This commonly occurring condition result in redness, flaking, itching, and/or a yellow greasy scale affecting the scalp, eyebrows, creases on the nose, smile lines, chin, chest, and/or armpits. Seborrhea is now believed to be caused by a yeast that lives in the oil glands. Although most people have this yeast living in their glands, most do not get any symptoms of seborrhea.
There are many different prescription and over-the-counter medications available for the treatment of seborrhea.
For the face, chest, and armpits:
Lamisil cream may help reduce the symptoms of seborrhea if used once daily and is available without a prescription. Nizoral (econazole) cream is available by prescription and has helped some individuals if used daily.
Prescription sulfur-based medications, including Plexion, Sulfacet, Novacet, and Rosanil, have been proven to improve the signs and symptoms and seborrhea when used daily.
Hydrocortisone 1% cream (available without a prescription) can be used to reduce flares if used once daily as needed to reduce flares. This should not be used every day. Prescription hydrocortisone 2.5% cream, desonide (Desowen) cream or lotion, or Elidel cream can be used and is slightly more effective than the over-the-counter hydrocortisone.
For the scalp:
Over-the-counter shampoos are often effective if used regularly. Tar-based shampoos (such as T-gel) often help to reduce itching, redness, and flaking and can be used at least twice per week if not daily. These shampoos can stain gray hair. T-gel intensive anti-flake shampoo has an additional anti-yeast ingredient and may be more effective than the extra-strength T-gel for some people. Several anti-yeast shampoos are available and include Head & Shoulders, Selsun Blue, DHS Zinc, Nizoral AD, and Pert Plus. These shampoos can be used at least twice per week if not daily. Some will benefit from alternating a tar based shampoo and an anti-yeast shampoo (i.e. use the tar shampoo on Monday and the anti-yeast shampoo on Tuesday). For severely itchy scalp, use T-gel Stubborn Itch Control (found at Walmart)
Prescription medications are also available. Capex shampoo is a corticosteroid –based (anti-inflammatory) shampoo that helps reduce itching, redness, and flaking. Most will use the shampoo daily for one or two weeks until all symptoms resolve and then use it only once or twice a week for maintenance. Several corticosteroid solutions are available and include Locoid solution, Lidex solution, Cormax scalp solution, and Temovate scalp solution. These solutions are applied to the scalp at bedtime and are rinsed out the following morning. Most will apply the solutions daily for one or two weeks until all symptoms resolve and then use it only as needed for symptomatic relief.
Other prescription anti-yeast preparations are available and are proven to be effective. Carmol Scalp Treatment lotion is a clear gel that is applied to the scalp daily after showering for one or two weeks until symptoms resolve and is then used one or twice a week as maintenance.
For thick scaling, over-the-counter T-sal shampoo can be used to help dissolve the crusts and scale. Some may prefer to rub olive oil into the crust to help dissolve them away prior to showering and shampooing the hair.