How to CLEAR SEBORRHEIC DERMATITIS on the face| Dr Dray

Summary

In this video, the host discusses seborrheic dermatitis, a chronic skin condition similar to dandruff, affecting oily areas like the face and ears. Flare-ups are common in colder seasons and can be triggered by stress or medical conditions. The host recommends managing the condition with scalp hygiene and over-the-counter treatments like salicylic acid, zinc pyrithione, selenium sulfide, and ketoconazole. They also suggest moisturizing and using sunscreen to protect the skin barrier.

Takeaways

• 🍂 **Seasonal Flare-ups**: Seborrheic dermatitis tends to flare more in fall and winter compared to summer.
• 🧬 **Genetic Connection**: It's a chronic inflammatory skin condition with a genetic predisposition causing an abnormal response to the yeast Malassezia.
• 🔴 **Symptoms**: It presents as red patches and flaky areas, especially around the nose, mouth, eyebrows, and beard in people with pale skin.
• 🌡️ **Stress and Health**: Stress, including emotional and physical, can trigger flare-ups, as can underlying medical conditions like HIV and neurologic issues.
• 💊 **Dandruff Link**: Seborrheic dermatitis is related to dandruff, and scalp care is crucial for managing facial symptoms.
• 🚿 **Salicylic Acid**: It's an effective active ingredient for managing seborrheic dermatitis, used in scalp shampoos and facial cleansers.
• 💧 **Scalp Hygiene**: Regular scalp shampooing with specific ingredients can control seborrhea and prevent facial flare-ups.
• 🛑 **Zinc Pyrithione**: Found in anti-dandruff shampoos, it helps calm the yeast causing inflammation.
• 🌞 **Sun Protection**: Sunscreen is important for those with seborrheic dermatitis to prevent additional skin irritation.
• 💧 **Moisturizing**: Regular use of a moisturizer can help with the skin barrier issues associated with seborrheic dermatitis.

Q & A

What is seborrheic dermatitis?

Seborrheic dermatitis is a chronic inflammatory skin condition that is similar to dandruff on the scalp but can affect the face and other parts of the body, particularly areas with many oil glands.

What are the common areas affected by seborrheic dermatitis?

Common areas affected include the face, especially around the nose, mouth, eyebrows, beard area, and ears. It can also affect any body site with a lot of oil glands.

How does seborrheic dermatitis present in people with pale skin?

In people with pale skin, it often presents with red patches and flaky patches around the nose, mouth, eyebrows, and beard area.

What is the relationship between seborrheic dermatitis and dandruff?

Seborrheic dermatitis is related to dandruff as they are both chronic conditions that can affect the scalp and face. Dandruff can exacerbate seborrheic dermatitis on the face.

What factors can trigger or worsen seborrheic dermatitis?

Triggers include emotional stress, being run down, getting sick, and underlying medical conditions like immunodeficiency, HIV, epilepsy, or Parkinson's.

Why do people with certain neurological conditions tend to have worse seborrheic dermatitis?

It's thought that people with neurological conditions like epilepsy or Parkinson's may have more neuroinflammatory mediators in their skin, which could trigger seborrheic dermatitis.

What is the role of the yeast Malassezia in seborrheic dermatitis?

Malassezia is a yeast that lives on the skin, and people with seborrheic dermatitis may have a hyper-responsiveness to it, leading to an inflammatory skin reaction.

How can stress affect seborrheic dermatitis?

Stress can increase oil production in the skin, which can worsen seborrheic dermatitis, as the condition is related to oiliness.

What is the significance of scalp hygiene in managing facial seborrheic dermatitis?

Scalp hygiene is crucial because dandruff can worsen facial seborrheic dermatitis. Shampooing the scalp can help control seborrhea on the face.

What are some active ingredients that can help control seborrheic dermatitis?

Active ingredients include salicylic acid, zinc pyrithione, selenium sulfide, and ketoconazole. These can be found in shampoos and cleansers for both the scalp and face.

How often should you use salicylic acid products for seborrheic dermatitis?

Salicylic acid products can be used daily, especially during a flare-up, and then the frequency can be reduced once the condition is under control.

What is the role of moisturizers in managing seborrheic dermatitis?

Moisturizers can help with the skin barrier issue associated with seborrheic dermatitis and reduce redness. They should be used consistently, especially at night.

Are there any prescription medications that can help with stubborn cases of seborrheic dermatitis?

Yes, prescription medications like topical steroids, pimecrolimus (Protopic), and sodium sulfacetamide (Avar) can be prescribed for more stubborn cases.

Outlines

00:00

🌬️ Seborrheic Dermatitis Overview

The speaker begins by introducing the topic of seborrheic dermatitis, a chronic inflammatory skin condition akin to dandruff but affecting the face and other areas with oil glands. They note its increased prevalence during fall and winter, affecting people with pale skin with red patches and flakiness, while darker skin types may show lighter spots. The condition is linked to stress, underlying health issues like immunodeficiency or neurological disorders, and is related to an overactive response to the yeast Malassezia. Stress and hormonal changes can exacerbate it. The speaker also points out the importance of scalp hygiene in managing facial seborrheic dermatitis.

05:02

💧 Treating Seborrheic Dermatitis with Salicylic Acid

The second paragraph focuses on treating seborrheic dermatitis with salicylic acid, found in scalp shampoos and facial products. The speaker recommends using it daily during flare-ups and then reducing frequency as symptoms improve. They suggest Neutrogena T/Gel as a good shampoo and a face wash from the same brand for the face. The salicylic acid leave-on product by Polished is also praised for its anti-inflammatory properties, which can help manage oiliness and inflammation. An alternative scalp treatment without the need for shampooing is also introduced from The Inkey List, which can be used by those with dry hair or who cannot wash their hair frequently.

10:03

🧼 Other Ingredients for Seborrheic Dermatitis

This section discusses additional ingredients beneficial for seborrheic dermatitis, such as zinc pyrithione found in anti-dandruff shampoos like Head & Shoulders, which can also be used as a facial wash. The Vanicream Z Bar is highlighted as an effective and non-drying soap for facial cleansing. The speaker also mentions selenium sulfide, present in Selsun Blue and Head & Shoulders Clinical shampoos, and ketoconazole available as Nizoral shampoo. They emphasize the potential benefits of combining different treatments and adjusting based on individual responses, as there is no one-size-fits-all solution.

15:03

🌞 Final Recommendations and Conclusion

In the final paragraph, the speaker summarizes the discussion, reiterating the importance of not skipping sunscreen and using basic moisturizers for managing seborrheic dermatitis. They acknowledge the trial-and-error nature of finding effective treatments and suggest that some individuals may require prescription medications like topical steroids, pimecrolimus, or tacrolimus for stubborn cases. They also mention sodium sulfacetamide as another prescription option. The speaker invites viewers to share their experiences and concludes with a reminder to subscribe and apply sunscreen.

Keywords

💡Seborrheic Dermatitis

Seborrheic dermatitis is a chronic inflammatory skin condition characterized by red patches and flaky skin, commonly affecting areas with high oil glands such as the scalp, face, and ears. In the video, it's discussed as a prevalent condition that flares more during fall and winter, affecting many viewers. The script mentions that it's related to dandruff and can present differently in people with different skin tones.

💡Malassezia

Malassezia is a type of yeast that naturally lives on the skin. The video explains that people with seborrheic dermatitis may have a genetic predisposition to an abnormal response to this yeast, leading to inflammation and skin lesions. It's a key factor in the development of seborrheic dermatitis.

💡Oil Glands

Oil glands are sebaceous glands in the skin that produce sebum, an oily substance that can lead to oily skin. The video script mentions that seborrheic dermatitis often focuses on areas with a lot of oil glands, which can exacerbate the condition. This is why controlling oil production is part of managing seborrheic dermatitis.

💡Salicylic Acid

Salicylic acid is an active ingredient used in various skincare products to treat seborrheic dermatitis. The video recommends its use for both the face and scalp, highlighting its anti-inflammatory properties and suggesting products like Neutrogena T/Gel and Polished Choice 2% BHA Liquid Exfoliant.

💡Zinc Pyrithione

Zinc pyrithione is an active ingredient found in anti-dandruff shampoos that helps calm the yeast Malassezia, thus reducing inflammation. The video recommends using products containing this ingredient, like Head & Shoulders, for managing seborrheic dermatitis.

💡Selenium Sulfide

Selenium sulfide is another active ingredient used in shampoos to treat seborrheic dermatitis by targeting the Malassezia yeast. The video suggests using it in the form of Selsun Blue or Head & Shoulders Clinical shampoos, applying it to the affected areas and rinsing off after a few minutes.

💡Ketoconazole

Ketoconazole is a medication that can be found over the counter as a shampoo (Nizoral) to treat seborrheic dermatitis. The video describes its use as a game changer for some people, suggesting that it can be used daily during flare-ups and less frequently for maintenance.

💡Sunscreen

Sunscreen is emphasized in the video as an essential part of skincare for individuals with seborrheic dermatitis. It helps protect the skin from harmful UV rays that can worsen skin conditions and contribute to skin barrier issues.

💡Moisturizer

A moisturizer is recommended in the video for nighttime use to help with the skin barrier issues often associated with seborrheic dermatitis. It can also help reduce redness, as seen in the recommendation of Cetaphil Redness Relieving Night Moisturizer.

💡Neurologic Problems

The video mentions that people with certain neurologic problems, such as epilepsy or Parkinson's, tend to have worse seborrheic dermatitis. This could be related to the nerves and neurochemicals in the skin, suggesting a complex interplay between the nervous system and skin health.

💡Hormones

Hormones are discussed as potential triggers for seborrheic dermatitis flare-ups. The video notes that hormonal changes, such as those during pregnancy or from hormonal therapies, can exacerbate the condition by increasing oil production.

Highlights

Seborrheic dermatitis is a chronic inflammatory skin condition similar to dandruff.

It primarily affects areas with a high concentration of oil glands, such as the face.

Seborrheic dermatitis is more common in colder seasons like fall and winter.

People with pale skin may experience red patches and flaky areas around the nose, mouth, and eyebrows.

Individuals with darker skin types might see hypopigmented spots.

Seborrheic dermatitis can be associated with dandruff and may worsen due to flakes from the scalp.

Stress, illness, and immunodeficiency can trigger flare-ups of seborrheic dermatitis.

Certain medical conditions like HIV, epilepsy, and Parkinson's may exacerbate the condition.

The condition is linked to an abnormal response to the yeast Malassezia on the skin.

Salicylic acid is an effective active ingredient for treating seborrheic dermatitis.

Neutrogena T/Gel is recommended for scalp treatment with salicylic acid.

Salicylic acid can be used daily and is available in various forms for the face and scalp.

Zinc pyrithione is found in anti-dandruff shampoos and helps calm Malassezia.

Selenium sulfide is effective in calming inflammation and is found in Selsun Blue and Head & Shoulders Clinical.

Ketoconazole, available over the counter as Nizoral shampoo, can be a game changer for some people.

Sunscreen and basic moisturizer use is important for managing seborrheic dermatitis.

Prescription medications like topical steroids, pimecrolimus, and tacrolimus may be necessary for severe cases.

Sodium sulfacetimide is another prescription option that can help control the condition.

There is no one-size-fits-all approach to treating seborrheic dermatitis; trial and error is common.

Transcripts

well hey guys in today's video i'm going

to talk with you guys about seborrheic

dermatitis it's been a while since we

chatted about it i know a lot of you

cope with this condition

and honestly moving into fall and winter

it's a time of the year where

for a lot of people they're seborrheic

dermatitis flares more

often than like in the summertime for

example so i thought now it would be a

good time to chitchat with you guys

about it what is

seborrheic dermatitis it is a chronic

inflammatory skin condition

that is actually basically the same

thing as dandruff on your scalp i think

most people are familiar with that

but it affects the face it actually can

affect really any

body site predominantly it focuses

in areas where you have a lot of oil

glands

it's actually an oily skin condition and

in people with pale skin it often

presents with

these red patches and a lot of flakes

flaky patches

around the nose around the mouth in the

eyebrows

in the beard area anywhere where there

are a lot of oil glands in your face

there are a lot of oil glands it's also

really common

in the ears behind the ears people who

have deeper skin types their seborrheic

dermatitis actually can present

as hypopigmented spots or spots that are

lighter in color than their background

skin type

don't worry when the seborrheic

dermatitis is well controlled the color

will come back

but like i said it's related to dandruff

so you may also have

dandruff in the scalp as well and

in as a matter of fact some of that

dandruff can actually trickle down onto

your face it's thought

and cause the subderm on your face as

well so it's a chronic thing there's

not a cure for it and i'll tell you this

it's something that will flare

with things that stress you out

emotional stress being run down if you

get sick

people who have really really tough and

stubborn

seb derm include people who have

underlying medical conditions where they

have

immunodeficiency for example people who

have

hiv and for whatever reason people who

have some underlying neurologic problems

also

have uh historically have worse

seborrheic dermatitis people who have

conditions like epilepsy or parkinson's

we don't really understand fully why

that is perhaps it has something to do

with the little nerves that innervate

our skin

and the neurochemicals that are released

and people

who have those diseases maybe they're

more prone to having more

neuroinflammatory mediators present in

the skin that trigger the subderm

subderm is also an inflammatory response

to the little yeast that lives on her

skin malassezia

and he's not bad it's not something that

people should try and

obliterate or anything but people who

have seborrheic dermatitis it's thought

that their

genetics are such that they have an

abnormal kind of responsive hyper

responsiveness

to that yeast and that's why they get

these inflammatory skin lesions

and it's also related to oil production

oiliness so anything that

leads to increased oil production in the

skin can worsen the sub derm when we're

stressed out

our stress hormones drive oiliness aka

seborrhea and that can worsen this

condition hormones

of course the thing that we like to

blame everything on but hormones can

certainly exacerbate this so it can

flare with hormones and it can flare

with hormonal

therapies as well like testosterone

supplements

certain birth control pills you may find

that your skin is oilier and if you

suffer from sub derm it's worse on

the birth control pill and around

pregnancy as well and then of course

with the menstrual cycle

and in terms of helping the seborrheic

dermatitis on your face don't neglect

your scalp even if you don't have

obvious

dandruff i'm sure if you go scouting

through your hairline you'll find some

patches of dandruff and so it's just a

good idea to stay on top

of your scalp hygiene shampooing your

scalp

is one of the best things that you can

do to help control the seborrhea on your

face

because like i said at the intro some of

that dandruff even if you don't

note obvious dandruff some of the

dandruff

and the flakes from your scalp can

trickle down into your face and

exacerbate this further

so the scalp hygiene is a major piece

that you might be missing

but there are many active ingredients

that can help control the seborrheic

dermatitis

the first active ingredient is one that

you'll find in shampoos for the scalp

and

in numerous products both cleansers and

levon products for the face

and that is salicylic acid this is a

great ingredient for people

to use you can honestly use it daily and

you can use a variety of forms for both

the face and the scalp

for the scalp uh neutrogena makes a

salicylic acid

shampoo neutrogena t cell it's fantastic

it's fragrance free

but the way to use a salicylic acid

shampoo is

just lather it to the scalp let it sit

on there for a few minutes

and then rinse it out now you can do

this every day

if you're somebody who can tolerate

shampooing your hair daily you can do it

every day in the setting of a flare and

then

back off once things get under control

to maybe

once a week and a lot of people have to

shampoo their hair

can't shampoo their hair more than once

a week so

when you do your shampoo incorporate a

salicylic acid

shampoo into at least the scalp piece of

that

and that can really help they also make

neutrogena also makes a salicylic acid

face wash that you

you know it's marketed for people with

acne but it can help the seborrheic

dermatitis on the face a lot

and you can honestly use that up to

twice a day

to help control the seborrheia on the

face you can just lather it

exclusively to the areas that are most

affected so some people you know they

just have subderm around their nose

you can just lather it to that area you

don't need to use it all over the face

it makes it last longer

leave it on the skin for a few minutes

and then rinse it off and like i said

you can do it you can use that

up to twice a day and instead of a

flare you can use it daily and then

maybe you might want to back off

to using it every day once a day or

every other day

depending on you know how your sub derm

goes

everybody sub derm is individualized so

it's not a one-size-fits-all approach

you also can use a salicylic acid

levon product this is a great choice for

your face

and my favorite salicylic acid levon

product

is the polished choice uh two percent

bha

liquid exfoliant this is a great option

for

seb derm on the face it helps control

oiliness

and it really can help calm down some of

that inflammation because salicylic acid

is actually anti-inflammatory

now another product i wanted to share

with you guys for the scalp

is for people especially who can't

really shampoo their hair that

frequently

this is a great option it's new to me

and i've been trying it out for several

weeks now it's by the inky list you guys

know i love the inky list

is there salicylic acid what's it called

exfoliating scalp treatment

this is just a liquid

that you could put a few drops in your

hand and massage it into your scalp

you leave it on the scalp for 10 minutes

and then when you get in the shower

you rinse it out you do want to rinse

this out after the 10 minutes

so this is a good option for people who

find that most salicylic acid shampoos

are too drying for their hair

uh this you know removes the shampoo

piece of it

and you're just getting the salicylic

acid almost like a toner or some

you know a mask and just massage it in

leave it on for 10 minutes and then

rinse it off i will say this so be very

careful when you're rinsing this out

tip your head back and let the water you

know rinse it out from behind

you don't want it to run into your eyes

i made that mistake and it burns if it

gets in the eyes

like the dickens so be very careful but

this is quite good

and it will help lift up those scales

you i think they say to use this one to

two times a week

but you could actually use it more

frequently than that

yeah i really like this it's a good

option try it out

and they also make a good salicylic acid

face wash as well that's fragrance free

and the inky list is cruelty free so

that's

an option for you guys that and the

polish choice are options for you guys

who want cruelty free only

the next ingredient is zinc pyrithione

zinc pyrithione helps calm down that

little malassezia critter

and that's what you're going to find in

anti-dandruff shampoos you're going to

find zinc pyrithione and head and

shoulders

and the generic versions of head and

shoulders in the

in the pharmacy and it's a great

ingredient for this you do need to

lather it to the scalp or in the case of

the shampoo you can lather it to your

face and use it as a face wash just

lather it to the affected areas

leave it on the skin for a few minutes

to allow that zinc pyrithione to go to

work

and then rinse it off now the

shampoos tend to be on the more drying

side especially for people with textured

hair

but uh head and shoulders actually came

out with some

recently that have more moisturizers

added

so definitely try that out if you have

more textured hair and you've had a bad

experience with head and shoulders

for your hair type in the past i do

think the new

the new the newer formulations with

more moisturizing emollients i think

they are a nicer option

but i want to give a shout out to a

great zinc pyrethione

facial product that you guys do not

sleep on this if you have seborrheic

dermatitis because i find it to be one

of the most effective

over-the-counter products for sub derm

and that is

the vani cream z bar this is a fantastic

bar soap for washing your face and it

works really well for

severe dermatitis it's also really

helpful if you have rosacea or acne

because zinc

pyrithione is anti-inflammatory and can

really help calm down those conditions

but this particular soap is not drying

it doesn't have harsh surfactants in it

to strip the skin barrier

it's really good so i highly recommend

that for facial seborrheic dermatitis

now you may be wondering as we go

through these ingredients which one is

better and there's really not a better

best ingredient

but you might find that you benefit the

most from combining a few of these

things

so say for example you use a salicylic

acid levon product on the face and you

also wash your face with the zinc

pyrithione

shampoo or the bar soap you may find

that you need to change

change ingredients around each

ingredient kind of has a slightly

different mechanism of action

and helping the seborrheic dermatitis so

you often can get better

results using a combination of

ingredients

kind of alternating them around and

using different forms like cleanser

versus

leave on one day hopefully we'll figure

out you know

more of a tailored individualized

approach to figuring out which

ingredients work best for people

as it stands now i feel as though it's a

bit hit or miss

trial and error when it comes to

figuring out what works

best for you no one patient and one

person with subderm

you know is responds to

these ingredients the same the third

ingredient

is selenium sulfide now this is also

really good for

calming down that malassezia and

inflammation it's what's in salsa and

blue shampoo

and head and shoulders clinical is also

a selenium sulfide shampoo

so just like the zinc pyrithium shampoos

same thing with the selenium sulfide

just go ahead and lather it to the

affected area either on your face or

your scalp

let it sit on there for a few minutes

and then rinse it off

and with this uh the frequency with

which you use it

you can do it daily every other day if

you're in the midst of a flare though

you really want to amp up the frequency

to

daily and then last but not least i have

a video on this bad boy but it can

it really can be a game changer for

people and that is

ketoconazole and over the counter that's

going to come in the form of nizoral

shampoo

again use it the same way that you would

use the zinc pyrithione shampoo or the

selenium sulfide shampoo just lather it

to the affected areas

leave it on the skin for a few minutes

and then rinse it off

in any of these shampoos you can use

them daily

especially in the midst of a flare i

think that's really where you want to

amp it up to

daily use either in the scalp and or on

the face

but for maintenance you can use these a

few times a week the shampoos

to your scalp that will help give you

control of the facial subderm long term

as well

and you can also use them like once a

week on your face is like a face mask

in terms of your skin care when it comes

to seborrheic dermatitis

don't skip out on sunscreen the other

thing that can be really helpful is to

just use a basic moisturizer at

nighttime

another piece of seborrheic dermatitis

is a skin barrier issue

and that can be helped with consistent

use of a moisturizer and a lot of

moisturizers have good ingredients in

them

for calming down that redness aspect of

the subderm

and one you guys have heard me recommend

numerous times is the cetaphil

redness relieving night moisturizer

anyways this product has

um niacinamide licorice root and

caffeine all of which will help reduce

redness

those are my recommendations for

products for seborrheic dermatitis

but honestly you guys a lot of

seborrheic dermatitis in terms of

products is personal trial and error and

honestly a lot of people do end up

needing prescription

medications topical medications a lot of

people might end up using

a prescription topical steroid i have

had to prescribe this

for patients for use on the face who

have pretty stubborn seb derm

and it helps a short trial of that so

you know your derm can help out with

that if it's really unresponsive to

these over-the-counter things

also a topical medication called

uh pimcrollimas or tacrolimus

protopic these medications are steroid

sparing

so they you know don't come with the

side effects

that steroids can can have so they're

safer option for the face

long term so that's another option

unfortunately at least here in the

states

getting insurance to approve them can be

a battle and they are

expensive but they are a good option and

then another ingredient that really can

help

and then lastly another medication that

can really help seb dermalot that's by

prescription only is sodium

sulfacetimide

this can come in the form of a like a

levon lotion

or a wash goes by the brand name avar

can be quite helpful for controlling the

derm

especially when the especially when the

over-the-counter stuff is not quite

cutting it

and uh i mentioned ketoconazole you know

you get that over the counter as a

shampoo

but there's also a prescription cream

that can be prescribed that can help

as well so those are my seb derm pearls

tips whatever you want to call it and

the products that i

would recommend the ingredients i'll

list all of these down below for you

guys

but for those of you with sub derm

comment below how is it going

you know share your experience i think

that really helps people

to build a sense of community in the

comments and you know share things like

what worsens it for you and how you

incorporate these ingredients

to manage it i think that can be really

helpful for people

especially people who maybe are dealing

with this for the first time

but it is a very common skin issue so

there's you know a good chance that

you've dealt with it at least sometime

in your life i hope these tips were

helpful if so

give this video a thumbs up share it

with your friends and as always don't

forget

sunscreen and subscribe i'll talk to you

guys tomorrow bye

[Music]

you