Eczema help

I have eczema in my eyebrow/upper cheek on the left side of my face.  I used to have dandruff, but it has essentially cleared after using zinc shampoo a few times a week.  But the skin is still greasy under my brow and on my eyelid, which results in hairs being weak and falling out.  Any suggestions to clear up the greasy skin?  I've tried hydrocortisone cream, but to little avail.  Also, the condition seems to worsen after a night of drinking alcohol - is that part of the problem?  Finally, will the lost hairs grow back, because the hair loss is beginning to make my eyebrows look asymmetrical.  I'm 21 year old male, if that's relevant. Thanks for the help.

[Bhupinder Kaur, MD]

Hello,
I cannot confirm without examination but apart from the possibility of eczema the possibility of seborrheic dermatitis is also there. Seborrheic dermatitis is a common skin condition that causes flaky, dry, white to yellowish scales to form on oily areas esp under the nose or anywhere on face.

This skin disease commonly affects adolescents and young adults, especially in warm and humid climates and is aggravated by sweating and humidity.

Topical antifungals and mild steroids are the usual treatment and combination of the two can be used to treat stubborn patches. Oral antifungal drugs and immunomodulators such as tacrolimus and pimecrolimus are used in very severe cases.
Please get this possibility also evaluated from your dermatologist.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[BigJordan]

Thanks a lot for the response. I researched seborrheic  dermatitis and that could be what I have.  I used to have dandruff/flaking, but not anymore.  Now, the skin is greasy with mild redness/itching sometimes.  I lose hair pretty infrequently, maybe a couple hairs a week.  But it has become pretty noticeable over time.

So with seborrhea, will the hairs grow back?  Any products I can use to restore growth?  Also, in addition to the zinc shampoo I use (which has worked well and apparently is used for dermatitis anyway), can you recommend any other treatments?  I've tried hydrocortizone cream in the past, but it has yielded no lasting results?

Once again, thanks for the help

[Bhupinder Kaur, MD]

Hello,
You can treat flaking and dryness with over-the-counter dandruff or medicated shampoos. Shampoo the hair vigorously and frequently (preferably daily). Active ingredients in these shampoos include salicylic acid, coal tar, zinc, resorcin, ketoconazole, or selenium. Mostly the hair loss due to seborrheic dermatitis is not permanent until and unless there is any damage to the hair follicle and hence the hair grow back.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.