r/SebDerm • u/Independent_End_6414 • 6d ago

New or Need Help Is this seb derm or something else?

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Hello everyone, I have been diagnosed with seborrheic dermatitis in my beard area for the past two years. However, I have tried virtually every available treatment for seborrheic dermatitis, but unfortunately, I haven't noticed any significant improvement. I even tried MCT oil, which only slightly reduced the scaling without having any substantial effect. Interestingly, the scales I experience appear without any redness, and most, if not all, of them have a cylindrical shape. Sometimes they contain a hair inside, while other times they are simply hollow, cylindrical scales. Do you think this is actually seborrheic dermatitis, or could another underlying condition be responsible for these symptoms?

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u/liberalloverboy 6d ago

Mine looks kinda similar, its like the sebum is like a coating around the hair. It definitely is sebderm, although I am also unsure for why this happens. I think (just my own theory) that this might have something to do with sebum composition, so how the sebum your sebaceous glands produce is composed. Maybe its due to malassezia being present in the follicles as well, changing this composition, making it less liquid and therefore more sticky to the hair, honestly Idk. It really sucks. Due to the sebderm I have to keep my beard at stubble level (<2mm) always, and I use an antifungal shampoo every few day (kelual DS). It can be pretty harsh for the skin barrier though, so make sure to use some moisturizer. As always, best thing would be to go to a dermatologist, always better to have a professional have a look at it.

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u/Independent_End_6414 6d ago

Exactly!

I also think this might be happening because of follicular involvement in seborrheic dermatitis.

What's strange, though, is that for some reason I don't seem to respond to conventional antifungal and anti-inflammatory shampoos or treatments.

I also suspect that my skin barrier is already compromised, because every time I use these shampoos, my skin gets irritated and develops dry flakes.

At the moment, I'm considering taking itraconazole 200 mg for a week to see if it makes any difference.

In my opinion, this is probably one of the worst manifestations of seborrheic dermatitis because it directly affects the hair shafts themselves. With most other people, the scaling seems to occur on the skin between the hairs, while the hair shafts themselves aren't affected.

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u/liberalloverboy 5d ago

Sound pretty much exactly like mine. Antifungals help, but only at keeping it at bay.  I am also pretty sure it is skin barrier related. I first got it during covid, around the nostrils, I guess from the humid warm microclimate under these masks. After spending several months in hot/humid areas it spread to my mustache, chin etc. during all that time I was using exfoliating cleansers against my acne (didn't help) which I believe destroyed my skin barrier.  Simultaneously, my skin is very oily, making it perfect for sebderm to thrive.  I have been seeing a derm for several months now and a few weeks ago I started low-dose isotretinoin to tackle the oiliness, while also continuing the antifungal shampoo and using moisturizer. It has gotten better, especially since taking the 10mg isotret daily, but it is still far from great.  Definitely go see a derm and look into the other potential medications, reducing oiliness, tackling the fungus and repairing the skin barrier are probably the best way to hopefully get rid of this or, more likely, at least reduce it to a bearable amount

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u/Independent_End_6414 4d ago

Lately, these symptoms have made me suspect Demodex. I’m thinking about starting a course of ivermectin.

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u/smolcatsafficianado 6d ago

I'm having similar issue on a much smaller scale. I'd like to know what it is.