The skin’s environment has the most direct and documented impact on seborrheic dermatitis progression. As a result, finding ways to stabilize the skin’s environment is likely to have the most rapid and dramatic effect on the condition of your skin.
Main Skin Related Factors Affecting Seborrheic Dermatitis Progression
When it comes to specifics, there are three main factors ones which appear to have the most direct connection to seborrheic dermatitis. These are:
- Amount of sebum produced – too much can create an overactive microbial environment, while too little could result in excessive moisture loss and skin barrier issues
- Specific composition of the sebum – issues in the composition of the sebum can cause inflammation and lead to heightened microbial activity
- Unique microbial environment of the skin – can influence both factors above, but can have a more direct role in triggering an immune response and damaging the skin barrier
The tricky part is that each of these not only interact and influence each other, but also influence and get influenced by the cells of the immune system as well. Despite this level complexity, finding ways to positively influence these factors is likely to produce beneficial results and help reverse seborrheic dermatitis progression.
Balance Sebum Production
Many factors are involved in determining the level of sebum that our skin produces. The ones that appear to have the clearest impact include:
- Drastic changes in blood sugar levels (high glycemic load) 
- Retinoids (Vitamin A) 
- Hormones (Androgens, Estrogens IGF and Growth Hormone) 
- Dairy consumption (due to effect on IGF production) 
So now that we know what factors to focus on, let’s review some possible approaches that can influence sebum production:
Improve Blood Sugar Control
To improve blood sugar control you simply need to be more consistent in food portions, intake frequency and reduce consumption of ultra refined foods. Additionally, try not to binge/overeat as this can cause intense spikes in blood sugar as well. If you do overeat a little here and there, don’t stress about it, it’s normal for us to break the rules once in awhile.
Increase Consumption of Vitamin A Containing Foods
Increasing retinoids may be as simple as eating more Vitamin A containing foods. The best part is that the foods may not only help control sebum, but have also been documented to impact the functioning of hormones  and overall immune function .
Balance Hormones by Balancing Your Mind
Hormones can be a little trickier to control. Most often they are dependent on the state of your general well-being and various factors outside of your control. One way we can influence them is through the reduction of stress hormones, which have been to shown to have far reaching consequences . Try to finds ways to balance your mental state and reduce the levels of stress you associate with everyday life.
Stabilize Sebum Composition
Finding actual research and medical advice dealing with specific tactics for improving sebum composition turned out to be rather difficult. Nevertheless, there are certain things which appear to have a direct impact on its composition. This includes:
- Dietary carbohydrate load [7, 8]
- Hormones 
- Skin bioavailability of Vitamin E, carotenoids, polyphenols, vitamin C, zinc and selenium (dietary effectiveness will depend on absorption) 
- Levels of stress, anxiety and depression 
Interestingly the majority of these factors are identical to those that influence sebum production. So it seems that these elements provide overall stability and likely target the immune system as whole.
Another thing to note is the impact each of these items is likely to depend on the relative initial state. For example, if you only have issues with vitamin E availability, increasing its bioavailability will have the strongest impact on your skin health. Analyzing your own unique circumstances can really help uncover which area the biggest improvements can be made.
The relationship between microbes and sebum
The unique microbial communities that populate your skin also play a large role in determining both the composition and the quantity of sebum your skin produces. This can make things rather tricky. Any of our efforts to change the sebum composition from inside may be offset by the activity of the residing microbes.
Reduce Topical Microbial Activity
The direct activity of the malassezia fungi on the skin’s surface is the most widely accepted direct cause of seborrheic dermatitis. Topical solutions may be required to modify the composition of these communities, but providing specific recommendations rather difficult.
Anti-fungal solutions are the most common approach in this area (as prescribed by dermatologists). And even if you disregard all other goals discussed in this chapter and strictly focus on reducing malassezia activity, your are likely to obtain quick and noticeable results.
The issue is that most of anti-fungal solutions appear to provide results for relatively short periods of time. And there are (currently) no guaranteed topical treatments for long term modification of the microbiome. There do appear to be many new potentially viable alternatives to synthetic anti-fungals in the making. This includes things such as anti-microbial peptides, anti-microbial fatty acids, and even the usage of topical probiotics. But these solutions are relatively new and are not yet widely accepted.
To improve your chances of long term success, reconsidering the items which stabilize the overall microbial community may be worthwhile. This includes:
- Reducing sebum production – restricts the amount of oils that the malassezia have available for consumption and may reduce skin temperature
- Improving sebum composition – influences the skin’s anti-microbial potential, barrier function and aids in preventing excessive malassezia colonization
- Improving lipid metabolism – essential to healthy sebum production/composition
- Improving immune function – influences the skin’s overall ability to defend against malassezia and other external threats
- Reducing levels of stress – improves production of anti-microbial peptides on the skin surface and reduces levels of inflammatory cells
The compounded effect of both a topical and internal approach is likely to drastically improve results obtained as the issue is tackled on both fronts. The topical component can provide the initial relief you desire, while the internal approach can secure long-term results and reduce our dependence on topical control.
Bonus – Reduce Environmental Irritants
When the skin is damaged (as the case in seborrheic dermatitis) and the epidermal barrier is not performing as it’s supposed to, many harmless environmental elements may cause inflammation and irritation. This includes dust mites, demodex mites, and practically any other element in your environment.
To help prevent further damage and speed up the recovery process it becomes necessary to minimize the environmental irritants. This includes items such as:
- Indoor air quality – particularly dust and moisture levels
- Amount of times we touch our skin – try to minimize contact and scratching
- The things we use on our skin – some products may be counter-productive as they may be stripping away the barrier that our skin works so hard to create
There are obviously many other factors which will influence the amount of possible irritants in each individual’s unique environment. The above are just some of the most obvious and widely applicable. Try to analyze and come up with specific things most relevant to your environment.
Consider your skin care regimen
Harsh cleansers can cause significant disruption to sebum rich areas of the skin. This could lead to skin barrier issues, pH instability, excessive moisture loss and drastic fluctuations in the skin’s microbial community. To minimize these negative effects, your skin care regimen may be need reconsidered.
This section reviewed the factors having the most direct connection to seborrheic dermatitis progression and provided ways we can improve each respective factor. Key actions items include:
- Improve blood sugar control by reducing consumption of ultra refined foods
- Increase consumption of vitamin A containing foods
- Increase consumption of nutrient rich whole foods
- Reduce levels of stress and find ways to improve your mood
- Find a suitable topical anti-fungal solution to provide initial relief
- Improve indoor air quality
- Reduce the amount of contact you make with the affected skin
- Reconsider the products you use and their effect on your skin barrier