Managing Seborrheic Dermatitis: Insights on Lifestyle and Treatment

Methods for Coexisting with Seborrheic Dermatitis

Inquiry about the condition: seborrheic dermatitis (having suffered for many years, I rarely consume spicy foods or stimulating beverages, and I am aware of the need to adjust my daily routine).

1.
Long-term observation suggests that masturbation or sexual activity with my girlfriend may exacerbate my condition.
Are there any studies or similar patient inquiries regarding this issue, and what might be the underlying cause? If this is indeed a fact, how should I respond? For example, should I adjust the frequency? I have considered abstinence, but it is difficult to control normal release.
(I have experimented with a frequency of once a week, which maintains a slightly noticeable but not severe condition.
However, if I cannot control myself and exceed that frequency, I need to space out the following weeks to allow my skin to gradually readjust, and the symptoms during that week tend to be significantly worse.)
2.
Long-term observation indicates that weight training exacerbates my condition (while jogging seems to have no negative effect and may even help).
Are there any studies or similar patient inquiries regarding this? If this is true, does it mean that patients with dermatitis cannot engage in weight training? If it is possible, how can I maintain a balance? (Basically, weight training seems to increase libido, but even without engaging in sexual activity, it appears to worsen my symptoms.
I wonder if there is some correlation with the first point.)
3.
If my scalp itches, is it acceptable to wash my hair twice a day?
4.
If water remains on my face or scalp for too long (regardless of whether it is rainwater, clean water, tears, or sweat), it seems to worsen my condition.
Have other patients experienced similar situations? I would like to understand why this occurs.
What would be the most appropriate and recommended cleaning process? (Currently, I use a less irritating shampoo on my scalp, applying it without mixing with water for a dry wash, and then rinsing with clean water, followed by immediate blow-drying.
For my face, I towel-dry, then blow-dry, and apply moisturizer and lotion.)
5.
Several shampoos that I previously found very effective (such as Kan~, S-type, ZP, etc.) still worsen my condition even when used with the aforementioned method.
After not using them for several months and then trying again, they still exacerbate the issue, and I cannot return to their previous effectiveness.
Is this normal? Are there any other recommended shampoos I could try?
*I have regular consultations, but some of these questions are difficult to ask in person, and others are based on my own observations that seem trivial.
I feel somewhat foolish asking these questions, so I am inquiring anonymously online.
If I could receive your response and valuable insights, Dr.
Wu, it would be a great honor, and I would be very grateful for clarifying doubts that I have hesitated to ask for years.
Thank you once again for taking the time to respond to these perplexing questions amidst your busy clinic schedule, and I wish you continued success in your medical practice.

Xiao Ha, 20~29 year old female. Ask Date: 2015/11/08

Dr. Wu Yuxin reply Dermatology

1.
No.
2.
No.
3.
Yes.
4.
No.
5.
There are still various scalp shampoos available, such as Rejuve and Pine Soothe Gel.

Reply Date: 2015/11/08

More Info

Seborrheic dermatitis is a chronic skin condition that can be challenging to manage, especially when it has persisted for several years. Your observations regarding lifestyle factors and their impact on your condition are insightful and warrant a detailed exploration. Below, I will address your questions and provide recommendations based on current medical understanding.

1. Impact of Sexual Activity on Seborrheic Dermatitis: While there is limited direct research linking sexual activity to the exacerbation of seborrheic dermatitis, stress and hormonal fluctuations associated with sexual activity could potentially influence skin conditions. Stress is known to worsen many dermatological issues, including seborrheic dermatitis. If you notice a pattern where increased sexual activity correlates with flare-ups, it may be beneficial to moderate the frequency and observe any changes in your skin condition. Keeping a diary of your activities, stress levels, and skin reactions may help identify specific triggers.

2. Exercise and Seborrheic Dermatitis: Physical activity is generally beneficial for overall health, but certain types of exercise, particularly heavy weightlifting, can increase sweating and oil production, which may exacerbate seborrheic dermatitis. If you find that weight training worsens your condition, consider adjusting your routine. You might try lighter weights with higher repetitions or incorporate more aerobic exercises, like jogging, which you noted does not seem to aggravate your skin. Maintaining good hygiene post-exercise is crucial; showering promptly after workouts can help remove sweat and oils that may contribute to flare-ups.

3. Washing Hair Frequency: Washing your hair twice a day is generally acceptable if you are using a gentle, non-irritating shampoo. However, over-washing can strip natural oils and potentially worsen irritation. It may be more beneficial to find a balance that keeps your scalp clean without over-drying it. If you experience itching, consider using a medicated shampoo specifically designed for seborrheic dermatitis or dandruff, but be cautious about frequency.

4. Water Exposure and Skin Irritation: Prolonged exposure to water can indeed exacerbate seborrheic dermatitis. This is likely due to the skin's barrier function being compromised, leading to increased irritation. After exposure to water, it is essential to dry your skin thoroughly and apply a moisturizer to help restore the skin barrier. Your current routine of drying your hair and face promptly and applying moisturizer is a good practice. Consider using a gentle, hydrating cleanser that does not strip your skin of its natural oils.

5. Effectiveness of Shampoos: It is not uncommon for treatments that were once effective to lose their efficacy over time. This phenomenon can occur due to the skin developing a tolerance to certain active ingredients. If you find that previously effective shampoos are no longer working, it may be worthwhile to rotate between different formulations or consult your dermatologist for alternative options. Look for shampoos containing ingredients like ketoconazole, ciclopirox, or salicylic acid, which are known to help manage seborrheic dermatitis.

In summary, managing seborrheic dermatitis often requires a multifaceted approach that includes lifestyle modifications, appropriate skincare, and possibly medical treatments. Regular follow-ups with your dermatologist are essential to tailor your treatment plan to your specific needs and to adjust it as necessary. Your proactive approach to understanding your condition is commendable, and I encourage you to continue monitoring your skin's responses to various factors. If you have further concerns or if your condition worsens, do not hesitate to reach out to your healthcare provider for more personalized advice.

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