.org/skin/dermatologic_diseases/seborrheic_dermati.html
http://www.dermadoctor.com/article_Seborrhea_66.html
http://www.yamhillvalleydermatology.com/Definitions/Seborrheic%20Dermatitis.htm

July 14, 2010 Update
Please check the Comments Section below for information about other skin problems. 
We included cut and paste links to diagnostic charts, slide shows and unusual conditions.  Not everything that develops in a PwP is going to be a typical PD issue.  Sometimes one needs to diagnose outside the PD parameter.

One other condition which was not mentioned in the comment is MRSA. 
While people who contract MRSA will usually not become a fatality statistic, it is impotant to understand what can be done to protect yourself if hospitalized and how to recognize the condition.
Take a look at this WebMD article about MRSA - be sure to read page 2