Managing seborrheic dermatitis

Hi everyone,

I'm a new member but I've had facial seb derm on and off for many years so I thought this Board would be a good place to post something about my treatment experiences and advice. It's been especially bad recently, since a major illness. Over the years, I have seen doctors, specialists, read loads of stuff, tried everything, etc. etc. When it flares, I'm nearly at my wit's end – dandruff, red face, horrible rash on forehead, itch, dry skin that burns and feels like sandpaper. I even get sore eyes. Like all skin problems, this can badly affect your self-esteem, make you highly self-conscious and really depressed. I tend to ration hydrocortisone cream, because it can end-up making things worse – but sometimes I HAVE to use it. For shampoo, I use nizoral, which might be good for your scalp but can play havoc with your skin, especially if you're going through a bad patch. Selsun is also effective. I also use daktarin, or canesten, for an anti-fungal and daktacort or eumovate as the steroid. For moisturising, which I really do believe in, cetraben. I'm afraid I don't know what the US equivalents are called.

Along with the fungicidal shampoo, HC cream is the mainstay of my seb derm treatment but I find it's best done, if necessary, in short bursts of about 5 days (max week) and then left off for as long as I can get away with it. This makes it much more effective than the “maintenance” approach which creates tolerance. I must intervene before it gets too bad, however. Although essential in my case, I have to be VERY careful with moisturisers, as the complaint thrives in oily conditions, but I need some moisture to condition my skin otherwise it can get very dry, tight, sore and peely. Seb derm robs the skin of its barrier function which basically means it gets too dry when you wash it. Funny really – it's a condition of over-greasy skin yet it causes dry skin!! So I need a moisturiser but too much and I end-up with a red shiny face – not a pretty sight. I like cetraben but trial and error is my best advice.

I've also found that ibuprofen tablets can calm a nasty flare, though not everyone can tolerate them. It takes a big dose – I take 2000mg a day for a few days, then slowly taper it down. After that, just the moisturiser/careful washing might be enough. The ibuprofen seems to reduce redness and itching, though you still need to treat the yeast. I discovered this by accident when I had a pain problem. My derm completely dismissed it but it might be worth trying. Anyway, I thought I would share this with you.

Personally, I've never found any dietary/lifestyle changes helpful, though God knows I've tried them. I'm not even fully convinced about the yeast connection, but accept it as it's a established theory. I use daktarin as a maintenance treatment (few times a week) but I often think I'm ONLY really using it as a moisturiser, in which case it's not a particularly good one.

Triggers are often discussed. In my case, stress/anxiety is definitely implicated, though its effect may be delayed. Not washing your face (tempting when it's bad) will soon make it worse. I use liquid Simple Soap – strong bar soaps are a disaster! By the way, NEVER EVER use wet ones or alcohol toners, not even baby wipes. Try to have fairly clean pillow cases. I wish I could identify other triggers because then I could do something about them, but frankly I can't. The condition can dramatically improve – even for years – but I'm damned if I can detect any patterns. At one point I was almost free of it for 20 years.....and it STILL came back. It's a very puzzling complaint. I would love to find a good natural remedy and have tried all sorts, but no joy so far. I did used to find a coal tar cream very helpful (pragmatar) but we can't get this in the UK any more.

I'm glad I found this forum and will post again. Do reply about any of my ideas or offer suggestions. I hope I've said something helpful.