As I explained in my oldest post, a series of "itis" (inflammation) problems have appeared during the last 47 years of my life. Four were skin problems (eczema, rosacea, scleroderma, and seborrheic dermatitis). My "anti-itis diet" (which I now humorously call the "prelithic diet") has stopped the arthritis, bursitis, tendonitis, iritis, colitis, and three of the four dermatitis problems.
I discovered recently in talking to my dermatologist that the cause of my fourth skin problem, seborrheic dermatitis, is unknown. (Stress, which is notoriously difficult to measure and track, is one suspect, either in the emotional form or the immune-system form.) Not surprisingly, there is no cure for it.
Apparently the sebaceous glands produce too much oil. The extra oil makes the skin scale--making the skin look chalky and dry. Itching accompanies the scaling, and the skin is very vulnerable to abrasion (which causes redness, swelling, itching, and peeling). Rubbing from an electric razor, a hat brim, or a large, stiff collar are examples of abrasion. I have not been able to shave with an electric razor for many years. (I have been using a hair trimmer set at the lowest setting, on my face and scalp.)
Last week, my dermatologist suggested a treatment program that has eliminated the symptoms. Following is the program, but be sure to consult your own physician. Your situation may be different. I am naming the particular brands I use, but there might be others equally effective.
FACE: Daily, apply a small amount (perhaps one-third teaspoon) of Hydrocortisone Lotion, USP 2.5%, Qualitest, available by prescription. Use it like a moisturizer. A little goes a long way, covering all of my face and front upper neck, that is, all the areas that had rough patches from scaling skin. I apply it about 15 minutes after taking a shower in the morning, when my skin is clean and dry. (I have not used plain soap on my face for fifteen years, but it was very irritating to my skin problems.) The prescription suggests applying it twice daily for the first week and then once daily after that. How long will I need to use it? Perhaps forever, if the purpose is only to suppress symptoms. I may experiment with cutting back the frequency, after a few weeks.
SCALP 1: Every night before bed, apply--throughout the scalp but especially in scaly areas--a small amount (perhaps 1 teaspoon total) of Fluocinonide Topical Solution, USP, 0.05%, 60 ml, TEVA Pharmaceuticals. This application is easy for me because my hair is extremely short. The nurse who told me how to use it has long hair; She said she soon learned to use the squeeze bottle to apply it efficiently and then use her fingers to spread it around the scalp.
SCALP 2: With a medicated shampoo, wash scalp (not the face) every morning. (Be sure to leave it on for a few minutes before washing it off.) Rotate the daily shampoo among the following five medicinal shampoos. I assigned each to a day of the week, for simplicity's sake (and I wrote the day on the bottle with a bold felt pen).
- 1. Monday: Prescription Ketoconazole shampoo, 2%; Perrigo.
- 2. Tuesday: Over The Counter (OTC), RiteAid "Dandruff Classic Clean" shampoo, containing pyrithione zinc 1%.
- 3. Wednesday: OTC, RiteAid "Therapeutic Shampoo," containing coal tar, 2.5%.
- 4. Thursday: OTC, RiteAid "Dandruff Shampoo," containing selenium sulfide, 1%.
- 5. Friday: OTC, Neutrogena T/Sal Therapeutic Shampoo, containing salycylic acid, 3.0%.
- Saturday: repeat shampoo from Wednesday.
- Sunday: repeat shampoo from Thursday.
With this approach, the scalp condition is medicated by a series of active ingredients in the hope that at least one of them will reduce the symptoms. Perhaps the various shampoos work individually to reduce different aspects of the symptoms. I do not know.
What I do know is that the treatment program outlined above works for me, and after only about five days of application. (My doctor cautioned me to continue even if the symptoms disappeared.) For the first time in 47 years, I am symptom-free!
This is not a cure, but it is a way, if applied regularly, to eliminate the symptoms.
I am very glad I live in a country that still has a little freedom of choice for doctors and patients.