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El sebo, es la secreción de la glándula sebácea y constituye el 95% de los lípidos superficiales. Seborrea es la hipersecreción de la glándula sebácea.

Los individuos genéticamente predispuestos, sometidos a otros estímulos que veremos mas adelante se instala en ellos la seborrea hacia la pubertad.
La glándula sebácea es un órgano efector de los andrógenos (corticoadrenales, testiculares u ováricos). La seborrea que acompaña a ciertos procesos neurológicos se debería a la alteración de un centro regulador de la secreción sebácea en el piso del tercer ventrículo. La l-dopa utilizada en el tratamiento del pakirson provoca una reducida secreción de sebo, sin que se conozcan los mecanismos.

Las áreas seborreicas están representadas por la figura que a continuación exponemos; es de señalar que la mas afectada de estas áreas es la medio facial, entre mamas, cuero cabelludo, retroauricular y pubis.

En el cuero cabelludo las glándulas son mas abundantes, voluminosas y despiden un olor rancio proveniente de la oxidación de los ácidos grasos.

En la capa cornea de las áreas seborreicas crecen dos tipos de hongos levaduriformes, lipofílicos, difásicos, que para desarrollarse requieren ácidos grasos de cadena mediana y larga.

La seborrea tiene fases de exacerbaciones condicionadas al stress, nerviosismo, preocupaciones, transgresiones alimenticias, agotamiento físico y síquico o el uso de determinados medicamentos como andrógenos, progesterona, clomifeno, anovulatorios, etc. A la quinta década de la vida la seborrea tiende a atenuarse. Las formas intensas de seborrea coexisten con variedades severas de acné y la proliferación de quistes sebáceos.

El tratamiento general va dirigido a darle importancia a la prescripción de un régimen higiénico-dietético adecuado. Es imprescindible corregir la obesidad, las dietas desequilibradas, vida sedentaria, controlar las horas de sueño.
La vida al aire libre , la radiación solar, el ejercicio físico son buenos coadyuvantes en el tratamiento de la seborrea. En ocasiones hay que añadir medicación sedante.
Localmente solo la higiene minuciosa y frecuente puede hacer mejorar la situación local. Evitar cosméticos grasosos. Lavado frecuente del cuero cabelludo, los champúes no deben tener demasiado detergente y deben incorporar proteínas, restauradores.
Otros tratamientos deben ser quirurgicos, para los quistes sebaceos. Se pueden emplear jabones azufrados y otros medicamentos que les indique el médico en su momento.

Dr Ricardo Martinez 


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