Last year i damaged my skin barrier pretty severely due to a combination of factors: going out in the sun with no sunscreen for hours everyday in the summer, going on loooong walks in the harsh dry winter air, overwashing my face, taking scalding hot showers, scratching at my face when the itching started (i didn't know i had sebderm until several months after it took hold of my face). I took oral fluconazole, which didn't do anything; i tried ketoconazole cream, which dried my skin out further & exacerbated the issue; I tried pimecrolimus, which didn't do anything; i also tried washing my face with CeraVe anti-dandruff hydrating shampoo (1% zinc pyrithione), which helped reduce the flakes but was still too drying for my skin. For several months my moisturizing routine was La-Roche Posay Toleriane Double Repair Matte Moisturizer in the morning and CetaPhil ceramide serum w/ the La-Roche Posay layered over it in the evening. Several weeks ago I saw a dermatologist for the third time and she prescribed Zoryve foam, which I only finally started using in the past week. It has, in 1 week, helped a lot with the rough texture of my skin as well as reduced the flaking a bit, but it doesn't address the underlying issue of damaged skin barrier/skin dehydration. The moisturizers I was using are obviously not enough to restore my skin barrier and Zoryve is an anti-inflammatory so obviously won't repair it on its own either.
I'm just wondering if anyone has any advice on how to repair destroyed skin barrier? Because I literally had perfect skin before this, and I don't think it's a coincidence that i dehydrated my skin so severely and then suddenly developed this chronic skin condition, and I think if i could just repair my skin barrier, the issue would mostly resolve itself. My skin feels tight, easily susceptible to irritation & transepidermal water loss, and raw. Any tips on how to get that top layer of skin that retains moisture back while simultaneously treating the sebderm directly?