20 May 2008

Seborrheic Dermatitis

I have been living with this scourge for 3/4 of a year. My second experience with the hell that comes with constant skin problems. And, of course, it can't manifest on my scalp, where no one but Emily would see it when I go in for a haircut. No, no, no. MY Seborrheic Dermatitis (SD) must manifest on my face, at my nose and chin, so I look like an adolescent in hormonal angst. AAAAHHHH!!!!

I first developed SD several years ago, and finally sought a dermatologist when I came to the conclusion that this "rash" wasn't going to go away. A month of treatment, and no more Seborrheic Dermatitis ... or so I thought.

Fast forward to last August/September time frame, and it came back. Yes, I was very stressed, fighting my way tooth and nail to the finish line of my degree. But, this condition isn't caused by stress, not helped, but not caused. (So I can't blame the professors for ALL of my problem.)

I blithely visit the dermo when I, once again, realize I can't fight this on my own. I snatch up my handy dandy little prescription for topical steroid foam, and hardly listen to, "Your SD went away last time? How unusual ... let's hope that happens again ..."

Dum-da-dum-dum

Dum-da-dum-dum

DUUUUUUUMMMM

It didn't. After two months of steroid treatment, 2x per day, everyday, I made another appointment with my dermo. And got the bad news. This is a lifelong condition, we're going to hope for control, figure out "your" treatment needs.

A few months down the road, March timeframe, and I get really concerned. I've weaned myself to steroid application once a day to every other day. Unfortunately, it is not getting better, and seems to be getting worse. And then I start reading up on steroid problems. My system's been exposed to too many steroids already (poison ivy several times a year, anyone?) I stopped using my foam, and only lasted for a week. At the end of the week, I look so bad my Dad asks, "What's that red crap on your face?" Not even makeup could hide it at that point. I pick up the steroids again.

So back to the (admittedly) spotty info I can find on the internet. This is only the third time I've spent hours upon hours researching this little problem of mine. Yeast overgrowth, blah blah blah, sebaceous gland overproduction, blah blah blah, immune system involvement (hmmm), and T-cell blockage/reduction/compromise (huh?).


From the information I discovered, I've made some changes. The below account covers the actions I've taken and my reasoning behind those actions.

... I haven't cured myself, but I am doing a lot better. Let me lead you down my path:


T-cell's are immune cells produced in the Thymus (well, converted to their final function in the Thymus). Step one, support the Thymus and therefore T-cell production. I've done this by taking my vitamins regularly and supplementing with Zinc and Potassium. Every single day (I used to be a real vitamin, whatever, type. Not because I didn't need it, but because it wasn't important enough to remember. Boy has that changed).


Skin, typing and cleaning. I borrowed Dr. Baumann's "The Skin Type Solution" from the library. According to Dr. B, I have the worst skin type: Dry, Pigmented, Sensitive, and Wrinkled. Yay boogedy. Can this get any more interesting?

The long and short of it is, be gentle with my skin (no scrubs, no tough cleaning), be aware of ingredients and what to stay away from (I know I have some skin allergies), and moisturize, moisturize, moisturize. Step two, toss all "bad" skin products, buy appropriate skin products, and take care of my largest organ.

Unfortunately, one of the products that Dr. B recommends I reacted rather horribly to. If you have sensitive skin, be very careful with Eucerin lotions. I ended up with: ugly blistering, severe itching, and a week to recover my former poor skin (as opposed to the super uglies I had after Eucerin application). Yikes! Dr. B's other recommendations have worked just fine.

Along with the previous vein, I've tossed a lot of makeup. I started keeping all makeup packaging with the list of ingredients, just in case. AND, I started using mineral foundation exclusively. Other products, especially with sunscreen, actually sink into your skin, absorbing into the top layer. I shudder to think what that's doing to my out of control yeast and sebaceous glands. So out they go.

I've used L'Oreal's Bare Naturale SPF19 Foundation (the extra "E" makes it what?) for over a week now. It has: titanium dioxide, zinc oxide, talc, boron nitride, dimethicone, Copernica cerifera (carnuba) wax, cetyl dimethicone, trimethylsiloxysilicate, triisocetyl citrate, Aloe barbadensis leaf juice, tocopherol, pathenol, and May Contain: bismuth oxychloride and iron oxides. So, it still contains some known allergens. I've not yet had a problem, but I'm on my guard. If I start to have a problem, or perhaps even when I run out, I'll switch to a fewer or no allergen mineral foundation.

BTW, I don't necessarily think "natural" OR "mineral" is so much better than synthetic. What I look for is the shortest ingredients list. It makes winnowing out problem ingredients that much easier. Plus, I want to minimize my chemical exposure. I have a theory that chemical build up in the system (plus their many rxns within the system) is one reason that SD is set off in the first place.


There are steroid alternatives on the market for psoriasis and eczema. Coal tar products are one of them. Step three, I picked up a tube of Psoriasin Gel at wallyworld (coal tar is the active ingredient). I can't stand the way the stuff smells, but every time I use it, I have good results. I haven't applied it in a couple of days ... an application seems to last me a good long time.


I came across a little blurb in another book I borrowed from the library, "Dr. Neal Barnard's Program for Reversing Diabetes". (Now, I don't have type I or II diabetes, but I do have a family member with the disease, so I was researching.) This Dr. B (not to be confused with that OTHER Dr. B; besides which, they have different sex chromosomes), suggests that milk products, specifically the protein(s) within, have been linked to several diseases. Once little sentence includes "Eczema" in the list. SB is also known as Sebhorreic Eczema. Step four, become vegan. Admittedly, I've been vegetarian for ~six years, so this wasn't a big step for me.


I read another quick blurb on Psoriasis and UVA and UVB treatments, which seem to help. Most of them sound expensive. But I know of a cheap (and fairly painless, at least painless at the moment) method of UVA and UVB treatment. It's called the sun, and I can find it outside every day. Step five, sun myself, without ANY sunscreen, for 15 minutes three times a week. Some weeks I get more, but when I do, I'm wearing a sunscreen of some sort. I know a lot of dermatologists and skin care enthusiasts would absolutely freak about my being in the sun for 15 minutes without sunscreen, especially given the subtropical climate in which I live. However, I need the vitamin D, and we evolved to need some sun exposure.


I've also gotten back into my workout routine. I lift weights three times per week and do aerobics three times per week. I'm back up to an hour per workout. Everything I've read says that exercise exacerbates the skin reddness, and I have to agree. The first couple of hours after a workout, my SB is definitely more obvious. BUT, it starts looking better starting about three hours on. When you think about it, more blood flow = greater movement of T-cells = greater healing.


Like I said, not quite two weeks on, I'm not cured. BUT, I'm doing so much better. I can't wait to see what another week brings.

14 comments:

Joan and Brandon said...

Kira--After suffering from Seb. derm. for 25 years, I recently ran across the notion that it may be related (for some people?) to food allergies and intolerances. I cut out wheat and citrus and the itching went away within days. I also was applying organic apple cider vinegar topically and drinking 1 tablespoon with honey in a glass of water twice a day. At this point, about two months later, I'm not 100% sure that wheat was the problem, but that's what I'm betting. Some problems that I now think were related to the SD (odd things, like a bump that swelled up a couple of years ago at the joint of my index finger, on the palm side, have gotten better or disappeared. I had gotten SD in the inner corner of my right eye and behind my left ear for the first time, and those went away. I had been making lots and lots of bread, usually with wheat, over the last 6 months, leading me to think that wheat might be the culprit. Also, mild indigestion and bowel "knots" have disappeared, and I had begun to connect those with my bread independent of the SD issue.

Check out kitchentablemedicine.com for more.

Brandon in Honolulu

Kira said...

Brandon,

Thank you for posting about your own experience. You reminded me about my original diagnosis in the '04/05 time frame. I read about Celiac's Disease following diagnosis and treatment (unsuccessful) by my PCP. I stopped all gluten products to see if that was my problem. I had been gluten free for about a week or so when I had my first dermo appointment. When I asked the dermo, I got a "No, that's not causing this" response. (And he was right ... one month gluten-free had no effect on my skin.)

Basically, they don't know what causes SD, but they seem very confident about what does not.

The take home message is that this skin disease may have innumerable root causes, and if you don't have a doctor who's UTD on some pretty obscure research, you really are on your own.

And even more apparent, each SD "flare up" may have a different root cause, and therefore a different trigger mechanism.

I'm happy to report that I have just the slightest reddness at my naso-labial folds now.

I'm glad we both persevered in our quest.

Kira

George said...

Hi Kira, found your blog while researching on the topic. This is a great post! I've mentioned on my little blog.

BTW Those pics are showing great improvement! I hate putting steroids on my skin, as I know they bring side effects.

Richard said...

This really helps, I have SD, and I've tried all the things the Doctors gave me, but they didn't work.

I tried doing the natural health thing but it turned out bad, that's a long story.

But I definitely will try that gel, and get some exercise and sun. I mean if I can't cure it, I at least want to control it, I wanna be able to run my fingers through my hair without my head turning into the fucking Arctic lol.

Kira said...

Richard,

I know what you mean. My grandfather had Eczema on his scalp and SD on his face ... during my childhood that was just normal. That was my grandpa.

However, I now know what he went through, and I wish I could have helped.

I've found some more information linking dairy, gluten, and/or yeast to Eczema/SD problems.

I'm eight? months into my self-proscribed treatment plan, and I haven't used my gel since July 2008. I really think dairy was my biggest irritant, since I continue to down large quantities of yeast and gluten.

I know for American's (especially) giving up dairy seems impossible, but you might want to consider it for a couple of weeks. If you still have your symptoms, then you know it isn't dairy and can follow with cutting out gluten and then yeast. (Be prepared to look at lots of ingredients lists.)

Best of luck to you,
Kira

Fiona said...

I stumbled across this blog when I was researching SD.... I've had it since I was a baby, but had a big flare-up on my forehead/chin during a super humid summer day last year. My doctor prescribed a combination of Canesten and HydroVal, which got rid of the redness and itchiness. My skin is still bumpy, so I'm going to try and find that Psoriasin Gel and see if it has any effect. Thanks for blogging about this topic!

Anonymous said...

Hi,

I wanted to share my experience with you. I'm 27, and two years ago I started having bad bouts of SD. I went to a doctor (a specialist dermo) who told me "You have SD, but we don't know what causes it." I told him I thought it was an allergy. He prescribed steroid cream for my face that would atrophy the skin on my face, and permanently thin the skin. Needless to say, I didn't fill my prescription. I did some research online, and I found that others could control the seemingly never-ending flaky rash by using pure Tea Tree Oil on it. The SD would get really enflamed when I would use it, but flake off quickly by the next day. That was a temporary fix. After about a year and a half, I decided I didn't want to live this way anymore. If the doctors couldn't (or wouldn't) tell me what my allergy was, I was determined to find out. I ended up eliminating eggs out of my diet fist, because I thought that might have been the cause. Not so. Then, I decided to try to eliminate wheat from my diet. That showed very promising results. I actually went a few days without my SD being completely enflamed. I had been eating a strictly sushi diet of rice and fish. The inflammation had improved dramatically, but my skin would still get a little itchy and red and then flake after I used the Tea Tree Oil. So, I decided to look up what a gluten allergy was. I was surprised to find out that gluten is in EVERYTHING. Seriously, look it up. I had failed to realize that the soy sauce I was eating my sushi with was made of wheat. I am now on a gluten free diet, and have been for almost a year. I can't tell you how much my overall quality of life has improved! I no longer need to use Tea Tree Oil. My SD never shows up anymore. You have to be 100% gluten free though and be dedicated, as it really makes eating out extremely difficult. (I'm restricted to sushi restaurants, and I now only eat sashimi with my wheat free/gluten free soy sauce). Cross contamination of gluten is a huge problem in restaurants, and it will cause my SD to come back. Tea Tree Oil is key! Don't use that steroid cream. Make sure to research the foods you eat, and look up a Gluten Free forum to get support! I hope this message finds you well, and I wish you all the best.

ludawg said...

Two things that have helped me. One RX drug, one diet related.

1) Diflucan - when taking this for vaginal yeast infections, my seb derm always improves.

2) Casein free diet (not just dairy free). Casein (a milk protein) is is added to so many things, even most soy cheese, margarine ...things you would never think contained a dairy protein! I went casein free due to another gut issue starting Jan 2007. Had no, repeat no! seb derm during the late winter to mid summer months which are my flare-up times.

Anonymous said...

Hi,
Try using Nizoral A-D 1% Shampoo (OTC anti-danruff shampoo with 1% Ketoconazole antifungal) as a body and/or face wash. Leave on in the shower for 5 minutes or so before rinsing off. This has completely cleared my SD in less than a week.

Anonymous said...

I am without a doubt so very thankful to have come across your blog about your journey with Seborrheic Dermatitis.I have been dealing with this awful,ugly rash on my face on and off for I can't even remember how many years now.On the sides of my nose and at the corners of my mouth and it get red and itchy and flaky,and absolutely hideous.I never used to wear any makeup accept a little eye shadow,mascara,and some lip gloss,but now I have had to resort to Bare Minerals,which I think that I would still continue even if this cleared up just because it's pretty cool,but for now It's just to cover up this nasty rash on my poor face.Like you said about the sun,I have noticed that over the years I really don't have this problem in the spring and summer,it starts late fall and all the way through winter when I'm not out in the sun,so the really does have a lot to do with it. So anyhow,blah blah and so on,I am so gonna try your rout,heck,why not I've tried everything else,and this sounds more promising than anything I've tried thus far,so thank you so very much for sharing your story and good luck to you.
Tiffany

M said...

Just wanted to share my experience. I was a big cereal for breakfast person since childhood. Starting in high school, I developed patches of eczema on my head (seb derm?), and I had acne throughout college. Took Accutane for the acne, was prescribed a steroid serum for the eczema on my scalp. Also, I was VERY itchy all over my skin -- so much so that I changed every detergent, every soap, every shampoo, every lotion, everything. No relief. Thought I'd have to live with it.



In my late 20s, I started getting sinus infections. Endless cycle of get sick...antibiotics...get better...get worse...antibiotics...steroid spray for my nose, etc. Finally I got so sick in my early 30s that I was home for 3 weeks with a sinus infection, pink eye, a cold, bronchitis, and God knows what else. I was so miserable, and I was kinda scared. Something was very wrong with me.



I turned to the Internet for answers. Found all this info on food allergies and discovered that casein allergy (as mentioned by ludawg) causes frequent sinus infections, itchy skin, eczema -- almost all of the problems I'd been suffering from for years! I was having at least one bowl of cereal with milk every day at the time. Casein is in all dairy products.



I got tested for food allergies and my casein antibody reaction was off the charts (normal reaction indicating allergy is .2, mine was a 28!). The test also showed I had mild allergies to chicken, rice, oats, and lemon. Bummer because I loved all of those things and ate them regularly. You can have a reaction to something and it won't send you to the hospital, but it might send you to the bathroom quickly. Or make your stomach hurt. Or make you feel itchy or like throwing up. Mild food allergies affect a lot more people than we think.



Cutting casein out was very hard. It's in practically everything, evidently. It's the "whey" in whey protein, and they use it to beef up the protein content of many types of foods and snacks. They even use it to pasteurize orange juice -- which explained why orange juice always made me feel sick to my stomach! I discovered as long as I cut out milk and ice cream, I could still have some pizza and milk chocolate occasionally. :) I haven't had a sinus infection since -- going on 2 1/2 years now!



Casein was my major issue. The other mild allergies didn't really seem noticeable once I took the casein out of my diet.



I found this blog because I've been super-itchy lately, my scalp eczema has flared up painfully and I just now discovered that what I worried were cold sores were actually sores from Perioral Dermatitis. Even as I type this, I'm itching my arms, legs and head like crazy. I'm not eating dairy (only soy milk), so that's not the problem. What's different lately?



I stupidly added Honey Nut Cheerios to my diet recently, in an attempt to lose weight and improve my health. It's all hitting me now that I'm likely having a major reaction to the oats. I knew I had a mild reaction before, but allergies can get worse over time.



I'm now going to review my allergy report and cut out everything my body reacted to. I suspect I'll be feeling better very soon.



I wanted to post to let people know that, in my extensive research on food allergies, I discovered that the skin is one of the first places your body manifests food allergy. Many skin conditions can be eliminated altogether by being aware of food allergies and avoiding foods that trigger reactions. Even a food that causes a mild reaction can be a problem if you eat it too frequently. Or your allergy could get worse over time. Every body is different. For me it's casein, rice, chicken, lemon, and oats. For you it might be spinach, almonds and turkey. Or maybe just rice. The food allergy (or reaction) literally makes your body build up histamines, weakens your immune system, causes inflammation, makes you tired, and makes you susceptible to so many other illnesses.



An endless cycle of antibiotics and illness is NOT how you have to live your life. And your doctors will NOT tell you about this. I was at the ear nose and throat doctor every other month...and at the dermatologist regularly as well. Just more medicine, more steroid spray for my noise, more topical solution, etc. Never getting to what was actually causing my illness. The treatments were band-aids.



I not only had to request the intial food allergy test...I had to go BACK to my doctor to get ANOTHER test when I found out the first test didn't even test for casein allergy -- which was the reason I wanted it in the first place! The second time, I had to ask the lab tech if the test he was sending with my bloodwork would detect casein allergy. Even the second time around, it wasn't! I insisted they use the test that would detect a casein allergy. And I'm so glad I did.



I couldn't believe it was so hard to get this done. I had to be aggressive and really take my health care into my own hands.



I am starting to wonder if doctors who make their living treating skin conditions are negligent or if there's actual malice in never exploring the cause of these problems. I found all I needed to know on the Internet, but doctors with years of experience don't know how food reactions cause drastic skin problems and continuous sinus infections? Of course, doctors make lots of money off frequent visits from troubled patients. And meanwhile I spent years being miserable with one sinus infection and skin rash after the next.


I urge everyone who suffers from any skin condition to GET TESTED FOR FOOD ALLERGIES -- specifically for CASEIN allergy. And you might encounter resistance from doctors who tell you it's not necessary, but keep pushing for it. Once you get the report, cut the foods that you react to out of your diet. It might be the miracle that will change your life.

Doug said...

Great to find this blog!

I have been suffering from SD for just about a year. I am 45.

Mine seemed to have started last year when I started using sunscreen on my face cuz I was playing alot of golf. I was using the spray which worked for my body but I would spray it on my hands and wiped it on face. it is HEAVY alcohol based. No issues for awhile. But I would come home and use scrub mitts to removed the sweat and sunscreen. I mean I would buff! So part of me wonders if with the sunscreen and buffing I screwed up the natural oil and chemistry on my face. Dunno. But at that point I would just experience redness and a light burn for a while, so no biggie. This was last summer. Fast forward to this past December, I got a BAD sinus infection, went on anitbiotics for it, and was using Kleenex like crazy blowing my nose. This is when the flaking started! So I thought, ok, its contact dermatitis to Kleenex, but since that sinus infection, and winter I have been in a daily battle with SD. Mine is just in the folds of my nose, some dryness and redness, burning on cheeks right on cheekbones, ears are dry and canals, and maybe once in a great while a spec under my left eyebone, underneath the eyebrow itself.

I have researched this to the max! And have found a number of possible factors, alot I found here too, thanks! One, I know stress isn't helping it. So I take an anti-anxiety med that I read has SD as a side effect. I also eat alot of bread. So I am gonna try weening of gluten, caesin since I read that here.

I have started to drink Kefir probiotic each day as well as 8 oz of grape juice with 2 tbsp of apple cider vinegar a day. I have increased my B vitamins and omega 3s which is good for skin. I might look into a zinc supplement.

As far as products, after MANY purchases and trial and error, this is what works for me. No flaking for months with this routine, just light redness and some burning at times which I can tolerate.

Cetaphil Gentle Cleanser - let face air dry.

Afterwards, if it's daytime, I use Neutrogena Combination Skin Moisturizer. It goes on clean, not shiny and calms the irritation.

At night I put a coat of Cetaphil Sensitive skin moisturizer cream on. Its shiny even though it claims "non-greasy" but I am sleeping so who cares.

Maybe once a month I will use hydrocortizone cream 1% with aloe in the corners of nose and when my ear canals itch from wearing ipod earbuds at the gym. This is just a management thing, not a must-do cuz of flare up. I read that if you use sparingly, you will not thin the skin or get the other bad effects. Its daily use that will cause that.

I also use the extra suds from Head and Shoulders from my hair to wash my face. The zinc seemes to help or at least it hasnt hurt. Then finish with Cetaphil cleanser. NEVER using hot water! I keep it as cold as I can stand it.

Some people swear by putting Milk of Magnesia on a cotton ball and dabbing the face. Didn't do squat for me, nor did any of the natural home-made face masks.

I wash my face a couple of times during the day. My face just feels oily if I dont, then I reapply the above routine.

As far as sunscreen goes - I avoid it, I try and play golf early morning or evening when the UV index is low and little chance of sunburn, plus the UV I do get seems to help. When I do need sunscreen, I ordered the sunblock from Keys Soap. It's a thick zinc based cream, all natural, all vegan and actually has healing antioxidants and vitamins. It takes time to absorb so you'll look like a mime for a while, so reapplying on the golf course is a pain cuz you got the white mask on your face. But hey, do what you gotta do, plus I try and not be outside where that 2 hour reapply window matters. It does not irritate or clog pores. 2 thumbs up! But I think it can only be purchased online, google Keys Soap.

Yes, exercise is great and I refuse to quit BUT the sweat aggravates my skin as someone mentioned here. It lasts maybe a few hours afterwards. I am sure the sweat has toxins that add to the issue. One thing to be aware of is BRING YOUR OWN FACE TOWEL! Gyms wash theirs in bleach, and will really send your SD flaring! I also wash my clothes in Tide Free - and non dye, chemical free version. Not that I have issues elsewhere on the body but just to ward off an issue and help with stuff that does come in contact with my face - towels, pillow cases.

With that, consider your pillow cases. Change them often and be aware of material they are made of and what you wash them in. If you sleep on you stomach or side like me, your face is grinding into the pillow all night. That's where the thick coat of Cetaphil works before bed to prevent sandpaper cheeks in the morning. I also sleep with a humidifier next to my head to keep air moist. This past winter was hell - wind, cold and no humidity. I am yet to expereince summer with this. But so far the warm days we have had, sun feels good, it's just the sunscreen that adds wrench into it.

I am fortunate that people do not notice mine, I know its there, but my wife thinks I am making more of it than need be. I am also fortunate that it is (for now) just in nose area folds and on cheeks. My ears are no longer an issue since they are part of the routine, but never a flareup. Nor do I have issues with forehead, shave zone, chin upper mouth or skin folds on the body like I have read some people have. So sometimes I wonder if it's SD, Psoriasis, or another one of the 100 terms for irritated, dry skin.

I am self diagnosed. I believe in heal-thy-self. I refuse to have a doc gimme steroids. And since this is a chronic thing that needs to be managed and can be with OTC and/or home remedies, thankfully I can skip the dermo telling me something I already know, and to hear there is no "cure" and offer me a prescription that I won't fill. That could change if this worsens and I get desperate of course.

But this sucks. I guess it comes with age and if I remember, my mom dealt with this too, so thanks to genetics. I am glad to find that I do not suffer alone and that this is a common skin issue. But that doesn't discount the fact we have it and live with it.

Thanks for the blog! Thanks for the tips! I hoped mine helped too. Next attempt is my wheat and caesin free diet. I don't consume alot of dairy, but hey, why not rid that too. I do have a sweet tooth and read that sugar promotes growth of yeast, so thats gonna be a tough one to ween off of.

This is a bookmark on my computer so I will check back often to see other insights and let ya know how the diet adjustment helped!

Doug said...

UPDATE: If you haven't tried ot already, there is a line of products from a company called Home Health. I purchased the psoriasis face wash and face cream and WOW, what great results!!!! Almost immediately!!! The products contain salicylic acid which make the redness disappear along with the dry flaky skin and burning sensation. The nice thing about the cream is it doesn't leave the "shine" like Cetaphil does although I use it as my night time moisturizer. Taking Apple Cider Vinegar (Braggs brand) cuz its 100% undiluted ACV and zinc and folic acid supplements along with adding more lettuce and a few servings of cantalope each day I think I may have a winning combination. But man o man, the Home Health products was a miracle find!

Anonymous said...

Have been trying the gluten free and dairy free for this SB hell. It started during my first pregnancy. My father has it as well. He uses apple cider vinegar topically which helps but he's too old and stubborn to go on such a restrictive diet. I recently cut out citrus which helped greatly. I was putting lime juice on everything. This weekend I had some tangerines and that night my ears turned into an oozing flaking nightmare. I applied tea tree oil which has helped,but seriously have to stay away from the citrus! Glad to know about casein. Will start looking for that. Thanks for this blog!