u/Duementon

I have been trying the non medication route (low histamine diet + supplements; mainly binders and nettle)

i think i am making slow progress, but then get very disgruntled when i get a big flare up

i have access to antihistamines (Fexofenadine & Famotidine) and also mast cell stabaliser Ketotifen. i know these drugs have helped so many people but I am just so worried that i will get side effects and go backwards

should i start with just 1 antihistamine or go straight to ketotifen to stabalise the cells?

ive been following a low histamine diet which ive had some success with but still get periods of intense itching on my scalp that i think is seb derm related as its localised rather than MCAS

it always comes after eating so considering i have already removed a lot out of my diet i think ive pinpointed the cause that is high salicylate foods = seb derm itch pretty much instantly

i wonder if salicylates are causing rapid skin cell turnover like topical SA does and that is what creates the dandruff flakes?

ive had a big breakthrough with my scalp stopping all medicated shampoos and just using baby shampoo once or twice a week

instead i use hypochlorous acid spray after a shower, azelaic acid serum and focus on moisterising tf out of the scalp (which stops it getting oily)

for reference i had multiple issues for 10+ years - all at once, seb derm, eczema and folliculitus

i really think i am turning a corner

those shampoos are so bad for the skin barrier and the biome but once you start with them its hard to stop

make sure all products you use are malassezia safe (scan the ingredients)