Treatments, that's plural for a reason. There is no single magic bullet to treat seborrheic dermatitis. There is no cure. As fine as our medical researchers are, there is also no known cause for this. WebMD calls this a disease, Wikipedia calls it a disorder. I call it a nasty prize in a lottery that I won ... along with about five percent of the adult population.
I have managed to find a few things that work well for me. If you try these out, keep in mind it is entirely at your own risk. I am not a doctor and I am not involved in the medical community in any capacity. I have had seborrhea for at least 45 years with light annual recurrences. It's only the last four or five years that my seborrhea has progressed, and only in the past year where it has become a nuissance affecting my life. I find the flaking and redness most embarassing.
Through my research and observations, I noticed that bathing or showering had two distinct separate effects. The first is that the warm water seems to help with itching and does temporarily remove the scaling (and oil residue on the skin). The second is that it also seemed to trigger redness followed by flaking within an hour of finishing a bath.
A bath (or shower) also seemed to be the most significant trigger of a seborrhea flare up – for me.
Since we have recently moved to our current home, I decided to purchase an inexpensive water testing kit to determine the hardness of the water, pH level, and any possible extras in the water (like fluoride and chlorine). I was most interested in getting the chlorine level in our water. It took me some time to locate a water testing kit, but I did take a water sample to one of the companies that sell home water treatment systems. They typically will test the water while you are there and give you the results immediately. Our chlorine level was at 3 ppm. That is roughly equivalent to the level of chlorine in a public pool. To find this level in tap water is quite unusual. The test also showed the water hardness at 8 grains – moderate hardness. I was not as concerned with the hardness since there were no deposit residues on any of our taps, drains, basins, or laundry.
I started to suspect that the chlorine was a major trigger for seborrhea. If it isn't obvious, having chlorine in your water affects everything in your home: laundry, food preparation, drinking water, ice cubes, as well as bathing and showering. This is extreme exposure to chlorine on a regular and sustained basis.
I hate spending money unless it is absolutely necessary. I wasn't prepared to invest in whole home filtration systems unless I knew it would help relieve the seborrhea symptoms. I decided to test this as a possible solution by purchasing an inexpensive shower head decided to reduce chlorine. Spending $30 on a "Sprite" showerhead. I installed it and ran it for about 10 minutes before taking a shower – and, it worked. It was immediately obvious that the redness was gone. I tested that showerhead for one week with the same result: no redness, no irritation, no trigger. Flaking didn't come back for at least 24 to 36 hours after the shower. I personally prefer a bath, though ... I like adding Epsom Salt to a bath and lounge for a good 20 minute soak. So, I used the shower head to fill up a bathtub full of water and added Epsom Salt. Absolutely heavenly. Epsom Salt is magnesium sulfate. I use it to soap the areas where seborrhea is prominent. It helps to rid the skin of the malasseiza fungus. And, the bath worked perfectly too. So I purchased a whole house water filtration system that would slightly reduce the hardness and reduce the chlorine. After the installation, tests show the chlorine at 0.
By the way, I use two shampoos. Both are as effective as the other, I have no big preference other than the first is quite a bit less expensive. I use Davis Miconazole Shampoo (yes, it is a pet shampoo) and Nizoral shampoo ketoconazole 2%. Both have active ingredients in the "azole" family of ingredients.
Reducing the chlorine in the water is one part of my self treatment. As I pointed out, the flaking still returns after 24 to 36 hours. I want to be free of the flakes for longer than that.
Vitamin D3 , 2000 IU four times daily. I have authored several articles previously on my health issues. One of the points that I make is the absence of certain compounds in our bodies. By "our" bodies, I mean those of us that have chronic illnesses or diseases. When I include all the lab tests others have shared with me, plus all of mine for nearly six years, I note that we are all deficient in 25-hydroxy (vitamin D3), B12, and have low pH levels. For many years, I have been taking Vitamin D3 (2000 IU daily), B12 (1000 mcg daily), and have taken steps to increase my pH levels. I have managed to slightly increase 25-hydroxy, B12, and maintained pH levels (no increase until recently). As I researched possible treatments for seborrhea, 25-hydroxy kept coming up as a possible treatment. I decided to increase Vitamin D3 supplements to 8000 IU (that is 2000 IU four times daily) and increase my resolve to raise my pH levels. I also increased Omega 3. With these changes, the flaking and scaling now stays away for up to 72 hours at a time (3 full days) and increasing.
Omega 3 , 2000 mg with each meal. I don't want to mince words here, Omega 3 is the only Omega supplement anyone should be taking. All of us are already getting far too much Omega 6 in our diets – and it's not a desirable supplement. I started taking Omega 3 at my wife's recommendation several years ago. I also have steatorrhea. One of the main symptoms is excreting oil with or without feces. To control this, my doctor and dietician recommended taking some psyllium husks with each meal. The theory is that the psyllium husks would absorb the oil – and that worked. The only issue is that psyllium husks are a carbohydrate (2 tbsp = 10 grams of carbs) and was not friendly to my diabetes control. While looking for an alternative, I tried Omega 3 at my wife's recommendation and found it far more effective at controlling steatorrhea than the psyllium husks and also helped with glycemic control. All it really took to help with the stetorrhea was an average of 1500 mg of Omega 3 daily (I was taking three 1000 mg every two days ...). I decided to increase this to two 1000 mg at each meal, meaning a total of 6000 mg daily. I believe this, combined with de-chlorinated water, and vitamin D3 to be working quite effectively.
As I write this, I have no redness. I am generally free of scales and flakes for about three days at a time.