
Q I am a salaried worker in my 30s in Dong-gu, Incheon. I get greasy, flaky dandruff on my scalp and both sides of my nose. Why does seborrhoeic dermatitis appear in only those areas?
A Seborrhoeic dermatitis occurs when Malassezia yeast overgrows in areas with well-developed sebaceous glands, triggering an immune hypersensitivity reaction. The reason it concentrates on the scalp, around the nose, eyebrows, and behind the ears — the sebum-rich T-zone — is precisely because this fungus feeds on sebum. The cycle of excess sebum → fungal overgrowth → inflammation → scaling repeats itself.
Detailed Answer
Seborrhoeic dermatitis is caused by Malassezia yeast breaking down sebum in areas with a high density of sebaceous glands, producing free fatty acids that irritate the skin barrier and cause inflammation, scaling, and itching. Major sites include the scalp, facial T-zone, mid-chest, and upper back. Symptoms worsen sharply during periods of reduced immunity, fatigue, and stress.
Korean Medicine Perspective
In Korean medicine, Spleen-Stomach Damp-Heat (脾胃濕熱) rising to the upper burner is considered the root cause of excess sebum secretion. At Dongjedang, we perform a constitutional diagnosis and then approach sebum regulation and immune recovery simultaneously using formulas such as Cheonghyeol-samul-tang and Jeseup-tang, which clear Spleen-Stomach Heat and eliminate Dampness.
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