Human Skin Things, Part 2

The regimen that seems to be working is taking a three-prong approach. Kill the fungus with ketoconazole and tea tree oil. Starve the fungus with moisturizers and cleansers that don’t contain the oils they like. I learned even more about Malassezia on this page, and it was seriously helpful. And here’s that author’s list of safe products.

I wash my face and ears with CeraVe Hydrating Facial Cleanser twice per day, once prior to my shower in the morning and once before going to bed.
Nizoral Anti Dandruff Shampoo every day until the scabs/scales are gone, then reduce to every 3 days until the flakes are gone, then reduce to once every 2-3 weeks as preventive. Apply shampoo, let remain for 5 minutes, rinse, reapply, then rinse again. I have not yet decided on shampoo and conditioner to use the rest of the time. If body symptoms are severe, use Nizoral as a body wash instead of the castille soap below until improved.
As the skin gets better, I use Dr. Bronner’s Hemp Pure-Castile Tea Tree Soap.
After the shower, I apply 2% Ketoconazole to all the affected areas. I apply Hydrocortisone to any severely affected areas after the antifungal is fully absorbed. I apply Hydrocortisone occasionally also.
In the morning I moisturize face, ears, neck, bosom, and arms with CeraVe AM Facial Moisturizing Lotion. It’s got sunscreen. It’s oil free.
In the morning I moisturize the rest of me with CeraVe Moisturizing Cream. At bedtime I moisturize all of me with it.
I treat my scalp with OGX Tea Tree Mint Extra Strength Scalp Treatment after my shower and at bedtime.

Human Skin Things

I’ve been having trouble with my skin off and on for a long time, but the most recent “on” has been going on now since around June of 2019. I didn’t realize the full scale and scope until looking at my health diary recently and collating all the things labeled “eczema” and “dermatitis” and “psoriasis” together.

I’ve never actually had a diagnosis.

I started a spreadsheet of everything I’ve been prescribed for it and looked up what those things are for.

Yesterday I learned that the Mayo Clinic says that seborrheic dermatitis is diagnosed via biopsy. I’ve never had a biopsy for this!! Not even when I had the same dermatologist over multiple visits. Which, admittedly, has been a rarity, as my insurance provider changed 5 times over 4 years and then changed again last year. It’s about to change again because I’m moving.

Anyway, I gathered all the data, found out what was what, and developed a treatment plan. So far it’s going swimmingly. But I also realize that I need to learn how to moisturize.

Like a lot of white people, I didn’t grow up with moisturizing of any sort. And then when everybody started saying we need to moisturize every day, it seemed like we were talking about delicate rejuvenators for faces and hands. Not lotion for the whole of me.

I am finding out from TikTok that I need lotion for the whole of me. So, um yeah, exploring this.

Because I’m oblivious (and now it’s increasingly apparent, neurodivergent) this data gathering exercise is helping me discover:

  • I have actually applied the same medication multiple occasions before and not realized it.
  • My container of face moisturizer is three years old. I’m throwing that out.
  • I thought dermatologists would know their stuff, but their approach is random and capricious, compared to the Mayo Clinic. F that.

Update: while doing some research into moisturizers, I stumbled onto this page and OMG science!!! But I’m discovering things …

Current products:

  • Nizoral Anti Dandruff Shampoo
  • OGX Tea Tree and Mint Shampoo
  • OGX Tea Tree and Mint Conditioner
  • OGX Tea Tree Mint Extra Strength Scalp Treatment
  • Dr. Bronner’s Hemp Pure-Castile Soap Tea Tree
  • Noxzema Original Cleansing Cream
  • Thursday Plantation Tea Tree Manuka Honey Balm
  • Nuvel Cocoa Butter Lotion

I’m finding out that the Noxzema, Honey Balm, and Nuvel have to go. They all use oils that Malassezia yeast loves to eat. The soap and hair products do too, but good rinsing will help with that. It’s what persists on the skin that I’m concerned about and Noxzema persists like a lot, even after a hard rinse. So I’ll need a new:

  • Face cleanser
  • Face moisturizer
  • Whole body moisturizer