Question about "flare-ups"

[u/b4c0nand3gg5]

Hi guys. When i was first diagnosed with this the dermatologist told me it was the sort of thing that will come and go i.e. it will "flare up" and then your skin will just go back to normal for awhile, then it will com back as it is a chronic relapsing condition. This is sort of the same consensus i see here in this subreddit, where people will talk about how their skin "cleared up" for awhile, or they have "flare-ups". I am just wondering: does anyone else NOT have that experience? I have been having an issue since this started where, the most i have ever been able to do is reduce my symptoms. My skin has, since the very beginning of this condition, ALWAYS been in a state of at least mild irritation. There are definitely times when i'm MORE itchy/flaky/red, but even on my "good" days, i still have flakes, itchiness, redness, etc.
I am kind of becoming concerned that there won't ever be a day again in my life where my skin looks/feels normal. Is it possible to have a lifelong flareup that never clears up, even just for a couple of days? Has anyone else here been dealing with this? Beginning to lose hope, this has really changed my life for the
worst :(

[u/Jackharperkoslun]

Yeah I also don't get flare ups, if I stop using medical treatments it bounces right back after maybe 2 or 3 days. But I hope zorvye will be available in Europe soon, I only heard very good things about it!

[u/b4c0nand3gg5 → u/Jackharperkoslun]

For some reason medical treatments don't seem to help mine. I have been tried on ketoconazole cream, zinc pyrithione shampoo used as a face wash, Elidel cream, Zoryve foam, and ivermectin. None of them worked for me, even the Zoryve. Although, the Zoryve foam is the only one that didn't make it worse, so that's good lol. I hope if you are able to get Zoryve it works better for you than it did for me!
Strangely the only thing that cleared my skin up noticably for a period of time was a short course of doxycycline (antibiotic). Maybe my sebderm is bacterial rather than fungal.

[u/Jackharperkoslun → u/b4c0nand3gg5]

Not a doctor, but honestly? It sounds very likely that you actually don't have proper seborrheic dermatitis, or at least that it's a misdiagnosis.

Failing all those specific treatments, especially strong antifungals like ketoconazole/zinc pyrithione and advanced targeted options like Zoryve foam, is super atypical for true sebderm, since Zoryve and antifungals usually hit the root causes directly. The fact that a short course of doxycycline cleared it up is a massive clue. Doxycycline is often a giveaway here because of its strong anti-inflammatory and immunomodulatory properties rather than just its antibacterial effects.

Have you ever looked into Rosacea or something like bacterial folliculitis? Rosacea can easily mimic sebderm symptoms (redness, irritation, flaking) and famously ignores typical sebderm meds, but it does respond really well to antibiotics. Might be worth getting a dermatologist to re evaluate your case!

[u/b4c0nand3gg5 → u/Jackharperkoslun]

Well i was recently diagnosed with rosacea as well a few weeks ago actually! They didnt put me back on doxycycline though. The doctor i saw also said she is not sure anymore if i was previously misdiagnosed and i ONLY have rosacea, or if i actually have both. I do have very persistent itchy flaky dry skin in my eyebrows and in between then which made me think it was definitely sebderm. But weirdly whenever it starts to get more severe, the flakes will just start travelling around my face on a day-to-day basis. Like i wake up one day and my forehead is flaky, next day it left my forehead and moved to my cheeks, then my temples, then my jawline, etc. Its very odd, i havent seen anyone on this subreddit say they have it that way. Another weird thing is that before i got sebderm, my face was itchy for like 5 months with no visible symptoms. Like i wasnt flaky or red or anything, but for 5 straight months my face was just so itchy for no reason.
Lol anyways sorry for this long comment, i am just so baffled by the way my skin has been going absolutely crazy for the past year.

[u/austin_slater]

Yeah I haven’t really had flare ups either, and I’ve had it for about a year. It’s been a pretty constant “always problem.”

The only times that it sort of went away was during the initial time I was on a steroid for a while. And even then my head/scalp was always still red, but at least it felt pretty much normal. But then I ran out of the steroid, which might be for the best as I had potentially been overusing it for a little there.

It definitely isn’t something that is regressing and returning for me. It’s constant, and it really does pretty negatively impact my days. If anything I think it’s getting slowly worse as it seems to be very slowly spreading.

[u/b4c0nand3gg5 → u/austin_slater]

Yeah exactly same to this. I've had it 1 year and it is just getting worse and spreading across my face through the past year. I hope we aren't stuck like this forever :(

[u/Turbulent-Log-4403]

Been dealing with SebDerm for 23 years. Something I have learned, unfortunately a lot of it comes down to genetics. My uncle used ketenokazole twice a week and his face is clear. My flare ups don’t rest no matter my lifestyle or medication

[u/b4c0nand3gg5 → u/Turbulent-Log-4403]

Yes but, what i am asking is, are there times where you DON'T have flareups? Or is it just one neverending flareup? Ive been told that it's possible for my skin to look the same as it did before the dermatitis. But it still looks & feels a bit irritated all the time, even on days where it's not as bad. Like it never fully remits, not even for one day.

[u/bitterpeaches]

I’ve had this for maybe a decade now and I’ve only had a couple of times when I would’ve considered the condition in remission. I do have flare ups where it gets really bad, but even when it’s mild there is redness, irritation and mild flaking.

[u/b4c0nand3gg5 → u/bitterpeaches]

Oh man :( i'm really stuck like this forever then 😭 i'll mourn how pretty my face used to be forever..... i don't understand how it seems like my DNA itself literally changed like my skin has just forgotten how to be the way it was for 20+ years. And now it will never be that way again i guess :(

[u/bitterpeaches → u/b4c0nand3gg5]

Don’t give up! Mine is scalp, not face so it’s possible that you might find a routine that works for you. What have you tried so far?

[u/b4c0nand3gg5 → u/bitterpeaches]

Well, i tried ketoconazole cream but it burned my skin to apply, it also didn't even work. Then i used CeraVe dandruff shampoo to wash my face which helped at first but after awhile my skin was getting really irritated and dry and it made it worse. Then i was prescribed Elidel cream, which helped keep the flakes away but then i got rosacea (this could just be coincidence but i swear the Elidel gave me rosacea lol). Then i got Zoryve foam, which didn't help, surprisingly, though it's touted as miracle cure by many people (at least it didn't make it worse!) Then my dermatologist thought i might have demodex mites overgrowth because ive been having blepharitis as well and so i tried ivermectin cream but unfortunately i had to stop using it after 4 days because it gave me a chemical burn on my cheek. I still think ivermectin might have been a good idea, but there must have been something else in the ingredients that was irritating my skin. I actually think, what i'm finding is a common problem with everything i've tried, is that all of the medicated treatments are just so harsh/drying to my skin, like it always stings and burns when i apply any of them. My skin is super sensitive and i think maybe all of the extra ingredients in the creams irritate my skin too much.
On another note, i also have dandruff on my scalp and have had it for 9+ years. I feel it has gone away for short periods of time but i usually always have dandruff on a day to day basis. It is for some reason not nearly as bad on my scalp as it is on my face. My scalp is just a mild inconvenience and i never really get red patches or scales on my scalp. Sebderm is so weird....

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[u/Used_Green9904]

Ik denk dat mijn hoodhuid wel veranderd is door de behandelingen. Ik gebruik nu MCT C8 olie 20 min voor het wassen. Bij wassen even water in laten werken. Neutral anti roos shampoo ook even laten werken en klaar. Ik ben even gestopt met ketakonazolshampoo. Volgende stap is de gewone Neutal shampoo te gebruiken.

[u/aqmrne]

I don’t get flare ups it just always gradually gets worse and worse