Seborrhea Dermatitis

[kgbman]

I was recently diagnosed with Seb Derm.  Have had redness on the side of my nose and under my eyes, and tiny flakes in my beard for about a month and a half now.  I was given the Ketocy...2% cream which seemed to do absolutely nothing for 2-3 times a day for two weeks.  I do not really have any problems with dandruff other than some small flakes from time to time, which usually go away with H&S Shampoo.  I am in good health and have good personal hygeine.  Recently went to Dermatologist again she told me to use Selsun 2.5% on my face once a week and H&S on my face daily.  This seems to be making the flakiness bareable, but the redness is starting to get pretty annoying along with the fact that everytime I wash my face with shampoo it feels "tight" and uncomfortable.  Here are my questions:

1-- Sun seems to work?  Is this a good idea or true? Obviously wont help this coming winter.
2-- I have recently grown my hair out for the first time ever (about 5" long).  Does length of hair have a direct affect on my face?  If so I will most certainly shave it again.  
3-- Used to exercise/perspire regularly but haven't since the redness showed up out of fear that it will worsen?  Is there a link?
4-- Most Importantly, I absolutely hate putting anything on my face including lotions, shaving cream, etc because I have pretty sensitive skin in general...so you can imagine how much I don't like using persription medicine.  Are there oral alternatives to help with this redness?

Thanks in advance for your responses and hopefully I can get this redness to subside

[Alan Rockoff, MD]

I suggest you treat this with a low-potency hydrocortisone.  The books say that anti-fungal creams like keoconazole and Selsun work, but in my experience they don't.  Exercise makes redness redder for a while, but doesn't make the overall condition worse.   Perspiration makes the redness redder too, but that doesn't mean anything either.  All you need is a more effective treatment, and then you'll only have to use it once in a while.  Ask your dermatologist.

Best.

Dr. Rockoff

[redface43]

I also have seb.derm.  The only thing that seems to work for me is something made by Bass and Boney, for rosacea. I have both conditions, but the "salt block" actually works better for the sebborhea than it does for the rosacea.  It takes a few days, but then it totally clears it up.

[lmarco]

For a couple or so years I have had a quite itchy scalp.  I saw a dermatologist and he says it is dermatitis.  I used a foam steroid which really didn't help at all.  Have used oral steroids, didn't help.  So, what helps?  is my question? I switch shampoos as I feel this is causing my head to itch as wehere my hair falls is also where my shoulders burn and itch .  My niece has also been complaining aboout the same problem and she is very young, barely into her teens.  Would appreicate any imput into our itchy scalp problem.  Around my face also itches!  Help!!!!!!

[oldbaldy]

I'm a sufferer not an expert so I can only tell you what works for me. Dandruff shampoos remove my scaly skin, often leaving redness and "tight skin".

Creams such as HC45 (1% hydrocortisone) and Betnovate  (1% hydrocortisone) control the flaky skin, making it normal. However, these work only for a few weeks or months before the problem returns. Also excessive use results in "thin" skin and bleeding. They should be used very sparingly and preferably not near the eyes (although I don't have much choice!) I also use Dovonex (softens the skin and loosens flakes) and Dovobet (Dovonex with added hydrocortisone). I also use Trimovate (hydrocortisone plus an antifungal and an antibacterial agent) on really bad patches occasionally. Finally, I've used Dithro cream. This helps to combat the underlying problem (overproduction of skin cells) but it MUST be washed off after half an hour, otherwise your skin turns brown.

[oldbaldy]

I forgot to add that moderate exposure to ultaviolet (e.g. sunshine) can be beneficial but overexposure makes my problem worse.