It manifests itself in patches of red, flaking skin on the face, around the sides of the nose and above the eyebrows. An examination of the scalp often reveals sticky flakes at the edges of the hair. There is sometimes a round, flaking patch in the middle of the chest. The face skin is easily irritated. The scalp itches. The problem patches flare up from time to time, often during periods of tiredness and stress.

I recommend gentle cleansers (micellar lotion and other types of lotion) but never soap, which aggravates the irritation. Moisturising creams are not always well tolerated. However, if the skin is tight, it needs moisturising. I choose dermo-cosmetic products that are designed for tolerance and which contain active agents that relieve sebhorreic dermatitis.

While they are effective, they may produce small lesions resembling acne in these areas, which are rich in sebaceous glands. They can also result in rosacea if used too regularly. I prescribe anti-fungal creams (with ketoconazole or ciclopirox olamine) that act on pityrosporon ovale. Local, lithium-based treatments are effective. I recommend prolonged maintenance treatment to stabilise outbreaks.