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Skin conditions
Dermatitis
Originally Published: January 20, 1995
 

Dear Alice,

I have always used moisturizer during winter time because of my dry skin. However, something strange happened last spring. Areas of my face turned reddish as if it were flushed and were slightly puffy. It went untreated for a while as I thought it was only a minor irritation or allergic reaction. After 2 months, as it had not gone away yet, and the condition fluctuated between almost about to heal and starting to puff up, I went to a dermatologist who diagnosed this as sebborheic dermatitis. He said it is something I'll always have if I don't wash my face often and keep it clean. He also said moisturizers are off limits as someone my age (19) would not need it.

That was during the summer and I could live without moisturizer. Also, during that time I found that if I used soaps to wash my face, my skin would start to get red again. I stayed away from soaps, cleansers, and moisturizers for the summer and relied on warm water. Now it is winter. HELP! My face feels like a desert without moisturizer, but any moisturizer I have used irritates my skin. I haven't found any cleanser which doesn't give me immediate bad results either. Can you suggest anything for me to use or explain why my skin is reacting the way it is to anything and everything besides water?

—Winter blues

 

Dear Winter blues,

As mentioned in an earlier Alice answer (Dry skin and eczema help), eczema, or dermatitis, is a bit of an elusive disease to the medical community. Seborrheic dermatitis is a common, scaly superficial skin condition that affects more men than women. It appears to be associated with an oily complexion, and historically has been found in two major age groups, the first three months of life and 40 - 70 years. Onset in adults is gradual, and the dermatitis is usually only apparent as dry or greasy scaling of the scalp with variable itching. Genetic and climatic factors seem to affect the incidence and severity of the disease — it is usually worse in the winter.

Treatment for seborrheic dermatitis is an anti-dandruff shampoo that is used until the dandruff is controlled. Corticosteroid lotions are used for the skin areas. It sounds as though you need to visit another dermatologist. Your symptoms seem to be of another type of dermatitis, not seborrhea, although there may be more symptoms than you described over the computer. In terms of the short run, try hypo-allergenic cleansers and moisturizers because they usually don't contain perfumes or colorings. Your dermatologist can offer some recommendations. It is a good idea to conduct a patch test first of each new product you try: put a dab of the product on your forearm and cover it with a small bandage. Repeat daily for three or four days, and then wait another day or two. If you have no reaction, it's probably safe for you to use.

Do see another dermatologist for a second opinion. Dermatologists are available for Columbia students by referral through Health Services. You can call x4-2284 for more information.

Alice

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