How to deal with seborrheic dermatitis that has spread to the nose and forehead?

Question

Hi doctor,

I have had seborrhoeic dermatitis for the past 20 years, I am 35 years old. Now mainly, it is affecting my nose and forehead. I have extremely sensitive skin. I cannot use any cleansers (just plain water), and I only use a tiny bit of medicated dandruff shampoo every second day, as even that irritates my skin and scalp. I wash my skin with just plain water once in the morning and once at night. After wash I use a moisturizer designed for sensitive skin (Nivea for men sensitive moisturizer). I use Elidel cream at night before I go to bed, which seems to help, but I still have very sensitive skin. I have used 1 % Hydrocortisone cream in the past, but it does not work for me anymore.

Is there anything else you would consider that may help?

Thanks in advance.

Answer 1

Hi,

Welcome to icliniq.com.

It seems you have seborrheic dermatitis.

Seborrheic dermatitis is a papulosquamous disorder that involves mainly sebum-rich areas of the body like the scalp, face (postauricular areas, eyebrows, side of nose, chin), and trunk. It is intermittent and have active phases manifesting with burning, scaling, and itching, alternating with inactive periods. Activity is increased in winter and early spring, with remissions, commonly occurring in summer.

The treatment plan includes,

1. You can continue antifungal Ketoconazole shampoo, to be used two times weekly.

2. You can use Desonide lotion (Aluminium Acetate and Cetearyl Alcohol) once daily over affected areas for a few days after consulting your general pathologist and take the tablet Levocetrizine once daily for a week.

3. Continue the same routine that you are following.