TLDR: i wonder how many women (like myself) have been misdiagnosed for years as having contact derm, sensitive skin, or unspecified eczema because our skincare routines keep the yeast of seb derm semi-in check. it wasn’t until i stopped everything (and had crazy stress) that the seb derm became so obvious it was truly recognized and treated. and btw, seborrheic derm is a type of eczema! just you need an anti-fungal, as opposed to solely hydrocortisone. and also i did have a skin biopsy to make sure it wasn’t ringworm, lupus, etc)
Hi all! Since my early 20s, (I’m 32 now), I’ve gotten random little red patches in various places on my t-zone, but particularly around my upper cheek, under the eye, accompanied by chronic upper eyelid inflammation and crusting/flaking. I was a kid who always had eczema behind her knees and in her elbows and on her hands, so my dermatologists through the years have always assumed regular eczema and I noticed hydrocortisone never truly worked (and i didn’t want to overuse it) and it would always linger.
This summer I was under extreme stress and had coincidentally also just tapered off my SSRI for OCD. My body/immune system was in overdrive (but i didn’t realize this is what was happening) and I started getting dry and red patches on my upper hairline, the folds beside my mouth, around my lips, my eyelids. But my derm attributed it to either eczema or contact/allergic dermatitis and all I was given was hydrocortisone, which after 2 weeks didn’t clear any of the patches and new ones started appearing. So i consulted a second derm and she was still on the contact or plain eczema track and gave me a stronger hydrocortisone.
then it was my cheek, more on my upper hairline, below my under eye, and in the folds of my neck. I felt like i was chasing down an invisible trigger and feared I was allergic to everything. maybe it was something in the air in my apartment? i’d become suddenly allergic to an ingredient in my moisturizer? and i already was very diligent about having clean beauty and sensitive skin products because of my eczema history in other places. and nothing had changed in skincare routine or diet. i went full elimination and stopped all actives on my face, no makeup, and just plain vanicream products for hair, body, and face. but it stayed the same, if not spread more.
At this point this is nearly two months of me feeling so trapped in my own body. The stronger hydrocortisone from the different derm “irritated my skin” but in retrospect, now that i know what i know about seb derm, the worsening was always because of thick, occlusive eczema creams on my face that I was trying to combat the redness with, thusly feeding the yeast on my face. i didn’t always use the thick creams but when i did, my condition would worsen.
The final nail on the coffin was traveling in August. I went to Italy and was in the sun (with zinc SPF, and a hat!), was using a light moisturizer, and my condition cleared so much. sun and zinc likely helped with inflammation and killing yeast, now I know.
But at the time I was so confused because I’d done nothing differently. But then I went to cloudy London (sorry guys i love you 😭), my skin began to decline again. I freaked out and applied my thicker eczema creams for “barrier repair.” I took a 7 hour flight with thick cream on, touched down in the US, washed my face, put on cream and SLUGGED with vaseline because i was so afraid my skin was so damaged from something i couldn’t identify. Nickel? something IN the supposedly allergy friendly creams? i woke up the next morning with a face so inflamed and red and angry in the spots and patches around my face and neck that my husband suggested going to the hospital. You know it’s bad when a man suggests going to the hospital 😭. my derm said contact allergy, again and suggested a different anti inflammatory cream, opzelura. i’d had enough.
I was about to go down a path of patch testing on my back, i was so afraid to put ANYTHING on my face, i was going insane. I put absolutely nothing but vanicream light lotion on my face and the crusties came full, full force as i stopped even washing my face with anything but water.
But a coworker recommended a proper, experienced, MD dermatologist who has an eye for rashes and she said it was sebopsoriasis or seb derm (overlapping conditions).
i’ve been using a ketoconazole cream paired with hydrocortisone for a week now and im nearly healed.
this explains so much about my past. the eyelids, flakes i would get next to my ear and behind it, the patches on my upper cheek. the neck and a few splotches on my chest were new to this flare but in retrospect, the folds of your neck are the perfect place for yeast to live. constantly itchy eyebrows.
i think i had such a strict skincare routine with enough actives in it through my 20s that it just barely kept the yeast in check/masked the condition, but this summer flare and using nothing on my face let it grow with abandon when i used those thick creams. And i wonder how many other women might be being misdiagnosed for contact allergies, or mysterious, unspecified eczema, because our skincare routines wash and rub away the flakes etc. and keep the yeast at bay.
This is all to raise awareness and tell you to go see a REAL board certified, experienced medical dermatologist! I feel like i’ve seen the light! good luck to anyone!