Simple changes in your skin care regimen will help you control your facial seborrheic dermatitis (aka facial dandruff). You also need to know what things make seborrhea (dandruff) flare up so you can avoid them as much as possible. Finally, when this chronic rash starts to act up in spite of your best efforts, you need tools to treat it fast before it really gets going and makes an embarrassing mess out of your face.
Here’s what I tell my patients:
1. Washing with medicated soap is the best skin care trick to control seborrheic dermatitis.
Pyrithione zinc is my favorite medicated ingredient for facial seborrhea because:
- It is a powerful medicine for facial dandruff.
- It is rare for someone to become allergic to pyrithione zinc.
- It works really well in my dermatology practice.
You need to pick the right product for your skin and dandruff shampoos are too harsh for facial skin. People with facial dandruff and who have sensitive skin that is normal, dry or oily respond really well to my Calming Zinc ® soap. It’s a natural soap, which means the glycerin was not removed when the oils were turned into soap. This also means it is hydrating and won’t dry out your sensitive dandruff-prone skin. Calming Zinc contains the maximum allowed amount of pyrithione zinc and some natural ingredients to soothe inflammation (redness). If you’re going to choose just one treatment product for your facial dandruff, this is it!
To help remove the scale buildup, I recommend you use Calming Zinc soap with a Facial Buf Puf in the morning. Gently lather your skin and then rinse well. This helps exfoliate the loose scale to give your skin a clean look. The soap leaves a layer of medicated pyrithione zinc on your skin to help combat the pityrosporum yeast, which lives in your pores and plays an unknown, but integral role in seborrhea flare-ups.
When your seborrhea is a big problem, use your medicated soap twice a day. When things are pretty quiet, you can get away with using the soap just once a day.
2. Seborrhea may flare up even with diligent use of your medicated soap. If this occurs, you can treat the flare-up by applying over-the-counter medicated creams to the affected areas of your skin. Some options include:
- Lotrimin Cream (the generic ingredient name is clotrimazole) should be applied twice a day until two weeks after the rash abates. Stopping too soon will result in a rapid recurrence of the rash. With seborrhea, you need to ensure that it have been completely treated because it’s a tenacious rash.
- If Lotrimin alone doesn’t clear the problem after about 2 weeks, you can try adding 1% hydrocortisone cream on top of the Lotrimin for a few days. This should help jump start the Lotrimin by quieting the inflammation of the rash. (Be aware that hydrocortisone is CORTISONE and will thin your skin and damage your eyes if you use it for long periods of time. You can use it for a few days, but if things don’t clear up, you need to see your doctor to supervise your treatment. Also, don’t use it on kids without your doctor’s supervision. Remember, never self treat yourself by using prescription cortisone on your face without your doctor’s supervision. Many prescription cortisones are much stronger than the over-the-counter cortisone, even if the names sound similar, and will cause big problems on your facial skin!)
- A natural remedy for facial seborrheic dermatitis that I have seen yield remarkable results is oil of oregano. I don’t know why it works, and it smells a little like a Greek salad, but I had one patient with sever disfiguring seborrhea who failed to clear with all the biggest, strongest prescription treatments available. She completely cleared up with oil of oregano applied twice a day. Topical oil of oregano is available in health food stores. Another natural skin care remedy for seborrheic dermatitis is tea tree oil. Tea tree oil is an anti microbial natural medicine and has the potential to kill the pityrosporum yeast that I mentioned above. However, products containing tea tree oil are irritating so I typically don’t recommend using them on facial skin.
3. Avoid coming into contact with irritants on your dandruff-prone skin!
Seborrhea is a rash that makes your skin more porous. Things get into your skin faster when you have an active rash because the barrier power of the skin is weaker. That means that substances that your healthy facial skin can tolerate may now be too irritating for your seborrhea rash zones. Adding irritation to seborrhea makes for more red scaly skin. Irritating substances include:
- Harsh soaps
- Anti-aging products with glycolic acid, Retin A or Renova and Retinol, vitamin C, salicylic acid, etc.
- Harsh sunscreens (zinc oxide sunscreens are OK)
- Harsh weather
- An environment with harsh chemicals in the air, including paint fumes, new carpet, spray cleaning products, etc.
- Additional harsh things can make your seborrhea flare. For me, excessive facial sweat sometimes irritates my seborrhea and causes a flare-up.
4. Pick general skin care products that don’t irritate your seborrhea-prone skin.
Irritation of your seborrhea zones may be your first indication that your seborrhea is about to flare up. At Dr. Bailey Skin Care, I have products that are gentle and safe for most sensitive skin types including the seborrhea-prone areas of your face.
All of my sunscreens (Citrix, Glycolix Elite, Raw Elements and Solbar Zinc) are gentle for most skin.
My facial moisturizers are soothing and nonirritating for sensitive dandruff-prone facial skin. Click here to see the facial skin moisturizers I recommend for my patients:
Also my favorite non-medicated cleanser Toleriane is nonirritating.
Remember, if a product stings your seborrhea-prone skin, it is too irritating, so don’t use it!
When your seborrheic dermatitis is in remission you may be able to tolerate some of the more difficult-to-use skin care products, like anti-aging products. But, it’s important to discontinue their use the minute you see a little irritation develop. I, for example, can only occasionally treat the skin around my nose with Retin A, whereas the rest of my face gets treated almost every night with this powerful but irritating anti aging cream.
5. Use skin care products that help control your seborrhea.
This is big! The most successful product I’ve found for controlling facial seborrheic dermatitis is Replenix CF Cream. This is my absolute favorite skin-care product, bar none! The amount of green tea antioxidants is so high (the equivalent of 500 cups of brewed tea’s antioxidant polyphenols per ounce of cream) that you just can’t compare Replenix to any other green tea containing product with a “fairy dusting” of green tea ingredients. The chemist who created Replenix CF Cream also added caffeine and hyaluronic acid which, with the polyphenols, is a magic combination to control the inflammation of seborrhea. My facial seborrhea is so soothed by the combination of Replenix CF Cream and Calming Zinc ® soap that I always pack them in my travel kit and I never risk running out of them. In fact, I’ve created my Redness Relief Kits with these two products because they work so well together for both facial dandruff and rosacea (another facial rash that causes redness).
6. Lastly, I’ve seen Intense Pulsed Light treatments take the edge off of really stubborn facial seborrheic dermatitis.
Intense Pulsed Light (IPL), like the Sciton BBL that I use in my office, helps with rosacea, which often coexists with seborrheic dermatitis. Patients with both conditions (like me) struggle with a double whammy of facial inflammation and extremely sensitive skin. IPL isn’t a cure for either of these conditions, but in my practice, I’ve found it really helpful. It seems to quiet down the inflammation, allowing longer periods of remission between flares. It also helps patients tolerate some of the anti-aging products that can aggravate both rosacea and seborrhea, but that keep skin looking nice as we age.
Facial seborrheic dermatitis is annoying and is a chronic issue for those of us who are prone to it. There’s no cure for seborrhea BUT with carefully selected skin care products and quick treatment of flare-ups, it’s possible for you to have healthy and attractive skin almost year round.
Want to learn more? Dermatologist’s seborrheic dermatitis information series:
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