r/SebDerm

Hi - I believe i've got some seb derm around my hairline and behind my ears (red angry looking patches of skin that flake off) and was hoping to get some recommendations for products i can buy in the UK

The ones i've tried so far:

Body Shop anti dandruff ginger shampoo - this really cleared my scalp up for a long time, eventually stopped working but I might try it again soon as it's been a few months now

Tesco anti dandruff - worked for about 1 bottle, then the red patches and flaking came back

Lidl anti dandruff - hasn't really done anything, no improvement

Can anyone recommend some other products I can buy in the UK? I think a lot of the shampoos referenced here are in the US, so i'm looking for our versions

For context, I have been experiencing seb derm for almost a year along with eczema my whole life. My seb derm is around my hair line and gets SUPER flaky. I have always been a picker and used to pick at my face a lot growing up but got really good at leaving it alone the past couple years.

I have been picking and scratching non stop. I cannot explain if it’s satisfaction, wanting it gone or just being bored. I find myself constantly with my hand in my hair picking the dead skin. I have since discovered it is started to thin out my hairline.

I am still in the stages of figuring out what works. I have avoided any anti fungal for almost a month as a “reset” before trying Nizoral again. I use head and shoulders dryness rescue, BYOMA barrier repair products and that is it. With this routine, I have seen tremendous improvements but nothing with the flaking. It ALWAYS come back on day 2 after washing, just like it was before I washed with no improvement (even with Nizoral).

I have tried MCT oil, prescription anti-fungals, steroids (I know this doesn’t actually treat it), so many creams, lotions and ointments. I find MCT oil hard to get right, sometimes it helps and sometimes it doesn’t, I may be doing it wrong.

What do you use that actually works for flaking?

Been using MCT oil (Hunter Gatherer Pure C8) for over a month. A small amount on a dropper bottle, dropped onto the scabby areas of my scalp and gently rubbed in for 30+ seconds then left overnight in a silk cap.

While it initially did help, the yellow crusty scalp flakes have come back with a vengeance and my SebDerm has started to spread further onto my scalp, where it was previously just on the top. It's weeping, cracking, burning pain and even a heavier wind feels painful.

I'm currently back to Aveeno sensitive baby shampoo trying to get the scalp pain to calm down before I start tackling more of the flake with ketoconazole again.

I'm hoping to see a dermatologist at some point, but it's a grey area on my health insurance and I currently can't afford to be charged full price if it comes down to that.

I have pretty intense sensitivity to fragrance, and will be an itchy burning mess if my products have fragrance in them! So far I have not been able to find a selenium sulfide shampoo that doesn’t have fragrance, but would really like to try it out!

Some backstory:
I have had some form of psoriasis/eczema/seb derm my entire life. When I was a child I got diagnosed with eczema, but then during puberty had a huge flare up on my scalp and groin and was rediagnosed with psoriasis. We tried every treatment for that besides biologics, because my insurance would never cover it, and even was taking Otezla sample packets under the instruction of my derm for 1 1/2 years. Eventually, my derm rediagnosed me with seb derm, and kept me on Ketoconazole shampoo, T-Gel (Amazon basics), Calcipotriene, Clobetasol, Triamcinaolone, and Hydrocortisone.

I moved states 4 years ago and have not gone back to a dermatologist due to insurance and money issues. I had to wean myself off of the medications but have recently restarted using ketoconazole through Amazon Pharmacy. Ketoconazole alone somewhat works, and the scalp hydrating serum from the Ordinary has somewhat helped with the dry scalp that Ketoconazole leaves behind.

I saw on here that many of you have luck rotating medicated shampoos, but not much is offered that is fragrance free. I will be continuing to avoid Pyrithione Zinc, because my old derm pointed out that it actually flares me. Have any of you found suitable fragrance free selenium sulfide options?

I tried leaving tacrolimus alone overnight but it makes my face dry (I'm also on isotretinoin).

i have been suffering from seb derm it started 2 years ago but with treatment i managed it.. but today it came back it used to flare up in between too but i managed it but this time it came back my whole chin area moustache area is full covered with white yellow flakes type i vistited doc 3 time and he put me on u mometasone and ebercanzole ointment and then itracanazole and methylprednisonone too but its not working i am using mct c8 and c10 oil from 4 days and washing with ketocanazole 2%. and i am on acritretin too for many years for different skin condition knows as pp kearatoderma.. any one i need ur help guys

Help please!!

My whole life my skin has been normal and clear, but in my 30s (I’m 35 now) I’m having lots of sebderm issues. Mostly little pimples popping up around my mouth, on my chin or between my eyebrows. Right underneath my eyebrows I’ll get random red patches where the skin will look like its peeling too. Even my eyelashes have what looks like dandruff on the tips.

It calms down when I take doxycycline which I’ve been on off and on for maybe 2 years. I also use clindamycin and elidel prescribed by my derm. Everytime I go off the doxycycline it comes back with avengance. Its driving me nuts!!! I don’t wear any makeup or anything.

Help!!! Anyone else dealing with this or have tips I can try???

These two get mixed up constantly, and it's easy to see why, both give you a flaky, irritated scalp, and a bad seb derm patch and a mild psoriasis plaque can look almost identical at a glance. But they're different conditions with different drivers, and treating one like the other is a big reason people have no success in treatments. Here's how I've come to think about telling them apart.

The most useful difference is the flake itself. Seb derm flakes tend to be greasy, yellowish and soft, they smear rather than lift, because seb derm is tied up with oil and a yeast (Malassezia) that lives on everyone's skin. Psoriasis scale is the opposite: dry, silvery-white, thicker, coming off in more defined layers, and the skin under a plaque often looks shiny and pink. Seb derm usually just looks red and irritated underneath.

Location helps too, since seb derm loves the oily zones and rarely stays only on the scalp. If you've also got flaking around your nose, eyebrows, behind the ears or in the beard, that spread leans seb derm, and its edges tend to be fuzzy and blend into normal skin. Psoriasis is more likely to sit as well-defined plaques with a clear border, and it often doesn't respect the hairline, marching past it onto the forehead or down the neck in a way seb derm tends not to.

Also, your body gives some clues. Psoriasis often shows elsewhere, elbows, knees, lower back, and the nails especially. Pitting in the nails (little dents like a pin was pressed in) or plaques on the elbows shifts the odds toward psoriasis even when the scalp's ambiguous. Itch, on the other hand, isn't much help: both itch, and there's too much overlap to lean on it.

Why it matters is the treatments diverge. Seb derm responds to controlling the yeast (antifungal shampoos, keeping the oily areas in check) and it's a maintenance thing, not one-and-done. Psoriasis is immune-driven, and stubborn scalp psoriasis often needs a different class of treatment entirely. So if you've been hammering a flaky scalp with antifungal shampoo for months with no change, that lack of response is itself a clue you might be treating the wrong thing.

They can coexist (there's a whole overlap category), and the only way to be sure is a professional actually looking, sometimes with a biopsy. This is an attempt to help in "what to ask", not a diagnosis. But pointing the clues one way means you can walk into an appointment saying "I think it's X because of Y" instead of "my scalp's flaky, help", which tends to get you a better conversation.

What do you all use topically for itchy flare ups? Oils aren’t good for me. Have tired the dermazen with colloidal silver,
works OK but is messy and expensive!

19M, on dutasteride + oral minoxidil for AGA. Considering low-dose isotretinoin just for scalp oiliness/seborrhea. Looking for others' experiences.

My situation:

• AGA (frontal/hairline). On dutasteride 0.5mg + oral minoxidil 2.5mg for a few months.
• Very oily + flake-prone scalp, concentrated in the frontal hairline + forehead (androgen-sensitive zone). The oiliness is my main quality-of-life problem — oily again within hours of showering.
• I did a course of isotretinoin before — it completely controlled the oil/seborrhea. Interestingly, my hair also shed noticeably LESS while I was on iso (I think because my scalp stayed calm/non-inflamed). After I stopped ~2 months ago, the oiliness AND the shedding came back.
• Now considering low-dose / intermittent isotretinoin (~20–40mg per week) only for oil/seborrhea control, while keeping duta+minox for the hair.

My questions:

1. Has anyone here combined low-dose isotretinoin with dutasteride/finasteride? How did it go for you?
2. For those who used low-dose iso — did it control your scalp oiliness/seborrhea, and for how long?
3. Did any of you also notice LESS shedding while on iso (calmer scalp), or the opposite?
4. What side effects did you get on low-dose long-term?
5. For those doing intermittent long-term — how do you personally think about cumulative dose?

Just looking to hear real experiences before deciding with my derm. Thanks!