048: Connecting The Dots Between Seborrheic Dermatitis And Candida w/ Dr. Alan Dattner

Seborrheic Dermatitis is an embarrassing, frustrating, persistent skin condition. My guest today is here to shed some light on seborrhea and how yeast plays a large role in the condition.

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My guest today is actually a returning guest, Dr. Alan Dattner. He is a board-certified dermatologist practicing holistic and integrative dermatology for nearly 40 years, helping patients who have failed conventional care.

He uses nutrition, herbal medicine, supplements, functional medicine, applied kinesiology, psychosomatics and more to heal the underlying causes of skin disorders.

Dr. Dattner has a background in immunology, having worked in six different immunology laboratories with renowned scientists, culminating in studies of cross-reactive immune recognition as a visiting scientist at the National Institutes of Health, and that is pretty cool. The research led him to understand the scientific validity of digestive issues as a cause of inflammation in the skin.

Join us as we talk about the relationship between seborrheic dermatitis and candida.

Has your seborrheic dermatitis improved with treatment for candida albicans? Tell me about it in the comments!

 

In this episode:

  • What is seborrheic dermatitis?
  • Why aren't current treatments helping people see massive improvement?
  • How is yeast involved in seborrheic dermatitis?
  • How to control seborrheic dermatitis
  • Can addressing yeast help with seborrheic dermatitis?

 

Quotes

“Seborrheic dermatitis is the condition that underlies the common condition we know as dandruff. But seborrheic dermatitis can be more extensive than just scaling in the scalp.” [1:34]

“Candida Albicans is a frequent inhabitant of our digestive tract. And if you look at the immunology literature, you'll find that although it's phylogenetically very different from Pityrosporum (now known as Malassezia), it is immunologically cross-reactive.” [8:49]

“In our culture, we have been growing more and more Candida in our guts because the sugar consumption has gone up.” [14:06]

 

Links

Find Dr. Dattner online

Radiant Skin from the Inside Out

Dr. Dattner's first Healthy Skin Show interview about hives

Addicted To Sugar? It’s Not Your Fault (And Here’s Why): GFS Podcast 100

How Much Sugar Is Too Much? (Here’s How To Tell): GFS Podcast 101

To see a clear diagram of what he’s discussing, check out page 181 of his book Radiant Skin From the Inside Out

Kamedis Dermatology

 

048: Connecting The Dots Between Seborrheic Dermatitis And Candida w/ Dr. Alan Dattner FULL TRANSCRIPT

Jennifer: Hi everyone and welcome back. Today I have with me a very special guest who's actually returning for his second interview and we're going to be talking about something that we have not touched on yet here at the Healthy Skin Show. You may remember a Dr. Alan Dattner. He is a board certified dermatologist practicing holistic and integrative dermatology for nearly 40 years helping patients who have failed conventional care. He uses nutrition, herbal medicine, supplements, functional medicine, applied kinesiology, psychosomatics and more to heal the underlying causes of skin disorders. He has a background in immunology, having worked in six different immunology laboratories with renowned scientists, culminating in studies of cross-reactive immune recognition as a visiting scientist at the National Institutes of Health, and that is pretty cool. The research led him to understand the scientific validity of digestive issues as a cause of inflammation in the skin. Well, thank you so much for joining us again, Dr Dattner. Today, let's talk about Seborrheic Dermatitis. This is the first time ever we have discussed this topic here on the Healthy Skin Show. Why don't we start out by having you just describe very briefly what exactly this condition is.

Dr. Dattner: Seborrheic dermatitis is the condition that underlies the common condition we know as dandruff. But seborrheic dermatitis can be more extensive than just scaling in the scalp. As most people know, dandruff appears as scaling white scale in the scalp that often shows up on a black dress or black suit and can be a little bit disturbing. But the more advanced forms involved, the eyebrow is involved, redness around the sides of the nose and also even can involve portions of the sternal section of the chest. So it can be more involved in symptoms. The scale can be very thick and there's even a little bit of a crossover almost to psoriasis in some patients, where we have what we call sebo-psoriasis with very fixed scale and redness in the scalp. So it involves inflammation of the skin that leads to a sequence of events that causes over-proliferation of the inflamed skin so that the scales start developing because their skin is dividing so fast and then those appears is what we see is dandruff and sometimes is the redness that we see.

Jennifer: And I know too, a lot of times the solutions that are provided people especially with dandruff are likely special shampoos, which I think to some degree help in some people and in others they don't. Why do you think it is that people are struggling so much? I mean this is an embarrassing, frustrating, annoying problem that as you said, can show up on your dress, on your coat. If you are a performer or you're somebody out in public, that can be really embarrassing and make you feel uncomfortable in showing up. So why do you think it is that we're just not, the current treatments just aren't hitting the nail on the head and helping people really see massive improvement?

Dr. Dattner: There are a couple issues involved. One of them is that I don't think anybody's ever died or been hospitalized for seborrheic dermatitis. That's both the good part and the bad part because the good part is that, you know, it's not a a life threatening condition. It doesn't debilitate you unless your new date says was it snowing outside, which gets a lot of embarrassment. And because of that, there hasn't been the kind of scientific power brought to the subject to really try to analyze it and only only recently have some of the organisms that are involved been looked at more closely and and some of the causes. So that's the good and bad of it being a benign condition. But there are things cropping up in the literature and there were discoveries made that have led to a partial understanding of the condition. But the official understanding is still quite incomplete. And I've taken it a step further in my understanding, based on my work 40 years ago at the NIH, and I'd like to share my hypothesis because I found that it works in people.

Jennifer: I would love to hear that. And I'm sure anybody listening who has been struggling with this for a really long time would love to hear it because the answers that you get when you go to the dermatologist and ask for help are like, you're just going to have to manage it. Sorry.

Dr. Dattner: Even before my training and probably more than 50 years ago, it was noticed that there was a particular organism that lived in the skin. It was a type of yeast, used to be called Pityrosporum and now it's called Malassezia. But in the early days it was called Pityrosporum and there seemed to be some kind of relationship of pittosporum to the dandruff. Rhat's where certain pharmical chemists created shampoos with the zinc pyrithione, the blue shampoos, like head and shoulders. They had an anti yeast effect. And what that does is give you a reduction of the yeast. And it appears to give a temporary improvement of the scaling, but you have to keep using it over and over because it doesn't really kill it. And that's great for the shampoo manufacturer. And it's also as far as they could do with that. I don't think it was just on purpose that they, they did it that way. So the question is, if you look at the literature, you see some articles that show that there's an increase in the Malassezia at the sites of inflammation, but some don't. So it's not completely clear from the literature that the Pityrosporum is just the cause, but it seems to be involved there somehow. So what could that be? Why would it be? Well, this is where my work at the NIH came in really handy to inform me of what the likely cause was. And so what's happening is there's an inflammatory attack on the Pityrosporum, and then that is causing a sequence of events.

Dr. Dattner: So the inflammatory attack is that the immune system sees that yeast and says, oh, we don't like it. And they start started attacking and then there's a cascade of events that occurs from that attack. So I asked the question, why is there a stronger attack in some people than others? Right. So the answer that I get is that something else must've stimulated the immune system to attack that yeast more vigorously in that given individual at that time. What could stimulate it? It could be another yeast that looks somewhat like it morphologically or immunologically or biochemically. So what kind of yeast? Well, we have a lot of yeast that can live in the intestinal tract. It's not the country north of us, but it sounds like it. It's Candida, not Canada. Candida Albicans is a frequent inhabitant of our digestive tract. And if you look at the immunology literature, you'll find that although it's phylogenetically very different from Pityrosporum, Malassezia (I'm using the two terms, depending upon how old an article you read), it is immunologically cross-reactive.

Jennifer: So when you say that for somebody who doesn't have a science background. So what I'm hearing you say is, I'm thinking about simplifying this would be that your body's little police service sees Candida and says, Whoa, we need to address that. We need to stop it in its tracks. And now that it's already recognized, this candida that's in the intestinal tract, it goes looking elsewhere for other things that look similar and it sees this other type of more of a fungal organism. And it goes, oh, we should attack that.

Dr. Dattner: Exactly. Because it's being smart, trying to control that. You've done the work for me in terms of making the analogy. Another way I would say is, I meet an attractive woman in a yellow sweater with the things in their ears and dark hair at a party, just for a moment and then I go looking for her and I see somebody who's wearing a yellow sweater that has those same characteristics. I might seek them out. So the immune system sees something similar. Sees something that it has a particular opinion about and it seeks out others like that. We call that molecular mimicry, we call it cross reactive recognition. And it's the principle of most autoimmune attacks and a lot of inflammatory attacks.

Jennifer: So I guess I'm asking you a question just cause you said that, based off of my thoughts: Are you implying that this process could be somewhat autoimmune in nature?

Dr. Dattner: You have your own immune system that is attacking something that looks like a bandit, a culprit, a problem. So there's a fine line between autoimmune and allergic or inflammatory in a way.

Jennifer: This fungal organism that lives on the skin, is that technically a part of the normal skin microbiome? You know, like Candida is normally in the gut. It's just that the good gut bacteria help keep the levels in check when things go crazy. So is that part of the normal skin microbiome?

Dr. Dattner: Very much so. So most people have Pityrosporum, Malassezia in the skin. So the attack is because there are a variety of things that are going wrong and I'm grasping on one or two possibilities. There are a host of other enzymes that are involved in its activity for preparing the skin to be a good meal for it. And some of these things may be maybe shifted in their activity. So yes, you're right, it's not the only piece that's involved. And so I'm looking at the literature and where everybody's saying, well, we think it's involved, but we can't prove it. Well, the point is that, first of all, they don't discuss the cross reactivity in most of the articles that I've seen. Second of all since my training, there's been a differentiation of the types of Malassezia that live in the skin. A Scandinavian has written a lot about Malassezia and looked at the different types. And I mentioned a few of the types that are most likely to be associated with seborrheic dermatitis. And let me see if I can tell you some of those. The names are a problem because different people have different names for them. The different subtypes. But that may be part of the issue. I just also want to say that it's not just the Candida Albicans, but other yeast. And their byproducts can be aggravators, such as the yeast from bread or beer or fungal products, which are, again, more distant cousins. And in our culture we have been growing more and more Candida in our guts because the sugar consumption has gone up. I think from the 1990s it was 90 pounds of sugar per year per person in this country. It's up to 151, or it was the last time I looked, it may be higher.

Jennifer: It is quite significant and I know people listening to this get nervous. I think, oh my gosh, I've got to go sugar free. I got to cut out all the sugar out of my diet and I've got to do all these crazy things. But I think the first thing that's important, at least from my understanding is to say, okay, do we have this yeast issue going on in the gut? I mean I would love to hear your perspective on this, about how to address this because everybody is thinking about how do I with it topically, but if the original trigger happening from internal, you really have just start internally.

Dr. Dattner: That's the point I wanted to make. And probably you have to do both parts of the equation. Because if you have the stimulus there and the stimulus here, you've got to lower both stimuli. And incidentally, I think that this is why there's so much excitement now about Keto diets and sugar free diets and ancient diets and all of these diets. I mean, we didn't have access to five pound bags of sugar for most of our development, right, as a species? So nowadays we have sugar added to so many different foods. You know, 150 pounds of sugar is nearly half a pound of sugar per day.

Jennifer: Oh my gosh, what? Sometimes when you think about it, you don't really know what that translates to. Until somebody makes it like what it is in your real life. And you're like, oh, that's a lot of sugar.

Dr. Dattner: I looked at some of these little cans of fruit drink. It was at the Indian store and I said, Gee, I'd like to have the guava or drink or whatever it was. And then I looked and it was 39 grams of sugar. That's a lot of sugar. That's just one drink. And then you talk about the sweetened drinks and then it's hard to buy cereal that isn't sweetened and it's in so many different products. So we're not saying that a person can't have a piece of fruit here and there. We're talking about just making some shifts and not having sugar in everything they're eating. Sauces, the ketchup…it's all over the place.

Jennifer: What would you say if a patient comes to you as a general patient, everybody listening: We're not saying these are the exact steps you should take. You should always work with someone to figure out what you need to do. But generally speaking, if a patient presents him or herself and he or she has a seborrheic dermatitis on the scalp and the eyebrows maybe for a man has it around the beard, what are some of the like bullet points of what you're going to recommend as far as helping to get this issue under control?

Speaker 3: I'm going to recommend a tremendous increase in vegetables, especially steamed vegetables and an accompanying reduction in sugar and in simple carbohydrates, like flour or that sort of thing, white rice, so that they get a controllable level. So they're not having a lot of glucose either that they're eating or that is being released from the food that they're eating in a rapid manner. I'm gonna put them on some probiotics and some fiber and anti yeast supplements and I'm going to see how far that takes it. Now, there are some people where there are also food allergies that contribute to this. There's some people with essential fatty acid deficiencies that have to be corrected. Some people with neurological issues. And of course one of the places that, one of the issues that, that, that brought seborrheic dermatitis more to the forefront was that it can be very prominent and patients with AIDS.

Dr. Dattner: I haven't fully investigated that cause I don't have an age population that I take care of. Clearly that's people whose immune system is dysregulated in a lot of ways, some of which is under-regulated. It's not a simple issue, but in people who have a relatively normal immune system, it's really helpful to deal with the amount of yeast and fungal products that having and reduce that dramatically. And so we're lowering the yeast in the gut and maybe doing topical things to lower the yeast in the skin and the scalp.

Jennifer: Any suggestions on something more natural that you could use topically?

Dr. Dattner: There are companies that have been working on that a lot and they use products that consist of tea tree oil often, which has anti-yeast and antifungal properties. Some glycerin, but licorice-derived products. There's a company that sent me some products that makes a number of these products. They've taken some combinations with the zinc pyrithione and some products that don't have that at all, that are using some of these herbs and a bunch of other herbs that come up with. Anti anti yeast herbs can be helpful. In terms of internally, probiotics can be very useful and I like the basic ones that are containing both lactobacillus acidophilus and bifidobacterium.

Jennifer: Can I ask you a question about that? There is a particular type of yeast that can be used therapeutically, called Saccharomyces Boulardii. Do you know if or are you familiar with that, if that could potentially also be cross reactive?

Dr. Dattner: I think that's a very important question. I like Saccharomyces Boulardii for crowding out all kinds of stuff. Like especially traveler's diarrhea. So that's where it can be very useful. And maybe in the initial stages it could be useful, but I think that there's a potential problem with it cross-reacting in the later stages of treatment. If you're going to use it, I don't think you want to keep using that all along. Maybe initially. I didn't search literature specifically for that, but I suspect that it can be a problem. You see the two stages of this one is crowding out the yeast and the second stage is, you've heard of the four Rs and all that. So you know, remove, replace, all that kind of thing. There's an art to it, I don't think, Jeff Bland tended to use and that's the one that I add is called reinstruct. So the last one is to reinstruct your gut immune system to not allow the big level of yeast. So you've got immune system is keeping things under some kind of control. So you want it to keep control. Because normally we have some yeast in the intestinal track. We just don't want four plus Candida Albicans. We don't want the maximum overpopulation. You know, you let your friends have some parking spaces, but you don't want to let the whole neighborhood fill your driveway. Right? This is the same thing with the gut immune system. You want it to try to control a balanced population.

Dr. Dattner: So part of controlling that balance is using prebiotics and using soluble fiber to ensure that you have a diverse bacterial population. What does that like the analogy is you have a strong lawn. A good firm grass lawn, there's not a lot of room for the weeds. Okay. And there'll be a few but not, not a lot of room. So the same thing in the intestinal tract. We want a nice, healthy, diverse bacterial population should, there's not a lot of room. So that's one form of keeping control. The other form is that the gut immune system is probably playing some active role in controlling that. And the problem there is that if you've had yeast issues for a long, long time, you get good control of it, but your gut immune system is sort of remembering the way things used to be and you just have a beer or a sip of beer in the wrong time or whatever that can reinstruct the gut immune system to say, Oh hey, it's family. I'll let them stay. So that's a place that people who are not familiar with the concept of immune tolerance get hung up and miss the boat on this. And patients get in trouble if practitioners don't quite know what what's going on.

Jennifer: I have one last question for you. We know that every case is different and so we're not in any way, shape or form by talking about this making a claim that if you do this, you're going to be healed or cured or anything like that. We're providing avenues and research to help people and give them other options. But generally speaking in your experience addressing the yeast issue, does that seem to make a significant improvement in people's seborrheic dermatitis? To the point where either it's not so big of an issue, or it completely resolves.

Dr. Dattner: I find that in a lot of people, this is one of the components of making a big shift. There are people who have a lot of other things going on. Food allergies essential fatty acid imbalance, maybe certain kinds of anxiety issues. What's interesting is that in patients who have a denervation, maybe they have Parkinson's or they have some kind of reason why they lose nerve function on one side of the head, they can get seborrhea on that side. So the nervous system has something to do with this. I can think of one person in the past with very resistant seborrhea in the beard area that did everything and he still wouldn't get better. But there was very significant anxiety overlay. And I often wonder whether that had something to do neurologically with the information going.

Dr. Dattner: Remember we've got a whole host of enzymes that were using, that the organism is using to try to strip our skin. This organism doesn't make its own fats. So it has to get the body to make the right fats for it to use, the skin. So it's not just using what's there, it has to kind of put stuff out and informational molecules out to get back what it wants. So these interactions are really multidimensional and so we have to keep listening to somebody who has a problem, if you're a practitioner to get some idea what kinds of things might be going on. What's the pathophysiology of that organism and a given individual that you can alter. Does that make sense?

Jennifer: It absolutely does. And I always remind people (clients, even listeners) that especially if your case is really chronic and you've got a lot of symptoms, you know, everywhere in the body you can't just fixate on the skin symptoms. You have to look elsewhere because the body's connected. And the more complicated the issue is, that's why it is important to work with someone who has experience and can turn stones over that you have no idea to even look in that particular spot because it's usually not one thing that fixes everything.

Dr. Dattner: Exactly. What happens is I see people who've done a lot of the right things, they come to me and they've gotten all kinds of advice from the blogosphere, but the people who were blogging don't put out enough information so that one can interpret the degree to which their case is similar to another person's case. And these are the kinds of people who I'm able to take to the next level. And who a practitioner who's really immersed in the various aspects of this, not just the herbalism, but the science, the immunology, the dermatology can often take the information that's coming in and keep pressing at it to get enough answers to understand what's often a person's pathophysiology that has to be shifted. I had a patient yesterday who'd come from some distance and when we were dealing with her issues, it was an hour and five minutes into the interview that I finally got out of her that she was eating nutritional yeast.

Jennifer: Oh my goodness.

Dr. Dattner: And that preceded the aggravation of her condition. Sometimes somebody is doing all the right things but they didn't catch one thing, or where they're using Kombucha, or they're using apple cider vinegar, which is loaded with yeast, which might help some other person in a different condition. But for them pushes them over. So it's only what you want is doing, but how the relationship between what one is doing and their change in symptoms that has to be examined to understand how their bodies work.

Jennifer: Exactly. Well, I just want to thank you so much for joining us again. I love talking to you and I hope that you will again come back and we can talk on some of these other topics because you are such a wealth of knowledge. And I love that you have helped clarify this issue for people who've been struggling a long time, who think that their only help is going to be a shampoo. And in reality this is an invitation to say, Hey, I do need to look deeper and I want to remind everybody, you have a fantastic website over at holisticdermatology.com. Even though maybe you don't have acne, there is a free ebook or you can sign up for. But either way I would suggest get on Dr Dattner's email list. That way you can stay in touch with him and learn about the things that he's doing. He's got a fantastic book called Radiant Skin from the Inside Out. And he also, for anybody listening who is a practitioner, he has written a chapter or several chapters in integrative medicine, which is a textbook for practitioners. So you can, you can, stalk him a little bit through his literature that he has published about what he is putting out into the world so that we can really help spread this information and knowledge further and help people start rebuilding healthier skin. Thank you so much for joining us, Dr Dattner.

Dr. Dattner: Oh, you're very welcome. I'm glad to have had the opportunity to share this with you and with your listening population because I hope that there's enough of a demand for this kind of medicine that more and more people do it and that the insurance companies finally start covering the time that's necessary for experts in these areas to maintain their expertise and to provide the detailed work that's necessary to get at the cause of people's problems.

“Seborrheic dermatitis is the condition that underlies the common condition we know as dandruff. But seborrheic dermatitis can be more extensive than just scaling in the scalp.”


Jennifer Fugo, MS, CNS

Jennifer Fugo, MS, CNS is an integrative Clinical Nutritionist and the founder of Skinterrupt. She works with women who are fed up with chronic gut and skin rash issues discover the root causes and create a plan to get them back to a fuller, richer life.


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