Oily skin results from large quantities of sebum, filling the follicular reservoir and leaking onto the body surface.   The amount of excessive sebum on the face is a very subjective of each individual (i.e. to some oily skin is not bothersome to others it is, and the very nature of this perspective is cultural), it is usually unappealing to most and cosmetically undesireable.  Oily skin contributes to the skin appearing very shiny, feeling greasy and unclean.

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Sebum is secreted by the sebaceous glands.  The glands exist all over the body, but are most prominent and numerous on the face, particularly around the forehead and nose. Sebaceous glands are present at birth, with sebum production being relatively high during the first 6 months of life. After this period, sebum production slows down and remains low until puberty, when sebaceous gland activity increases dramatically, as a result of increasing androgen output, and remains stable through adulthood. The number, size, and activity of sebaceous glands are inherited.  Throughout life, the number of sebaceous glands remains stable, their size increases, and the sebum secretion rate declines with age.

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Among the topical treatments used the most common are cleansers.  The recommended cleansers for oily skin generally should not contain oils, waxes, or any fatty agents that could aggravate the oily condition. Any applied moisturizer, sunscreen, and other topical products should be generally oil-free.   Generally , we recommend a gel based or powder based products for oily or acneic skin.  Skin cleansers and astringents (alcohol, witch hazer, etc.) are the simplest form of treatment of oily skin.  Some homeopathic treatemtns containing rich extracts of  saw palmetto, sesame sees and argan oil also show improvements in reducing the appearance of greasiness on the skin.

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Salicylic acid peels (light or superficial peel) are reported to be safe and effective for the treatment of acne and oily skin of all skin types.  This peel is a quick process that requires no down time, is cost effective, and will have no significant residual redness or flaking/peeling.

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Isotretinoin is an extremely effective drug if given systemically for severe forms of oily skin and acne. It is the only known retinol-based product to significantly reduce sebum production. Isotretinoin should only be used for women with practicing strong contraception methods, as it is passed through to the fetus.  Isotretinoin is equally effective in men. Other drugs, including oral antiandrogens, are also effective in reducing sebum production (i.e. spironolactone, cyproterone, etc.).  Another potent sebum fighter is Flutamide.  Flutamide is a strong nonsteroidal inhibitor of androgen receptors. It was introduced for the treatment of prostatic cancer but is also used in the therapy of hirsutism, androgenic alopecia and acne. For women, another potential benefit of oral contraceptives is related to a decrease in ovarian and adrenal androgen precursors; to an increase in sex hormone-binding globulin (SHBG), which limits free testosterone; and to a decrease in 3a-androstenediol glucuronide conjugate, the catabolite of dihydrotestosterone (DHT) formed in peripheral tissues. Certain oral contraceptives are used worldwide as a hormone treatment for acne and oily skin. Drospirenone, a new oral contraceptive that contains a unique progestogen, has both antiandrogenic and antimineralocorticoid activity also positively effects reduction of acne.

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Recently, new treatments were made available for treating acne, and reducing the sebaceous gland activity.  These treatments are photodynamic therapy, diode or nd:Yag lasers, and non-ablative radio frequency devices.

The most effective method of addressing active acne is with a topical aminolevulinic acid with photodymanic therapy (PDT).  Multiple PDT treatments have show to significantly reduce the sebum excretion, with some patients reporting acne under control for over 3 years after treatments. For some, reducing the facial hair also has positive benefits. Laser Hair Removal is a safe and effective method of reducing unwanted hair on the face and any part of the body.  UV light (Blue Light) has also been show to control mild to moderate acne in a series of treatments.  The UV light kills the p.acne bacteria and prevents acne breakouts.