Can anyone shed some light here
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Sun Jul 01, 2012 2:13 pm

Hello, first post here and I'm in need of some advice. I'm currently struggling with scaley, tight, and oily skin. It all came about as follows:

In January of 2011, I began over washing and applying topicals in attempt to get rid of some acne. After 6 months (end of June 2011) of using these harsh cleansers, exfoliants and chemicals without much success, I decided to quit using them because of poor results and the realization that they were most likely damaging my skin with the harsh ingredients. Within just a few days upon dropping this skin care routine and just letting water from the showerhead hit my skin, my skin responded with even more oil, flesh colored bumps, and extreme flakiness. After a couple weeks I had a lot of dead skin built up, mostly concentrated in my T-zone but it was everywhere, and my skin felt extremely tight, blotchy redness, itched, and had a stinging/tingling sensation to it.

In mid-August, I was still stuck in this condition and with school right around the corner, I scrubbed off all the dead skin I could and began applying jojoba oil after every shower thinking I was dealing with dry skin (which I now know isn't true or else it wouldn't be oily) . I actually did make some improvement in regards to tightness and these flesh colored bumps all the way into December/early January, however the itch and tingly sensation didn’t subside. Then my progress backtracked in winter and I decided to see a dermatologist in March. I was diagnosed with seborrhea but failed all treatments so far (ketoconazole, hydrocortisone, elidel). I’m not so sure this is a correct diagnosis because every picture online I looked at doesn’t resemble my condition. Scaley dead skin is mostly on my inner cheeks now but if you look closely, the entire skin on my face is flaking.
Anyway, here I am now, a full year later still not recovered from the topicals. Some things I have noticed:
-Tingling sensation is worse at night and in dry heated rooms
-Exercising in a heated gym in the winter made me extremely itchy and caused a red blotchy appearance that didn’t subside until I showered and applied the jojoba oil later.
-I still suffer from acne, but when I was making improvements from August to December, acne began to lessen. At the beginning my forehead and upper lip always had small pimple of some sort but they went away as the tightness and flakey skin began to improve.
-Hypersensitive skin. The barber resting his thumb above my eyebrow or on my cheek would make me red and itchy there for an hour after. In the winter, I even recall my own drool feeling like it burned my skin.

Sorry for it being so long, any help and insight on what’s going on would be greatly appreciated.

free skin care · Sun Jul 01, 2012 6:03 pm

Welcome!

What is your skincare routine at present, including shaving products? Have you tried waterless cleansing or washing in only filtered water? How much time are you spending under the shower? Are you consistently eating a low glycaemic index, anti-inflammatory diet?

Sun Jul 01, 2012 6:22 pm

Thanks for the reply, I knew I left some things out. As of now I'm not doing anything just letting only lukewarm/cool water in the shower hit my skin. Also to add to my first post, the only times my skin feels fully elastic and not tight is when the water from the shower is on it. I'm in and out of the shower in about 3-5 minutes and I have a water filter installed. Maybe my facial skin is still too sensitive/impaired even for water and the water is just delaying the healing? I'm using a beard trimmer now to take care of the beard instead of shaving with a razor.

My diet is pretty good. I drink around 1.5 gallons of water a day, take a quality multivitamin, and get at least 1100mg of EPA/DHA combined daily.

free skin care · Sun Jul 01, 2012 7:01 pm

What you describe does sound like seborrhoeic dermatitis to me, but it's relatively common to have two co-existing skin complaints which *may* partly explain why therapy has been ineffective. Not all SD is caused by the malassezia yeast so may not respond to anti-fungals, and hydrocortisone is a very weak corticosteroid.

So you are cleansing with water and not applying anything at all, no sunscreen or oil? Are you getting any shampoo or conditioner on your face, even just bubbles? Soaking skin that is dry or irritated is not a good idea, it can flush out the skin's natural moisturising factors. In addition skin can be irritated by compounds in sweat and sebum which water will not fully remove. Cleansing inflamed skin is a challenge. Confused

Can you supply more detail on your diet please? Higher or lower glycaemic index carbs, any sugar, how many portions of fruit and veggies, sources of fat in your diet, portion size of meat, alcohol or caffeine? That is not sufficient omega-3s for an active male - try 3g per day, even a few weeks at 5g if you are a larger build or exercising intensively.

Sun Jul 01, 2012 7:40 pm

Firefox7275 wrote:

What you describe does sound like seborrhoeic dermatitis to me, but it's relatively common to have two co-existing skin complaints which *may* partly explain why therapy has been ineffective. Not all SD is caused by the malassezia yeast so may not respond to anti-fungals, and hydrocortisone is a very weak corticosteroid.

When I went in for a follow-up of the elidel treatement (2x daily for 3 weeks), the derm said the inflammation was gone but I still had this brownish flakey buildup of deadskin. She mentioned that she has treated seborrhea in about 5000 patients and has never seen this response to treatment Confused

Firefox7275 wrote:

So you are cleansing with water and not applying anything at all, no sunscreen or oil? Are you getting any shampoo or conditioner on your face, even just bubbles? Soaking skin that is dry or irritated is not a good idea, it can flush out the skin's natural moisturising factors. In addition skin can be irritated by compounds in sweat and sebum which water will not fully remove. Cleansing inflamed skin is a challenge.

No oils or anything anymore, just the water from the showerhead. Interestingly enough, when I exercise outdoors or anywhere the air isn't very dry, it doesn't seem to make me itchy or red. In fact, when I'm sweating in a non-dry environment (indoor or outdoor) my skin feels less tight so it seems humidity plays a role.

Firefox7275 wrote:

Can you supply more detail on your diet please? Higher or lower glycaemic index carbs, any sugar, how many portions of fruit and veggies, sources of fat in your diet, portion size of meat, alcohol or caffeine? That is not sufficient omega-3s for an active male - try 3g per day, even a few weeks at 5g if you are a larger build or exercising intensively.

I get my carbs from whole grain wheat bread or brown rice. The sugar I get only comes from fruits. I get around 9 servings of vegetables and only about 2 or so fruits. Sources of fat come from lean red meats, salmon, chicken, and nuts. I eat around 180g of protein, very rarely drink alcohol and no caffeine. I'm about 175lbs for the record, very active with sports and weight lifting.

free skin care · Sun Jul 01, 2012 11:03 pm

It sounds like ontology of the other possible conditions your skin is dehydrated. There is a difference between dehydrated skin and dry skin. Dry skin lacks oil and dehydrated skin lacks moisture (water based). Try using products with hydrating ingredients like hyaluronic acid, aloe Vera, and glycerin.

free skin care · Mon Jul 02, 2012 6:34 am

That's encouraging that the anti-inflammatories had an effect! Skin doesn't exfoliate effectively if it is dehydrated, might be contributing to the flakes of skin which remained.

IMO supply your skin with a combination of the humectants and lipids found in a healthy skin barrier. These include urea, lactic acid, glycosaminoglycans, cholesterol, saturated fatty acids (stearic and palmitic) and ceramides. Research has proven imbalances in these in various forms of dermatitis, xerosis (clinical dry skin) and in psoriasis. Commercial products include CeraVe Cream or Eucerin Replenishing Night Cream 5% urea (for the day is fine). If your skin is currently inflamed you might find these are not comfortable tho. Something my skin loves when irritated or sore is an organic aloe vera gel (glycosaminoglycans, anti-inflammatory, healing) blended in the hand with a moisturiser containing lanolin (cholesterol, saturated fatty acids). Even better AV with pure medical grade lanolin OR AV with unrefined West African shea butter (stearic acid, anti-inflammatory, healing). This is a little tacky and heavy so definitely an overnight treatment.

Diet sounds pretty good as you say! Very Happy

Are you getting enough total fat grams for your activity level? Can I take it you are eating loads of nuts? Definitely bump up the DHA and EPA; the ratio of omega-6 to omega-3 in your diet is as important as the total amount. You might also try lower glycaemic index carbs and a much wider variety - brown basmati rice, stoneground granary bread, beans, lentils, barley, sweet potatoes, jumbo oats. Ideally you would not eat the same foodstuff more than once a day, so just two sources of carbohydrates - one of which is wheat - is not ideal. Confused

Mon Jul 02, 2012 3:44 pm

I understand the difference between dry and dehydrated now thanks, and it seems like this is very likely my condition. Another thing I noticed is that when I do drink alcohol, the day after I usually notice some extra flaking. I know alcohol dehydrates you and I'm guessing the dehydration showed up on my skin with some extra flaking.

So from here I will look more into the hydrating ingredients and products mentioned.

Firefox7275 - In regards to imbalances that you have mentioned, does this mean that only supplying my skin with only the Eucerin cream will have a negative effect since it doesn't contain all the humectants/lipids you mentioned (or does it)?

Another general question I have is does the skin respond to this dehydration with more oil? My skin was never this oily before I started using any cleaners or treatments.

free skin care · Mon Jul 02, 2012 7:46 pm

Alcohol messes about with blood sugar levels, immune function and inflammation as well as affecting hydration. Sad

Excess sebum can be the skin's protection either against dehydration or, perhaps more often, against 'attack' or irritation from outside chemicals. That can be chemicals in cosmetic products, those produced by the malassezia yeast, or even those in your own sweat or sebum! It's an integral part of seborrhoeic dermatitis but can also occur in contact dermatitis.

The different lipids and humectants are balanced in healthy skin. Unfortunately we don't know what imbalances are in your skin, some will be part of whichever form of dermatitis you have and perhaps some from imbalances in the fats in your diet or the showering your face. Confused

Different lipids and humectants can substitute for one another and AFAIK there is no product that contains absolutely everything anyway. It's a matter of trial and error to see exactly what works best, and addressing the internal at the same time as the external.

free skin care · Thu Jul 05, 2012 11:52 pm

Wow, Firefox, you are soo knowledgeable on skin!! Thanks so much for your input !!

I'm going to try the AV gel and Shea Butter you mention

also heard that probiotics can really help with SD

Thanks again,

Maria

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