If you have dandruff on your face, you probably suffer from embarrassing, itchy white flakes on your scalp as well, says the American Oesteopathic College of Dermatology. A skin condition called seborrheic dermatitis affected millions of people in the United States, says the AOCD, presenting on your face in the form of patches of flaky skin--just like the dandruff that affects your head--and in some cases, inflammation and redness. Surprisingly, this particular type of "dandruff" isn't caused by dry skin, but skin that's too oily.
The exact cause of seborrheic dermatitis is unclear, but the Mayo Clinic states that there are several known factors. It's believed that it's caused by an overgrowth of a yeast-like fungus called malassezia, normally present on your skin. Oily skin, stress or fatigue, extreme temperatures (usually cold weather), and simply not shampooing or washing your face enough make "face dandruff" worse. The AOCD states that illnesses such as AIDS, Parkinson's disease, stroke and injury to the head are also linked to seborrheic dermatitis. However, the AOCD goes on to say that most people with this condition don't have medical problems.
Where Seborrheic Dermatitis Attacks
Adults notice flaky, red patches on various parts of their face, namely the brows, ear canals, behind the ears and nose, although sometimes the chest, groin and armpits are affected as well. The AOCD states that most people who have symptoms on their face also notice dandruff as well, typically on the sides of the scalp and back of the head. Because it generally affects the scalp as well, seborrheic dermatitis is often synonymously used with the term "bad dandruff."
There's not a permanent cure for seborrheic dermatitis, cautions the American Academy of Dermatology, but treatment can get it under control. Generally, this starts with use of a medicated shampoo containing active ingredients such as tar, zinc pyrithione, selenium sulfide, ketoconazole or salicylic acid--the same ingredients used in dandruff shampoos. To treat dandruff on the face, nonprescription creams may be used, says the Mayo Clinic. If these don't prove to be helpful, your doctor may suggest prescription topical corticosteroids and antifungals, which may be used concomitantly to treat more resistant flaking.
If seborrheic dermatitis is present on not only the face but the body, a prescription oral medication, such as terbinafine, may be recommended. Rarely, a doctor will prescribe oral immunomodulators, such as tacrolimus and pimecrolimus. Because these affect the immune system when used for a long period of time, the U.S. Food & Drug Administration has made it clear that they are to be prescribed when all else fails.
The Mayo Clinic states that shampooing daily with a medicated dandruff shampoo and applying nonprescription topical creams may help you get seborrheic dermatitis under control. The clinic goes on to recommend clotrimazole, an antifungal cream, and 1 percent hydrocortisone, an anti-itch cream, as two topicals you may want to have in your self-care arsenal. Avoid using harsh soaps on your face (and body), and make sure to rinse off soap well. Dandruff on the face is often worse--and more obvious--under facial hair. The Mayo Clinic suggests that men shave beards and mustaches.