Managing Seborrheic Dermatitis: Or, My Face Is Melting Off

Fuzzy Cumulonimbus Cloud

I've had varying degrees of seborrheic dermatitis for most of my adult life but it has taken a turn for the worse. It waits till the end of the day, but large patches of my face slough off and it tends to happen at least three times a week. I used cetaphil for a while and it kept it at bay and I tried working dandruff shampoos into my face as well but it hasn't seemed to work as of late. Does anyone have any tips for managing it? Right now I'm trying salicylic acid.

I would rather my face be red than sloughy. Side Note: I hate this disease.

Ketar

I've been getting by ok for years now with my seb derm by showering daily with the dark blue bottle Head and Shoulders. That stuff works wonders, any other type of Head and Shoulders or other dandruff shampoo does nothing for me.

DHS zinc shampoo is what I used to use twice a week to prevent bad spells, or daily when things did get bad.

For my face though, the most helpful thing has always been hydrocortisone cream. The strongest I could get.

krapst78

After struggling with over the counter stuff for a while, I was finally able to control my outbreaks with a trip to the dermatologist. I had mild sebhorrheic dermatitis on my forehead, eyelids, nose, and scalp. My doctor prescribed an antifungal shampoo, and multiple topical steroids, including a low concentration cream for the skin near my eyes. The various rashes on my face went away in 1 to 3 weeks during treatment, with the rash over my eyelid being particularly stubborn. The redness and itching on the scalp took a little longer to fully go away at approximately 4-5 weeks. After the prescription shampoo was no longer needed, I switched from daily shampooing to only shampooing my hair 3-4 times a week, and have yet to have a flare up on my scalp for the past year. I still have minor flareups on the side of nose, but it's significantly better than before. The initial cost for the dermatologist visit and the prescriptions were a little high, but having relatively trouble free skin and not having to go through a bunch of unnecessary over the counter skincare products was definitely worthwhile for me.

Creagan

I can't remember, but I think that's what the dermatologist said was causing my dandruff. Anti-fungal shampoo reduces it significantly. Also, minimizing stress.

My mom swears up and down delousing shampoo is the reason my sister no longer has dandruff. (My sister had the same type of dandruff I did. Slept over at a friend's house. Mom got a call saying the friend had developed lice, freaked out, put mayonnaise on my sister's head for hours, combed it all out with a delousing comb, and then scrubbed her scalp raw with the delousing shampoo. Sister allegedly has not had dandruff since.) But my mom also used to swear up and down that the reason I had dandruff in the first place was because I used too much conditioner and wasn't washing my hair enough/properly. (Two years without conditioner and shampooing my hair twice a shower proved this to be false.)

JohnnyCache

How much sun do you get? I know brief shots in a tanning thingy helped my ex. Like, not a jersey shore amount or anything, just a bit. She had the standup kind so it wasn't like being in a coffin.

manji

coal tar and ketaconazole shampoo eventually stopped working for me and hydrocortisone just had me in a cycle of breakouts and flaking. i started on selenium shampoo (selsun) which i basically soak my face in when i do my hair. this has had me in remission for a good 8 years now, although i'm too scared to ever stop using it.

and yeah, i know what you mean about hating it. i basically wanted to spend all day locked away in my house wearing a phantom of the opera mask when it was at its worst

Panda4You

Holy shit, this thing has a name? The wikipedia image even looks just like I use to do. I've brought it up with doctors on occasions and basically just got brushed off with some variant of "use moisturizer, dumbo".

Eat it You Nasty Pig.

seborrheic dermatitis is (according to the dermatologist I talked to about it back when) basically a blanket term for 'bro, your skin is so dry that we can actually give you a prescription for it' (not a direct quote)

You just have to just try different products until you find one that works for you. In my case it seems to be localized around my forehead/scalp, and a combination of OTC coal tar shampoo and cetaphil keep it under control. I had a prescription facial wash for a while, but it wound up not working as well for me as OTC stuff.

ShinyRedKnight

I've been dealing with seborrheic dermatitis for several years. The first thing you need to do is find a dermatologist who will be totally devoted to making your skin clear, even without the redness. I've had several that have brushed me off. Now, I have a doctor who literally tells me her job is to make sure she sees me with clear skin. And she says this every time. That kind of doctor will be supportive, but also will care enough to regularly try a variety of treatments to keep up with the condition. Currently I'm using two prescriptions, ketaconazole 2% cream and sulfacetamide sodium lotion. Atop that I use an over the counter lotion called Vanicream lite lotion. Before this she had me go through several others to get me progressively better, so there is no one solution. I can't overstate how grateful I am for a doctor like that.

Other than that, you must limit stress and avoid hot water. As the weather cooled down I started heating up my showers, while stressing out over job applocations. My face ended up looking like I had burn scars all around my eyes. The moment my stress went down - which is its own hurdle - and I started using cooler water, my face cleared up. This condition truly sucks, its not serious enough to get more attention, but can really screw with your life just by being so visible. It can be dealt with successfully though, and I hope it works out for you!

y2jake215

i have had success for my scalp alternating head and shoulders, a tar shampoo, and a selsun style shampoo. have not yet found a good cure for the crap around my nose

Iruka

I weened myself off of acid face treatments and instead got myself on a better moisturizing routine, My problem was both dry skin and acne, I plopped down the money on that Microdelivery Philosophy abrasion kit (Its a abrasion cream and a face mask) and used that with my cetaphil, that started to work, and then I bought an SPF face lotion and started to really see a difference.

I'm still fighting a battle with my scalp. I had a Ketoconazole prescription once, and it did really work quite well. It was horribly expensive though (near 70 a bottle and that was when I was insured) but I do think that bottle helped me fight the dandruff off enough to start controlling it with normal product. It included a regimen of sleeping with a cream on at night in a showercap and rinsing it out in the morning, which made me in turn stop trying to acid dead skin off but rather try and moisturize the problem away. Now I find a super gentle shampoo and a thorough comb through with a good moisturizer is the best I can do. The harsher shampoos dry my hair out and make it a ton worse.

That may sound a bit contrary to using selsun/tar and trying to scortch the earth, but I used to scratch my hair out due to the condition of my scalp, so I don't think I'm necessarily some light case. I did spend a period really having to sit down and use a lice comb to get the patches under control and get the residual flakes out of my hair, though.

If you can find a good doctor, cling on to them, because the ones I ran into were often really dismissive.