Q. I am a 32-year-old male with very fair skin and ginger hair. I never had any problem with seborrheic dermatitis until about three years ago.
That’s when I started trying to grow a beard. Wherever I was growing facial hair, my skin got itchy, red and flaky. I have tried lots of remedies, both herbal and prescription, but it just won’t go away.
I have currently shaved my face and am on a three-month fluconazole treatment as a last resort. Do you know of anything I can do to get rid of the seborrheic dermatitis?
A. Seborrheic dermatitis resembles dandruff on the face. It is an inflammatory condition that leads to redness, scaling and flakes. Like dandruff, it appears to be caused by skin-loving yeast called Malassezia (British Journal of Dermatology, Suppl. S2, Oct. 2011).
Topical antifungal treatment (clotrimazole, miconazole) can sometimes control yeast overgrowth. Oral fluconazole is indeed a last resort, since this antifungal drug can cause digestive upset, headache and dizziness, not to mention liver enzyme elevations.
One study reported good results in treating seborrheic dermatitis with two months of topical hyaluronic acid gel (Journal of Clinical and Aesthetic Dermatology, May, 2014). Some readers have had success using dandruff shampoo (Selsun Blue) to clean their faces. Other OTC products that may help include Noxzema, Listerine, Vicks VapoRub, milk of magnesia or half-strength vinegar. Many of these, however, may be too messy to use with facial hair, so the shampoo containing selenium sulfide might be your best choice.
You might try changing your diet to see if that helps. Some readers have found that an eating pattern low in sugars and refined flour can be helpful.
