Seborrhea is a skin disease of the sebaceous (oil) glands marked by an increased secretion of sebum (oil) or a thickened sebum discharge. It can resemble acne and blackheads. One of the differences between acne and seborrhea is that in seborrhea the increased oil production is often accompanied by a scaly, thickened skin, especially on the scalp, and the oil itself can have a strange, viscous texture. However, in seborrhea—and sometimes in acne—the sebum (a firm, waxlike substance in the pore that liquefies into oil on the surface of the skin) in the sebaceous gland accumulates, causing the gland to become swollen and filled to the brim. When this overproduced sebum is covered over by skin, it forms a small, firm mound called a whitehead. When the sebum is exposed to air (not covered by skin) and the duct fills with dead skin cells, the sebum turns dark from oxidation and the blemish becomes a blackhead. The size of the eruption, the texture of the oil, and the flaky skin are what differentiate seborrhea from acne.
Seborrhea can show up wherever there are lots of oil glands. The scalp, sides of the nose, eyebrows, eyelids, behind the ears, and the middle of the chest are the areas most commonly affected. Other areas, such as the navel and the skin folds under the arms, breasts, groin, and buttocks, may also be involved. The swelling, breakouts, and accompanying yellowish, greasy-appearing scales make this skin disorder hard to miss.
Seborrhea is identified by excessive yellowing, thickened scaling, accompanied by excessive oiliness, and is possibly triggered by a yeast organism (yeast is a type of fungus) present in the hair follicle (Source: British Journal of Dermatology, March 2001, pages 549-556). Seborrhea can occur at any age, but typically it is seen in infants, when it is called “cradle cap.” Because yeast, or some other form of fungus, likely triggers seborrhea, antimicrobial agents capable of targeting this type of organism have been shown to have a high success rate.
Prescription medications for the treatment of seborrhea include ciclopiroxolamine 1% in a cream base. This is an antifungal that has been shown to be effective in a well-controlled study (Source: British Journal of Dermatology, May 2001, pages 1033-1037). Topical metronidazole (Noritate, MetroLotion, MetroGel, and MetroCream) can also have significant positive results, and are very effective in the treatment of seborrhea (Source: Journal of Family Practice, June 2001, volume 50, issue 6). An oral medication, terbinafine, has been identified as beneficial in the treatment of seborrhea as well (Source: British Journal of Dermatology, April 2001, pages 854-857).
Several over-the-counter topical treatments for seborrhea include zinc pyrithione 1% (Dandrex, Zincon, Head and Shoulders, Denorex), coal-tar preparations (DHS, Neutro – gena T-Gel, Ionil T, Tegrin, Esorex), ketaconazole (Nizoral), selenium sulfide 1% (Selsun Blue), and selenium sulfide 2.5% (Selsun). A very good fragrance-free moisturizer with zinc pyrithione is DermaZinc Cream; it is available from www. dermadoctor. com.
As in the treatment of psoriasis, UV light therapy can be of benefit for those who suffer from seborrhea, but it carries the same risks mentioned above for psoriasis. Topical steroids are often of limited use because they can cause thinning of the skin.
Treating seborrhea takes patience and experimenting to find what works for you. All of these medications, either alone or in combination, are options for achieving the best results.