Combination skin basics

Combination skin means what you would think it does: the skin with areas of dryness and oiliness. Typically, people with combination skin have oily T-zone (forehead and nose area) and dry cheeks. What you may not know is that combination skin is often a manifestation of the skin condition called seborrhea and its cousins, seborrheic eczema and seborrheic dermatitis. The main manifestation of seborrhea is overproduction of oil on the face and scalp. Many seborrhea patients also have yeast overgrowth, especially on the scalp and eyebrow areas, which causes irritation, itching, dandruff and other problems. You may want to see a dermatologist to determine whether you have seborrhea or related conditions.

Combination skin routines usually include the following recommendations:

• Treat oily and dry areas differently. Treat your scalp as well.
• Wash your skin with a mild cleanser twice daily. Get a cleanser free of soap, harsh detergents or alcohol, ideally containing an oil production reducing agent, such as salicylic acid.
• Switch to anti-dandruff shampoos (e.g. pyrithione zinc or selenium sulfide shampoos) and/or anti-yeast shampoos (e.g. ketoconazole shampoo). Use every other day until dandruff and other symptoms are under control; use twice a week after that.
• After washing apply oil-free moisturizer (you can moisturize dry areas only). You can also apply oil-free moisturizer to dry areas throughout the day as needed.
• Use oil-free sunscreen whenever sun exposure is expected.
• Some people with combination skin may benefit from a combination of two masks used once a week. A clay mask is applied to the oily area and a moisturizing mask - to the dry areas.