Treatment for Facial Redness & Scale from Dandruff
By Cynthia Bailey MD.
Treatment for facial redness and scale from dandruff is frustrating because very often people think that the redness and flaking is just dry skin. They try moisturizers and face oils without help. But,
could that flaky skin on your eyebrows, running around your nose and into the crease, and then down to your chin actually be facial dandruff?!
Have you been treating it like dry skin, slathering moisturizers on it to no avail?
Chances are that "dry skin" with redness, scale, and even itch in this distribution on your face is actually a rash called seborrheic dermatitis, aka dandruff. It’s not a thought that makes any of us feel glamorous but it is a common skin problem. If you have facial seborrhea, you are in good company and take heart because some simple tweaks to your skin care will help you control this embarrassing rash, so you can get your well-groomed glamour back on.
What parts of the face are most likely to get seborrheic dermatitis?
The sides of the forehead along the scalp
The temples and sideburns.
The skin between the brows.
The skin along the sides of the nose, crease of the nose and running down the sides of the mouth to the chin.
These areas are all prone to facial dandruff.
The flaking in your eyebrows is probably dandruff and not dry skin. - Dermatologist Dr. Cynthia Bailey
Why Do You Get Facial Dandruff?
No one knows. Most of us will have it at some point in our lives. It often makes its debut in adolescence as greasy redness along the nose creases and between the brows. It will flare up in the winter, during times of stress, or when your diet is sub-optimal and you are eating lots of junk foods.
Dealing with Facial Seborrhea
In adult years, facial seborrhea often starts as dry, white flakes in the eyebrows, which may spread to the skin between your brows. It will run down the sides of the nose where it is often itchy and red with white dry-appearing scale. It can also involve the chin. In severe cases, the rash spreads to the cheeks. The skin along the hairline can show dandruff. In men with beards, it globs on the skin between the hairs (beardruff). It’s all seborrheic dermatitis – oh yea!
Unchecked, facial seborrheic dermatitis will become hard to cover up. It may look better in the morning after you’ve washed your face, but as the day wears on, the scale builds up again. The seborrhea turns redder if you use any irritating skin care products, like harsh soaps or antiaging products with glycolic acid, vitamin C, or Retin A. Harsh weather can make it redder too. This is because places on your skin with seborrhea are weaker and can’t tolerate anything harsh. Trying to cover up the problem with makeup just makes things look worse because makeup gets stuck in the scales. Creams just make it all look shiny, greasy, and easier for everyone to see. Facial seborrhea is frustrating.
Practical Remedies for facial seborrhea from an Experienced Dermatologist
Over my 30 years of practicing dermatology I've found a number of practical remedies for facial seborrheic dermatitis treatment. I've helped countless patients control their seborrhea and I've tried many products on my own skin because I have seborrhea too!
I've found simple changes for your skin care routine that will help control the scale and redness of seborrheic dermatitis. Here is the multilevel approach I use in my practice and on my own skin. The important points are:
- To find the right medicated soap and skin care routine to help prevent flare ups of facial seborrhea.
- To intervene when the lovely rash of facial dandruff flares up in spite of your good efforts with your skin care. For intervention, there are some over-the-counter medicated creams to help snuff out the flare.
Below is the strategy used in my dermatology practice to control facial dandruff.
Skin Care to Help Control Facial Seborrhea
Cleanse once or twice a day with a soap that contains the medicated ingredient pyrithione zinc.
More sensitive or dry complexions do better with Calming Zinc Soap.
Both of these products contain the highest allowed amount of pyrithione zinc which is 2%. Know that pyrithione zinc itself can be drying and often they need to be alternated with a gentle non-medicated cleanser such as Extremely Gentle Foaming Facial Cleanser or my Naturally Best Bar Soap.
Why Does Pyrithione Zinc Work to Fight Dandruff?
Pyrithione zinc is my favorite medicated ingredient for facial seborrhea because:
- It is a powerful medicine for dandruff, helping to control the growth of the natural skin yeast called Pityrosporum, which plays a role in dandruff.
- It is rare for someone to become allergic to pyrithione zinc.
- It works really well on patients in my dermatology practice.
Exfoliate with an Exfoliating Facial Sponge
If you have a lot of dry scale build-up on your skin, you can very gently exfoliate it using a Exfoliating Facial Sponge. This can be irritating so go easy.
I always recommend that people who use an Exfoliating Sponge do so with their Calming Zinc Soap 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.
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.
Best Products to Control Your Facial Dandruff
After cleansing use skin care products that help control your seborrhea.
The best and most effective ingredient to control the inflammation of seborrhea is green tea antioxidants. The impact is huge actually.
The combination of Calming Zinc Soap and my Green Tea Antioxidant Skin Therapy forms the basis for my Redness Relief Kit because it is a magic combination.
My Facial Redness Relief Kit is unique because of the effectiveness of both of these products for the most common causes of facial redness, which are seborrhea and rosacea. I developed it specifically for these common skin problems. Know that if you have one of these conditions, you often also have a propensity for the other and the kit addresses them both.
My Green Tea Antioxidant Skin Therapy Cream is unrivaled. It is made by an FDA-approved lab to strict specifications and it is loaded with pure and active green tea antioxidant polyphenols. This is one of my absolute favorite skin-care products, bar none! I am never without it!
The amount of green tea antioxidants in this cream is so high (the equivalent of 500 cups of brewed tea’s antioxidant polyphenols per ounce of cream) that you just can’t compare this product to anything else. No other product with a “fairy dusting” of general green tea ingredients for marketing purposes can boast the effective results of my Green Tea Antioxidant Skin Therapy Cream. Plus, the cream contains additional ingredients that benefit irritated seborrhea-prone skin such as caffeine, hyaluronic acid, and resveratrol. You can’t drink enough green tea to get this level of antioxidants to your skin and you can’t find another product that’s as effective.
“I would just like to say that I have struggled with terrible skin conditions for the past few years and it was progressively getting worse. Upon finding Dr. Bailey’s website and reading her many blog posts, I realized what I had was a combination of rosacea, seborrheic dermatitis (facial dandruff), which were causing the redness, facial flushing, and clogged pores. I immediately ordered the redness relief kit & my skin just continues to get better!
I have since ordered many other products including her new mineral makeup! Thank you Dr. Bailey!” Angie C, Wichita Kansas
Dermatologist's Skin Care Tips to Treat Seborrhea Flare-Ups
Seborrhea may flare up, even with your most diligent skin care. If this occurs, you can treat the flare-up by applying over-the-counter medicated creams to the affected areas of your skin.
In my practice, I use the following options:
- Lotrimin Cream (the generic ingredient name is clotrimazole). Patients apply it 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 has been completely treated because it's a tenacious rash.
- Hydrocortisone Cream. If Lotrimin alone doesn’t clear the problem after about two weeks, I recommend that patients add 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 skin and damage eyes if used on the face for long periods of time. Also, don’t use it on kids without your doctor’s supervision. Another important point is to 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, they aren’t. Prescription cortisones have the potential to cause problems when used on your facial skin!)
- Natural remedies for facial seborrheic dermatitis. There are two natural remedies I recommend; one in particular that has yielded remarkable results is oil of oregano. I don't know why it works, and it smells a little like a Greek salad, but this tip was supplied by a patient years ago. She had very stubborn facial seborrhea that would not respond to even 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. The other natural skin care remedy for seborrheic dermatitis is tea tree oil. Tea tree oil is an anti-microbial natural botanical extract that has the potential to kill the Pityrosporum yeast. However, products containing tea tree oil are irritating and potential allergens, so I typically don't recommend using them on facial skin.
Avoid Irritating Products When You Have Facial Seborrhea
Another really important tip for controlling facial seborrhea is to avoid coming into contact with harsh or irritating products 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 sensitive skin on the seborrhea rash zones. Adding irritation to seborrhea makes for more redness, scale, itch and rash.
Irritating substances to avoid when you have facial dandruff 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 okay)
- 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. I've seen excessive facial sweat sometimes irritate seborrhea and causes a flare-up.
How to Build the Best Complete Skin Care Routine to Heal Facial Seborrheic Dermatitis
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, we have products that are gentle and safe for most sensitive skin types, including the seborrhea-prone areas of your face. These products include cleanser, moisturizers, and sunscreens. Look for a blue band on the bottom of a product label to know that I consider it mild and non-irritating for most sensitive skin. All of our sunscreens are gentle, hypoallergenic, and well tolerated by most sensitive skin.
Get the best results controlling your facial seborrhea when you build a Complete Skin Care Routine that provides your skin everything it needs to be healthy and fight redness. A Dr. Bailey Complete Skin Care Routine always involves these essential skin care steps:
For facial seborrhea-prone complexions, my most popular Complete Skin Care Routine is outlined below.
Step 1: CLEANSE with Calming Zinc Soap. Extremely sensitive complexions can alternate Calming Zinc Soap with Extremely Gentle Foaming Facial Cleanser, A Facial Exfoliating Sponge can gently be used for scale removal.
Oily complexions and complexions with clogged pores benefit from my Natural Hydrating Pore Minimizing Toner.
Tolerant complexions or hairy facial skin benefit from Foaming Zinc Cleanser.
Extremely dry complexions or complexions with fine wrinkles benefit from applying my Instantly Luminous Serum before applying their Green Tea Antioxidant Skin Therapy Cream and moisturizer.
In my dermatology practice, I have my patients apply other treatment products after Green Tea and before their moisturizer, which is Complete Skin Care Step 3.
Step 3: HYDRATE to prevent skin dryness and allow inflamed skin to heal. Use either one of my Daily Face Creams (Oily to Normal or Dry to Normal) or my Natural Lotion. Get the Calming Zinc, Green Tea and Daily Face Cream in my Facial Flaking and Redness Solution Kit.
Step 4: PROTECT inflamed skin with a mineral zinc oxide sunscreen matched for your skin type and needs. My patients with facial seborrhea love my Sheer Strength Pure Physical SPF 50 Spray Sunscreen because its light weight consistency works well for seborrhea prone skin. It is also great for hairy facial skin or flaky skin. It is gentle, invisible on the skin and hypoallergenic.
Remember, if a product stings your seborrhea-prone skin, it is too irritating, so don’t use it!
A Few Extra Tips for Dealing with Facial Dandruff
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 retinol, whereas the rest of my face gets treated almost every night with this powerful but irritating anti-aging cream.
Here's one final tip for helping to control facial seborrhea. I have seen Intense Pulsed Light treatments take the edge off of really stubborn facial seborrheic dermatitis. We use it in our practice and it has almost cured my own facial seborrhea. Although I'm not sure why this occurs, it is a blessed coincidence that once I started having IPL treatments, my facial seborrhea and rosacea went into a sustained remission.
Intense Pulsed Light (IPL), like the Sciton BBL that we use in our dermatology practice, is known to help 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 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.
Find the type of dandruff that you have and click below to see the routine I recommend:
Treatment for "dry" redness and scale in the eyebrows, on the nose, and on the face from seborrhea (this article)
Gary G. Optimizing treatment approaches in seborrheic dermatitis. J Clin Aesthet Dermatol. 2013;6(2):44–49.
Borda LJ, Wikramanayake TC. Seborrheic Dermatitis and Dandruff: A Comprehensive Review. J Clin Investig Dermatol. 2015;3(2):10.13188/2373-1044.1000019. doi:10.13188/2373-1044.1000019