Oily skin is a common dermatologic concern for many patients. A recent review highlights the different treatment options currently available.
Oily skin is a frequently encountered complaint in dermatologic consults. Besides acne, patients commonly decry the shiny or even greasy appearance that excess oil production gives the skin. The plethora of pharmaceutical and over-the-counter remedies is proof of the prevalence of oily skin as well as the concerns towards it.
What Causes Oily Skin?
The oil that our skin produces is called sebum. It is a mixture of fatty acids and esters that are produced by glands within the layers of the skin. Sebum serves as an additional protective barrier for the skin, as its oily composition serves as a barrier against many substances. Sebum also serves to lubricate the skin and keeps the skin from drying out, and it is a necessary component of our immunite system.
Different factors are implicated in excess sebum production. Hormones such as androgens are a well-known culprit (hence the acne in puberty). Other factors include race, humidity, and conditions which increase androgen production.
The numerous treatment options for oily skin were recently reviewed by dermatologists in an article in the Journal of Clinical Aesthetic Dermatology. The authors of the article give a concise summary of the treatments are available for oily skin, as well as others that may not be so well-known. The review article enumerates these treatments according to the method of delivery.
Topical treatments are applied directly to the skin. The majority of cosmeceuticals are topical treatments with the most common active components being niacinamide, green tea, or L-carnitine. These components have been shown to reduce sebum production. Topicals available by prescription include retinoids, which reduce sebaceous gland synthesis, and olumacostat glasateril (OG), which blocks the creation of fatty acids in the sebaceous gland itself.
Oral or systemic options include oral retinoids, diuretics like spironolactone, and oral contraceptives. While these have been shown to reduce sebum production, there will always be concerns about the broader effects of these medications throughout the body.
Other treatments currently being explored include injecting botulinum toxin into the facial areas susceptible to sebum production (the “T-zone”), photodynamic therapy, or selective laser treatments. The authors see these as viable options once further studies have been completed.
With each option having its inherent pros and cons, there is still no clear consensus on the treatment of choice. The authors recommend thorough consultations and discussions on these available choices to develop a treatment plan that best suits the patient.
Written by Jay Martin, M.D.
Reference: Endly and Miller. “Oily Skin: A Review of Treatment Options”. Journal of Clinical Aesthetic Dermatology. 2017: 10(8):49-55