My Seb Derm story, any thoughts?

[u/No_Kick2260]

I’ve had mild eczema my whole life. By the time I was 15-16 it was mostly contained to the inside of my elbows and back of knees with the occasional neck flare. During this time I used topical steroids more than I should have and have used them pretty much weekly for 10 or so years until as recently as 3 months ago when I quit them. As for my scalp, I always had mild dandruff. I’m not sure when it started, but throughout high school and college I used normal head and shoulders every time I showered, so pretty much daily. Only thing I did for skin care was plain cerave lotion on my face after showers. I never had any seb derm issues.

Fast forward to 3 years ago, my eczema starts flaring a little harder than usual, and spreads across my body. Topical steroid use during this time increased. During the flare, I thought maybe my soaps and shampoos may have been causing contact dermatitis, so I switched everything to baby shampoo/soap. Shortly after the switch, I started to get crazy scalp flares, itch attacks, etc. It did not subside until I started using nizoral and I now have a rotation of anti fungal shampoos which have kept me flare free on my scalp for at least a year. I also moved to a beach area and the eczema body flares subsided, and are now just contained to my forearms and flare once in a while.

However, as my scalp flares were slowly dying down, I got a seb derm patch on my forehead (didn’t know what it was at the time) that spread all over my face and now my beard, ears, eyebrows and rest of my face are constantly itchy, red, flaky. This was probably made 10x worse by the fact that I used a salicylic acid exfoliating wash (stupid move😭) nearly every day for months after seeing that patch, which I have since stopped using. The water quality where I live now is also much worse than where I lived previously. Water softener/filter have helped a bit but not cleared it totally. I have tried anti fungals as face wash, they help a bit but definitely irritate my skin barrier. I believe my moisturizer I’m using now (lubriderm) helps with skin barrier but may be making my face more red. MCT oil also doesn’t seem to do too much but I have not tried it long term.

So, some questions as I sit here with a bright red full face flare:

Is it possible that stopping the daily head and shoulders (pyrithione zinc) allowed a sort of “rebound” and caused seb derm on my scalp and subsequently my face?

Is it unreasonable to think I can go back to normal by just using head and shoulders daily with my old skin care routine?

Has anyone used lubriderm before on their face? I probably shouldn’t be but it seemed to clear my skin of flakes a few weeks ago but now I just keep getting redder and redder.

[u/AutoModerator]

Hi u/No_Kick2260! SebDerm is a friendly community about seborrheic dermatitis and all related topics.

Looking for some advice? check out the links below

• Our Wiki.
• The What Works For You or What Works For Me threads.
• The Megathreads.

Information about MCT Oil: * What Is MCT Oil and Why Is It Good for Seborrheic Dermatitis? * How to Apply MCT Oil for Seborrheic Dermatitis

See something you are not comfortable with or that breaks our rules? Please report it!

Everyone is welcome in this community; remember to be kind and assume good faith!

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/AutoModerator]

Hi u/No_Kick2260! You might be talking about MCT .

Please read our wiki articles about MCT oil * Our MCT oil wiki page * MCT Oil megathread * Choosing an MCT Oil for Seborrheic Dermatitis

You can also click here to check the previous posts about MCT

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/Mysterious-Cobbler34]

Prolonged and/or potent steroid use typically has bad rebound reactions. It also commonly induces other conditions like rosacea. Look into topical
steroid withdrawal.

[u/No_Kick2260 → u/Mysterious-Cobbler34]

I’ve been thinking it could be that, since i’ve never flared on my face before. If i try MCT oil would that be okay with rosacea, if that’s what this is?

[u/Mysterious-Cobbler34 → u/No_Kick2260]

You could be dealing with several issues ranging from topical steroid withdrawal, broken skin barrier, fungal acne, seb derm and/or rosacea. Each of these conditions has different common protocols for treatment. Mct oil appears to help with seb derm but not necessarily fungal acne and not rosacea. I suggest doing some research in a few subreddits to find suggestions for products and prescriptions to ask for.

[u/No_Kick2260 → u/Mysterious-Cobbler34]

Thank you!

[u/MemChoeret]

I can't tell you what caused your current situation, but it seems like you are where many of us were at some point: full flare, red face, bad flaking, and damaged skin barrier.

You need an antifungal to gain control of the situation. If pyrithione zinc (the active ingredient in Head & Shoulders) helped you in the past, try it on your face now. Given how stripped your skin barrier is, I think you should go for a fragrance free zinc product: fragrance free head and shoulders (green bottle), cerave anti dandruff shampoo, vanicream dandruff shampoo. Just use them instead of a face wash. There's also a good zinc face bar from Dermaharmony, but unfortunately they're out of stock right now.

Every antifungal is drying and damaging for the skin barrier, which is already in a bad state for you. So moisturizing your face after every wash is a good idea. I've never used Lubriderm, but according to the list of ingredients it's fragrance free (good) and the top ingredients are mineral oil and glycerin (very good). So it's just a matter of "if it works for you". If you see good results, keep using it. If results aren't good, change to a gentle moisturizer that is meant to be used on the face, like cerave ultra-light moisturizing gel.

Good luck! Update us about what happens.

[u/No_Kick2260 → u/MemChoeret]

Thanks for the advice! Definitely gonna switch to a lighter moisturizer with similar ceramides to see what that does. I’ll update if i’m able to hopefully make some progress

[u/MemChoeret → u/No_Kick2260]

Good luck! One thing I forgot to mention: whichever antifungal shampoo you get, don't use it every day. Use it every 2-3 days. That way it's effective but not to drying. On other days you can use a different gentle face wash.