Seborrheic Dermatitis

In my dermatology practice I see a lot of patients who think their scaly, red skin is just dry skin, but it is actually dandruff. Dandruff, also called seborrheic dermatitis, is so common that almost everyone will suffer from it at some point in their lifetime.

Signs that you may have seborrheic dermatitis include,

  • Red, greasy, scaly skin in the nose crease or between the eyebrows in your teens
  • ‘Dry’ and itchy scalp starting in your teen years and going on throughout your life
  • ‘Dry’, red, scaly skin in the T-zone of your face at any time in life
  • Crusty skin on, in, and behind your ears
  • Flaking of your eyebrows
  • Beardruff in your facial hair
  • Crusty scale and itching of your eyelashes (blepharitis), especially in the morning when you wake from sleep
  • Greasy, red scaly skin on your chest and upper back

The good news is that with the right Complete Skin Care routine you can control your seborrhea; use targeted over-the-counter products to keep your skin and scalp healthy and attractive (instead of red and scaly).

Dermatologist recommended Complete Skin Care routine to control seborrhea.

Cleanse: Use Calming Zinc™ Soap for facial seborrhea. It can be used on the trunk and ears, too. For hairy areas like the scalp use Foaming Zinc. A Facial Exfoliating Sponge or Salux Cloth  can help to remove scale. Gentle exfoliation with a rough scrub, such as my Bamboo and Clay Thermal Exfoliating Scrub, can work too. It's important not to be too rough with exfoliation, because seborrhea is a form of eczema. This means that the skin barrier is compromised and the skin is easily irritated. Because the skin barrier is more sensitive, all skin cleansers need to be gentle and non-drying. Some complexions may find the daily use of medicated pyrithione zinc is drying. When that is the case, try alternating the medicated product with a gentle non-medicated product to cleanse affected skin.

Correct: Facial seborrhea responds really well to my Green Tea Antioxidant Skin Therapy applied twice a day right after washing.

Hydrate: Balance skin hydration to help broken skin barrier heal by applying a good moisturizer such as my Daily Face Creams or All Natural Body Butter or All Natural Lotion to involved non-hairy skin. Beardruff responds nicely to my Omega Enriched Booster Oil. Both of my Booster OIls are great for seborrhea prone skin. 

Protect: I recommend one of my mineral zinc sunscreens be applied daily. Pick a sunscreen based on your skin type.

Dermatologist's tips to heal and control seborrheic dermatitis.

  1. Don’t use harsh products on actively inflamed seborrhea or you will add irritation on top of the seborrhea – and irritation looks red and scaly! This applies to cleansers, acne products, anti-aging products, exfoliating products, and sunscreens.
  2. Medicated cleansers and shampoos are really helpful for seborrhea, so pick the right cleanser for the skin area you are treating. Pyrithione zinc is my favorite medicated cleanser and shampoo ingredient. Other ingredients for non-facial areas include shampoos with salicylic acid, selenium sulfide, tar, ketoconazole, and prescription ciclopirox.
  3. Over my 30 years of practicing dermatology, I’ve found pharmaceutical-grade green tea creams to be the most important skin care product along with medicated pyrithione zinc. I use these as the cornerstone of any skin care routine I build to treat seborrhea.
  4. For thick crusty scale, pre-treating skin with oil for 30 minutes before cleansing or shampooing really helps. Use coconut oil, mineral oil, olive oil, or any other oil. Wet the skin, towel dry, apply the oil, then wait 30 minutes or more. Shampoo or cleanse off the oil and as a last lather, use your medicated shampoo or soap.
  5. Always moisturize non-scalp areas of seborrhea to help the skin heal. Dry skin heals more slowly.
  6. Apply facial sunscreen daily if you have seborrhea because, as with most rashes, the barrier of the skin is compromised and sun may pass through to cause damage more easily. Use non-irritating mineral zinc oxide sunscreens matched to your skin type.
  7. For stubborn seborrhea, I use clotrimazole cream twice a day until the rash is clear plus a month or so. This non-prescription anti-yeast cream provides additional control against the Pityrosporum yeast that plays a role in seborrhea. This medicated cream can also be applied to ear and trunk involvement, too. The cream base is too thick to use on hairy areas like the scalp. One-percent hydrocortisone cream on top of the clotrimazole is helpful if the rash won’t budge, but this medicine has side effects that include skin thinning of the application site and, if applied near the eyes, can cause eye damage. It should only be used under a doctor’s supervision.

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