Is this seborrheic dermatitis or something else

I have had these outbreaks of dark spots near my front hair line that turn grey-ish when i get in the shower or sweat. I went to a dermatologist and he said it was seborrheic dermatitis and gave me some desonide and a Znp bar back in February 09. The Desonide seemed to work but it began to discolor my skin "Im African American" so i use it sparingly. I have seen picks of seborrheic dermatitis and what i have doesnt look like that and i dont get itching or flaking just these spots right near my hairline, can someone please help me because i dont have insurance. I dont mind going to the doctor but i hate when they just guess and bill me for 90$. Im attaching pics, please help me i have been dealing with this for a whole year now. Thanks in advance...

[Bhupinder Kaur, MD]

Hello,
From your symptoms and picture, it looks like seborrheic dermatitis only. The other possibility is of atopic dermatitis. 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. You can also 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.

I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[csjr]

Well Doc I am still dealing with the same issues with my skin near my hair line 2 years later and once again my Dermatologist has given me yet another batch of creams to apply.  At the beginning of this year I was given Hydroquinone USP 4% skin bleaching cream and Mometasone furate cream USP 0.1%. I returned for a follow up and was then prescribed Acanya Clindmycin Phosphate and benzoyl peroxide gel 1.2 and 2.5% to apply in the morning. Also was given Atralin Tretinon gel 0.05 to apply in the evenings.  It's working but only seems to mask or treat the problem.  I want to be cured and free of using creams by curing this.  Is this not possible Dr. Kaur?  I am so frustrated with this and just want to go back to being normal... "Help"

Signed, Mr. Wanting to just give up...

[Bhupinder Kaur, MD]

Hello,
You have been given steroids, antibiotics and benzoyl peroxide on the lines of acne or folliculitis scalp. For seborrheic dermatitis, Treatment usually involves use of antifungal, anti inflammatory and sebo suppressive or Keratolytic ingredients. Dermatologist also recommends the use of photodynamic therapy which involves the usage of UV- A, UV- B laser and red or blue LED light to inhibit the growth of the yeast and reduces the inflammation. If you are not benefitting from the treatment it is better to take a second opinion and preferably get a biopsy scalp done to confirm the diagnosis.

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.