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Seborrhoea: Causes, Symptoms & Treatment

Seborrhoea is a condition of excessive sebum production by the skin's oil glands, leading to oily skin and dandruff. It commonly affects the scalp, face, and chest.

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Things worth knowing about "Seborrhoea"

Seborrhoea is a condition of excessive sebum production by the skin's oil glands, leading to oily skin and dandruff. It commonly affects the scalp, face, and chest.

What is Seborrhoea?

Seborrhoea (also spelled seborrhea) is a condition in which the sebaceous glands (oil glands) of the skin produce an abnormally large amount of sebum (skin oil). This results in visibly oily, shiny skin and a tendency to develop dandruff, skin flaking, and blemishes. The condition primarily affects seborrhoeic zones – areas rich in sebaceous glands such as the scalp, face (forehead, nose, chin), chest, and upper back.

Causes

The exact causes of seborrhoea are multifactorial and not yet fully understood. Key contributing factors include:

Hormonal influences: Androgens (male sex hormones) stimulate sebaceous gland activity. This is why seborrhoea is particularly common during puberty and periods of hormonal change.
Genetic predisposition: A family history of seborrhoea or oily skin increases the risk.
Microbial factors: The yeast Malassezia (formerly Pityrosporum) naturally lives on the skin and can trigger inflammatory responses when sebum production is elevated.
Neurological conditions: Seborrhoea occurs at higher rates in individuals with Parkinson's disease and other neurological disorders.
Stress and diet: Psychological stress and a diet high in fats and sugars may worsen symptoms.
Medications: Certain drugs (e.g., lithium, corticosteroids) can promote seborrhoea as a side effect.

Symptoms

The hallmark signs of seborrhoea include:

Oily, shiny skin particularly on the face and scalp
Yellowish or whitish flakes (dandruff) on the scalp, eyebrows, or beard area
Enlarged pores and blackheads (comedones)
Mild redness and itching of affected areas
Increased tendency toward acne vulgaris and seborrhoeic dermatitis

Diagnosis

Seborrhoea is typically diagnosed by a dermatologist based on a clinical examination of the affected skin areas. In some cases, additional investigations may be conducted:

Sebummetry: Measurement of skin oil content using specialized devices
Microbiological swab: To detect colonization with Malassezia or other microorganisms
Blood tests: To rule out underlying hormonal imbalances such as elevated androgen levels

Treatment

While seborrhoea cannot always be cured permanently, it can be effectively managed. Treatment is tailored to the severity and underlying cause:

Topical Treatment

Antifungal shampoos and creams: Active ingredients such as ketoconazole, ciclopirox, or zinc pyrithione target Malassezia and reduce flaking.
Salicylic acid: Helps loosen and remove scales through its keratolytic action.
Topical corticosteroids: Used short-term to reduce inflammation and redness.
Selenium sulfide shampoos: Provide antimicrobial effects and reduce dandruff formation.

Systemic Treatment

In severe cases, oral antifungals or retinoids (e.g., isotretinoin) may be prescribed.
Hormonal therapies (e.g., antiandrogens) are considered when a hormonal cause is confirmed.

General Measures

Stress management through relaxation techniques and regular exercise
A balanced diet rich in fiber, with reduced sugar and fat intake
Use of mild, pH-balanced cleansing products
Regular hair care with appropriate medicated shampoos

References

Nast A. et al. - S2k Guideline Seborrhoeic Dermatitis, German Dermatological Society (DDG), 2020.
Borda L.J., Perper M., Keri J.E. - Treatment of seborrheic dermatitis: a comprehensive review. Journal of Dermatological Treatment, 2019; 30(2):158–169.
Schwartz R.A., Janusz C.A., Janniger C.K. - Seborrheic dermatitis: an overview. American Family Physician, 2006; 74(1):125–130.

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