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Seb derm is caused by malassezia yeast (aka fungus) and particularly by the hyphal phase. The key principle for treating malassezia is that it's lipid-dependent. It needs oil to survive. Washing more or fewer times is not likely to matter much, as it's impossible and unhealthy to remove all skin oil (sebum). Therefore, skin needs to be treated with a cream, which is why Lotrimin Ultra, or Nizoral 2% cream, is effective when combined with a climbazole-based shampoo.

Shampoo by itself is only going to work against very mild problems, like "dry dandruff," which is also caused by malassezia but is merely an annoyance. Selsun Blue is not effective for treating "oily dandruff," which is another name for seb derm and a fairly descriptive term. The hyphal yeasts form a biofilm that is difficult to penetrate. Head and Shoulders is another dry dandruff product that is not effective on seb derm.

Heres a list of all the OTC climbazole shampoos:

1) Hegors 150 (1.5% Climbazole), which is made in France and is available in the US only on eBay and will be shipped from Bulgaria.

2) Aldermas Bioderma Sensibio DS Gel containing unstated amounts of climbazole and piroctone olamine, which is available on Amazon and ships from Portugal.

3) Eucerins DermoCapillaire Antidandruff Gel Shampoo containing 0.5% piroctone olamine and 0.45% climbazole, which is sold only in the EU and is not available online, as far as I can tell.

Climbazole is much more effective when the pH is lowered by adding 0.3% to 0.9% citric acid. Low pH won't work so well as a hair shampoo because it makes hair slightly strawlike.

I tried Aloe Vera and found that it helped a little, but I recently started adding 2% to 5% Xylitol to everything I use. Im inferring from candida research, that Xylitol prevents biofilm formation by making the keratin too slippery for the fungus to interact with the skin. We will always have malassezia because its commensal, or normally found, on all mammals skin.

The healing process in treating a fungal skin condition is like a time machine slowly going backwards. The medicine slowly dissolves the cells walls of the yeast and the contents of the yeast cells leak out and it dies. The redness results from your bodys immune system recognizing that there are fungal foreigners, to which the bodys first healing reaction will be redness and inflammation, which is normal. Do not be dismayed by additional patches of skin redness your body is healing, although it may take weeks or months to become normal.

Aquaphor or Vaseline is somewhat useful too, because they have carbon chain lengths in the range of C25 to C30, and malassezia can metabolize oils only in the C10 to C24 range.

Sounds very interesting and I ready the articles you posted in another message. I have good results with Selsun Blue so far, but true that it does not prevent the yeast from spreading or being inflammed.

How about water temperature when showing? 2 school of thoughts: 1. Water must be warm; 2. Water must be lukewarm or actually cold.

What's your take on that?

IMO water temp doesn't matter as far as seb derm is concerned. I've never seen any clinical studies on that, have you?

I always start with warm, turn of the water to lather up, and rinse-off with cool water but that's really so I don't start sweating right away.

Most people say that cool water is better rinse-off, but I don't know any reason for that.

2% or 5% Xylitol sounds good, but I can not find any OTC cream containing that.. Any brands that you could recommend?

You are right, there aren't any creams containing it. The only US cosmetic-product is a toothpaste from Tom's of Maine. I suspect that the Finnish company that holds the patents charges a high licensing fee to sell the product commercially.

In any event, there's no legal impediment to making your own products -- you just can't sell them. It's easy too, because Xylitol is water soluble and food grade.

Understood. I might try that.

Selsun is really helping clearing my skin so it must have an effect on my fungal infection.

However, very drying and can be irritating when used 2x a day. I just woke up and can feel my skin is very very dry, even hurting/burning, though it can not be seenat all on the mirror. Any hydrating cream I could use would severely break me out. I have tried them all, and the yeast thanked me each time by festing on the product!

I would like to leave my skin this way. Very acceptable this morning. But if I do not wash 2x a day, I have the feeling that oil and dry skin are building up. Another good thing........ for the yeast!

Hard to make the right call.

Yes, oils in lotions feed the yeast, but it seems to me that Aloe Vera gel does not. You could try that instead of lotion. The best kind of Aloe gel will list citric acid in the ingredients, which is added so the gel doesn't spoil through oxidation.

Selsun Blue (1% selenium sulfide) is somewhat drying even to me and I have basically oily skin. Have you tried Nizoral or the climbazole based shampoos as a facial wash? They are more effective as they dissolve the fungal cell walls, rather than simply removing the oil from the skin like Selsun Blue.

I have been diagnosed with facial seb derm, and scalp seb derm.

I am keeping it under control with selsun blue, but it is quite harsh.

What is your experience when it comes to washing? Once a day in the morning, or twice a day?

So much efforts to keep a clear and normal skin........

When my son was an infant he had seberrheic dermatitis on his scalp and cheeks. I used neutogena T- gel on it and it cleared very quickly. I was nervous about using it on his face but it worked great. Maybe give it a try! Good luck!

Thanks I'm gonna try the Aloe Vera gel. Need something to sooth my skin. It looks acceptable right now. A redness from a pimple I popped 2 weeks ago (bad idea). A pustule (with whitehead) on my chin. Rest is clear and I'd like to keep it this way. Hopefully Aloe won't break me out!