Seborrheic Dermatitis — Recurrent Scaling and Redness on the Scalp and Face

It is a disorder, not just dandruff

Seborrheic dermatitis is a chronic skin disease in which oily yellow scales and red flushing recur on the scalp, forehead, around the nose, and the eyebrows. The core mechanism is irritation of the skin by free fatty acids produced when Malassezia fungi break down sebum.

Korean medicine diagnosis: damp-heat (seup-yeol, 濕熱)

Korean medicine views seborrheic dermatitis as damp-heat (濕熱) of the spleen-stomach (bi-wi, 脾胃) rising up to the skin.

• Dampness (seup, 濕): Greasy scales and sticky excess sebum → impaired water-dampness metabolism due to weakened spleen-stomach function
• Heat (yeol, 熱): Red flushing, itching, burning sensation → heat accumulating from overeating, alcohol, and stress
• Wind (pung, 風): Itching that migrates and waxes and wanes → involvement of wind pathogen (pungsa, 風邪)

Treatment

• Modified Yongdam-sagan-tang (龍膽瀉肝湯): A formula that directly removes damp-heat from the liver and gallbladder (gan-dam, 肝膽)
• Topical heat-clearing, dampness-eliminating preparations: Scalp care with cleansers based on Phellodendron bark (hwangbaek, 黃柏, Phellodendron amurense) and Sophora flavescens root (gosam, 苦參, Sophora flavescens) extracts
• Acupuncture: Gokji (LI11), Hapgok (LI4), and Hyeolhae (SP10) to remove damp-heat and regulate skin immunity

Daily habits to follow

• Greasy food, sweets, and alcohol → the three biggest creators of damp-heat; reduce them thoroughly
• Wash the scalp daily, but use a low-irritant medicated shampoo
• Stress and lack of sleep increase sebum secretion