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Like many black women, Grace Floyd began using chemicals at a young age (8 years old to be exact) to change the texture of her naturally coarse, thick hair. Around that time, she started noticing patches of inflamed, flaky skin popping up around her eyebrows, hairline, nose, and inside of her ears. “I have early memories of my stylist pointing out my ‘dry’ scalp and telling me to oil it,” she recalls.
It didn’t help.
The adults around Floyd were also confused. What’s causing these symptoms? Some thought it was a reaction to hair relaxers. The school nurse suggested it was a cleanliness issue, but that only made Mr. Floyd more self-conscious. “At that age, I didn’t have the knowledge or confidence to question these assumptions,” she admits. “So I really internalized the belief that there was something wrong with me.”
The real diagnosis didn’t come years later, at the age of 12, when Floyd’s dermatologist told her that her long-standing skin problems were not caused by poor hygiene or a temporary reaction to hair treatments, but rather were caused by seborrhea. That’s when I was told that it was due to a recurrence of my sexual dermatitis. She was one of more than 10 million people in the United States living with an inflammatory skin disease known to cause chronic dryness, peeling and scaling of the skin.
the answer at the end
Seborrheic dermatitis, a type of eczema classified by chronic dryness, peeling, and scaling of the skin, is often accompanied by dandruff, one of its characteristic physical symptoms. “It’s a very common disease, affecting 1 to 5 percent of the population,” says Dr. Kenneth Mark, a board-certified dermatologist in New York City. And while the condition can appear in patients of all ages and skin types, research shows that it is one of the top five medical diagnoses received by Black patients, affecting 6.5% of this population. It is shown that there is.
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In adults, seborrheic dermatitis is a lifelong condition that cannot be cured and must be managed. The skin disease most commonly affects the scalp and face, but flare-ups are also known to occur in other areas rich in sebaceous glands, such as the chest, upper back, and inside and around the ears.
root of the problem
As with similar skin conditions, determining the cause of seborrheic dermatitis is not always easy. “It’s thought to be related to disruption of the skin’s microbiome due to an overgrowth of a yeast-like fungus called Malassezia,” explains Dr. Geeta Yadav, a board-certified dermatologist in Toronto. Malassezia thrives in the presence of the skin’s natural oil called sebum, so the condition can worsen if your sebaceous glands become overactive or if you wash your hair and face less frequently. This important detail came too late for Mr. Floyd. Floyd spent years following his hair stylist’s advice to treat scaly patches with emollients and oils, a solution often considered by patients of color. “It wasn’t until I was in my 30s that my dermatologist told me that oil on my scalp could worsen my seborrheic dermatitis,” says Floyd, now 45. “Who knows how much damage I was doing with my hair care?”
Other risk factors for developing the condition include “genetics, stress, hormonal fluctuations, dry air, and weakened immunity due to diseases such as HIV and Parkinson’s disease,” Dr. Yadav added.
unexpected damage
Inflammation and flaking can lead to secondary symptoms such as post-inflammatory hyperpigmentation and skin lightening, both of which are common problems in patients with darker skin tones. In rare cases, seborrheic dermatitis can cause hair loss, and some studies suggest that it is caused by mallesetia overgrowth, possibly due to scratching or oxidative stress.
However, the physical side effects are insignificant compared to the mental burden. “Similar to eczema and psoriasis, seborrheic dermatitis is easily visible and attracts unwanted attention, causing patients to change the clothes they wear to minimize the appearance of scales,” says Dr. Yadav. say. “A lot of people struggle with self-esteem issues because of this disease.” For Floyd, it led to years of shame that he was only able to fully come to terms with as an adult. “My seborrheic dermatitis made me shrink back to avoid drawing too much attention to myself,” she recalls. “I was always conscious that a person could grow, even on days when I started without a seizure. This awareness influenced how close I allowed people to get to me, my clothing choices, It influenced everything, even my willingness to be photographed.”
The difficult path to diagnosis
In many cases of seborrheic dermatitis, it takes time to be properly diagnosed. Symptoms, especially in people with darker skin, may differ from those with lighter skin. And while most patients try over-the-counter medications as a first line of defense, Dr. Yadav recommends seeing a dermatologist at the first sign of symptoms. “This condition can have a negative impact on your mental health, so it’s best to see a doctor as soon as possible,” she says. “Managing seborrheic dermatitis can go a long way in improving your daily life.”
In most cases, a conversation and physical exam are sufficient to diagnose a skin disease, but your dermatologist may also ask about your family and medical history to rule out other forms of eczema or psoriasis. .
Peace of mind within reach
Fortunately, those dealing with seborrheic dermatitis have a wide range of options, from easily available over-the-counter medications to prescription-strength topicals aimed at reducing the effects of Malassezia and removing dead skin cells and oil. There are a wide range of options, from steroids to anti-yeast medications. Dr. Mark says: However, research shows that while effective, many of these treatments are impractical, especially for Black women. The reason is that these treatments require almost daily use and do not take into account the fact that different ethnicities may require less frequent cleaning.
This is a challenge that Floyd has experienced firsthand. She tried her luck with commercial products containing zinc, salicylic acid, coal tar, and even tried sulfur products, but ended up burning her hair. “Most shampoos completely dried out my hair, and creams caused hyperpigmentation,” she recalls. “If you look at pictures of me from middle school, you’ll notice that I have some discoloration around my hairline. This is due to strong topical steroids.”
As a result, Floyd turned to home therapy. “I tried everything from apple cider vinegar to coconut oil to aloe vera to tea tree oil,” she says, admitting that she applied these ingredients to the affected areas of her face and scalp when her symptoms worsened. But she quickly learned that “just because it’s natural doesn’t mean it’s gentle or effective.” Of all these natural remedies, the only thing left in her treatment plan now is aloe vera, along with prescription steroid shampoos and the topical foam agent Zolib (roflumilast), which she discovered and cherishes earlier this year. ) 0.3%.
Also, although seborrheic dermatitis cannot be cured or reversed, it can be prevented from recurring. The best prevention method is to wash your body, face, and scalp frequently with antifungal ingredients, an especially important step after exercise or on humid or sweaty days. Dr. Mark says special precautions can also help, such as taking lukewarm showers, limiting stress as much as possible, wearing loose-fitting clothing that doesn’t irritate the skin, and adding moisture to the air with a humidifier. Masu. “The key is to treat and get better. This is a solvable problem,” he says.
way forward
But perhaps the most transformative step for Floyd was facing his vulnerability and openly discussing his condition. That’s when she began to realize how much her seborrheic dermatitis had been holding her back over the years, and how she needed to break out of that mindset. “After living with feelings of shame and unattractiveness, I began to find strength in sharing my story,” she says. “Now, honoring myself for who I am has become an important part of my journey.”
Gabby Shacknai is a New York-based journalist and editor who creates high-quality content for a variety of outlets and brands across a variety of industries.
