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The Seborrheic Dermatitis thread
Hi everyone.
I thought about starting a thread focus on persistant Seborrheic Dermatitis and on strategies that everyone have tried in order to get rid of it. I have been trying to find a solution about this specitic disease for +/- 6 years now. Started at 21, and spreaded since (face/scalp/beard/ears). This is the main reason I've done a Master in Biology & Medicine - in order to gain knowledge to finally silence this disease. I have several theory/rabbit hole that I'm currently investigating, and I have tried MANY approach already.
So the first things I have done early in this journey was to try specific diets. So far, I have tried : Lactose/Gluten free, Vegetarian, Vegan, Raw vegan, Fasting, AIP Paleo, Ketogenic and IF, Carnivore, GAPS and several twitch here and there. The last on the list would be low vA, which I'm doing since june/22. None of these helped, tho on low carb diet it was a bit better but it gave me upper right quadrant pain (only small sludge was found on endoscopy) that is still there to this day (2years after stopping the high fat)
Then since I've been graduating of my Master I have done MANY blood and functionnal (stool, urine, hair..) tests. I have a massive databank. Several markers that are off being :
- WBC is on the lower side, tho in range
- Fecal Elastase is in the severe EPI range, but no digestive issues and taking binder will raise it to normal range somehow. Starch has appeared to be undigested in stool too.
EDIT : After starting NDT (T3,T4), stool frequency improved (less constipation-ish) and fecal elastase bounced back up to 600 which has never happened ! And I was not using any binder. Also, there is now no starch undigested in stool, but fatty acids. Long chain tryglicerides are not present, so the fat digestion seems good. But it's the absorption that seem to be lacking.
- Fasting Insulin is low (good? bad? could not say but C peptide is in range but lower side and T1D antibodies are negativ)
- 24h Urinary T3 is low and T4 is great. Blood T3 and T4 are great. There seem to be a T4 to T3 conversion issue (liver?) - I'm DIO1 heterozygote, don't know about DIO2.
- Low blood pressure, and no orthostatic hypotension but sometime It can feel like it.
- Salivary and urine oestrogen elevated but allgood in blood and prolactin is OK
- High SHBG, high total Testosterone but low free Testosterone
- Gum inflammation
- Th2 and Th17 very low, Th1 in range but this makes me somewhat Th1 dominant
On the many gut tests that I have done, nothing huge appeared. I seem to have lots of Strep and Staph as per GI MAP. Antibiotics taken in the past or herbs did not seem to have any impact on the SD. Urinary mycotoxin seemed to show some tricothecenes, I have since moved out of the house but the next test showed a bit higher tricothecenes - so either I'm still somehow exposed, or I detox it well but I have not seen improvment in the SD symptoms.
Regarding the micronutrition (vitamins/minerals..) nothing appeared to be out of range, tho I have still tried the classic "SD deficiencies remedies" - B6, B2, Biotin, Zinc... Nope.
So I will not expend too much on what I have tried and that didn't work.
Here are the main area I'm investigating at the moment :
- The thyroid connection : I'm experimenting with NDT and I'm seeing my basal temp and resting heart rate improving. Transit seems t improve too (less on the constipation side). As per Dr Broda Otta Barnes, acne (which I feel is very similar to SD) respond very well to thyroid treatment within 6 months.
- The ALDH enzyme connection : I will copy/paste my theory about this in the comments below.
- The vA connection : This can actually be linked to that ALDH connection. More on the comment below.
- The mycotoxin connection : I'm still doing urinary mycotoxin test every 6 months. Not sure it is linked since I should feel other symptoms and/or get better when I'm away (or when I moved) but I'm still monitoring it and taking binder just in case.
- The heavy metal/pyrroles/porphyrin/CBS connection : This is a mix of my own research on metals, detoxication pathway and from a chat I had with Jenny. I'll do a Kryptopyrolle test soon.
- The dopamine connection : Basically this is because lots of SD is found in Parkinson disease. So I have read multiple testimonies of people curing there SD by using stuff like Cabergoline, which is a D2 agonist. So basically lack of dopamine would cause SD. But I guess that using D receptor agonist wouldn't "cure it" but still worth to investigate. I have just run a urinary neurotransmetters test to see what my D levels are.
- The streptoccocus/bile acid connection : This is from Dr Ely. Basically, Psoriasis (which is cousin with SD, can be also Sebopsoriasis) comes from Peptidoglycans migrating through the gut (classic) but specifically from streptoccocus. Psoriasis (SD) sufferers have low bile acid in the bile, thus they do not work as they should (cutting LPS into pieces). He recommends to kill the strep, taking bile acids and Quercitin (blocks LPS absorption)
Links : https://nextstepsinderm.com/derm-topics/healing-the-gut-to-treat-psoriasis/
https://www.jaad.org/article/S0190-9622(15)01133-0/fulltext#relatedArticles
So here we are ! I do feel that there is a liver connection. I have done 16 liver flushes because when you do it you basically get rid of bile as it mixes with the oil mixture that you ingest going through a sort of saponification process, thus you're eliminating it and bypassing entero hepatic circulation. Sometimes, after such flushes I would have some improvment of the skin.
So I wonder if it was because I was getting rid of toxic bile and/or because I was flooding the gut with bile, thus even with less bile acid in it it could still diminish the LPS load. IDK.
I would appreciate any long term persistant SD sufferers to chyme in and share about the subject. Thanks !
Here is the ALDH theory :
OK so the "basics" of seb derm seems to be that it may be caused by a yeast called malassezia. The yeast is a normal inhabitant of the skin that feed from the fats produced by the skins sebaceous glands. They feed on the saturated fatty acids and excrete the unsaturated fatty acids along with some toxic byproducts. The unsaturated fatty acids and toxins are reabsorbed into the skin where they cause an immune reaction.
Other potentials causes seems to be multiples, like : "In children, excessive vitamin A intake (aldehydes load?) can cause seborrheic dermatitis. Lack of biotin, pyridoxine (vitamin B6) and riboflavin (vitamin B2) may also be a cause. Also, "There is evidence that there is relationship between seborrheic dermatitis and intestinal yeast, such as candida. An antifungal diet consisting of the elimination of sugar should reduce seborrheic dermatitis."
So we have a couple of possible causes. I have to say that I've been into the candida rabbit hole and it never seemed to help. I don't believe much in the theory at all but I might be wrong.. But it's interesting when you try to connect things.
So Candida is a yeast that inhabits the intestinal tract of most all humans. Usually it's harmless and kept in check by friendly bacteria like acidophilus and bifidus bacteria. Candida lives by fermenting sugar which it turns into acetaldehyde. Acetaldehyde is also produced as a intermediate step in the breakdown of ethanol (the alcohol in beers, wines and liquor) by alcohol dehydrogenase (ADH)
Acetaldehyde is eventually converted into acetic acid by aldehyde dehydrogenase (ALDH) but it causes a lot of damage while it hangs around as everyone know in this network. Activating aldehyde dehydrogenase to metabolize acetaldehyde consumes NAD (the active form of vitamin B3) and zinc. It binds strongly with Acetyl Coenzyme A (the active form of vitamin B5). It binds strongly with P5P (the active form of vitamin B6).
So we have a pretty solid link from candida/aldehydes load to vitamin B deficiencies which were listed as possible causes of seborrheic dermatitis. But what's the connection to that yeast called malassezia that was also a pretty solid cause to seborrheic dermatitis?
It also looks like ALDH deactivates something called delta-6-desaturase. To create more delta-6-desaturase the body needs B6, zinc and magnesium. Since acetaldehyde depletes B6 and zinc somebody with a lot of acetaldehyde is going to be deficient in delta-6-desaturase.
And guess what ? It looks like delta-6-desaturase converts saturated fatty acids to unsaturated fatty acids in the sebaceous glands (https://pubmed.ncbi.nlm.nih.gov/12713571/)
So the lack of it would mean MORE saturated fatty acid on the skin for malassezia to feed on.
So we've got candida/aldehydes load to vitamin B/zinc deficiencies to (possibly) excess saturated fatty acid production in the sebaceous glands. And we know that malassezia feeds on saturated fatty acids which could lead to an overgrowth and the inflammation of the skin that we know as seborrheic dermatitis.
Great theory but does it hold up? If it does we'd expect a few things right?
1) Seborrheic dermatitis should be a side effect of chronic alcoholism since they are getting a lot of acetaldehyde from the metabolism of ethanol. It is - check.
2) Alcohol should exacerbate seborrheic dermatitis because they would be getting a double dose of acetaldehyde. It def does - check.
3) Infants seem to lack full delta-6-desaturase activity until about six months after birth. We should commonly see seborrheic dermatitis in infants under six months in age. Seborrheic dermatitis in infants is commonly known as cradle cap and "resolves itself in a few months." - check.
4) Candida often takes over the digestive tract after friendly bacteria are destroyed after a treatment of antibiotics. Many people with seborrheic dermatitis should be able to trace their initial symptoms to a antibiotic course - it seems to be the case tho it was not for me.
5) Things that clear acetaldehyde from the body should help seborrheic dermatitis. For instance NAC, B1 and C are supposed to help clear acetaldehyde (hang over treatments) - I have not experience with NAC but I have tried C and B1 without success. If anyone have antidote against ALDH I'm curious to know them ? I have read testimony of people taking high dose NAC to keep there SD in check.
6) Immune suppressed people are more likely to develop candida. Seborrheic dermatitis should be common. Seborrheic dermatitis is one of the most common skin manifestations of AIDS - check !
7) Sugar free/low carb diets should reduce the symptoms of seborrheic dermatitis. I have verify that myself, tho it seems that it does not last as it's a bandage and will worsen overtime. - check, and as I was looking at the Ray Peat forum (sugar crazy) it seems that A SHIT TON OF THEM developp SD on this diet.
8) Stress depletes B Vitamins so stress should cause flaring of seborrheic dermatitis. Stress does tend to aggravate the condition - check.
I have jumped into the candida rabbit hole multiple time and it never did a thing. I guess that candida isn't the only species that can "produce" ALDH and maybe some other bacteria/yeast etc can ? If anyone have info on that I'd love to hear it.
MOLD can produce similar acetaldehyde byproduct. And anything that would increase aldehydes thus ALDH work's load could be the culprit. Again, liver...
Just revisiting this useful thread @mat to add in some of my recent observations.
When I was very vA toxic I had skin reddening. I thought it might be rosacea but I never really knew. Looking at pictures of seborrheic dermatitis I wonder if that was what I was developing. Anyway it wasn’t bad and it went pretty soon into the vA detox.
Since getting covid I’ve had this symptom back. Covid (I’m now convinced) involves a dump of retinoids from the liver (see Anthony Mawson paper) and since getting covid I’ve had various high vA symptoms again. I suspect I have ALDH overload again. Then last week I went to my SIL and drank too much wine (yes I know stupid of me!). My skin flared up. This time the red patch next to my nose has stayed. I thought about your theory Mat. This would seem to fit with it. Overload of aldehydes (vitamin A and alcohol) and a slow ALDH.
I’ve been looking at the NADPH steal (see thread of this name) as I think that a lack of NAD could be another factor for a slow ALDH. Anything that stimulates NOX (many things) could drain NAD out of the system.
Just wanted to say I think your ALDH theory is very valid. Supporting ALDH, reducing aldehyde overwhelm, reducing NOX, supporting delta 6 desaturase would all seem sensible things to do.
I personally think that B6 deficiency is a huge problem, it connects many dots for me - it’s required to make de novo NAD, it’s required to turn glutamate into GABA (excess glutamate stimulates NOX and steals NADPH), deficiency increases oxalates (that stimulates NOX), required for delta 6 desaturase, required for sulphation etc etc. Lack of B6 throws a big spanner in human metabolism. Depleted by many things, including aldehydes, pyrroles.
Getting covid has been a pain for me as I was doing a nice slow detox and covid has thrown a load of toxicity out at once. However, by recreating acute vA toxicity, it’s allowed me to get clarity on a number of issues. Conclusion - I think aldehydes and slow ALDH and the knock on effects of this could well be behind seborrheic dermatitis.
Edit: I think that low NAD due to slow production and/or the NADPH steal by NOX could be a huge driving force for slow ALDH. I just thought, ‘I wonder if long covid involves low NAD?’. I’m not the only person to consider this. https://nkalex.medium.com/the-team-of-front-line-doctors-and-biohackers-who-seem-to-have-solved-long-covid-5f9852f1101d
Hi @mat,
Excellent thinking and research. I'm now three years into a low vitamin A diet. Seb derm has been a major complaint for me and I've discussed my thoughts about it on this forum over the last few years. Do you know about hydrogen peroxide? It can be helpful to control seb derm until you cure it.
Hypervitaminosis A significantly harms both gut and liver health, it depletes all B vitamins, it messes with D receptors, it disturbs hormone balance and more so yeah it definitely causes seb derm. Over the last three years on a low vitamin A diet I've seen a consistent decrease in seb derm to the point where it's almost non existent.
I think your ALDH theory is interesting but here's a problem: Why is seb derm patchy? Malassezia appears to thrive in high sebum areas but for those with seb derm some high sebum areas are often unaffected by seb derm. We know what retinoic acid peels do to the skin. I've speculated that elevated levels of retinoic acid in the skin could cause increased skin cell turnover. When this occurs in high sebum areas this could send malassezia into a feeding frenzy resulting in inflamation and seb derm. Whatever the cause is though, Hypervitaminosis A is at the very least one of the main causes of seb derm. Infants often have Hypervitaminosis A. As a side note acetaldehyde is less toxic than formaldehyde which is significantly increased when we consume large amounts of foods containing pectin (fruit, vegetables and legumes). Agreed though, very important to get gut health in check. I had SIBO when I started a low vitamin A diet which is now cured. I took SIBO herbs which were very effective but I haven't taken any for a long time and I'm confident that a low vitamin A diet has enabled my gut function to heal.
I'm not supporting the use of it but taking thyroid hormone will speed up vitamin A depletion.
Liver flushes can be very helpful and I believe it's due to eliminating large amounts of bile. I'm wary of them though due to the "stones" that get formed during the flush, for some these "stones" can cause intestinal stress and blockages. It's worth noting that emetics have been historically known for their powerful healing effects.
@jaj Thank you for your observations. We also are suffering from increased vA detox after Covid. When we thought we were going to slower detox, this hit us hard. The low NAD is probably right. In fact yesterday we took 100 mg niacinamide I had and 20 mns later we felt a bit better, and slept very deeply afterwards. We are going to keep it up for a month to see how it goes. I just ordered nicotinic acid because the link you provided favours it over niacinamide.
@tim-2 Interesting to know that thyroid hormone will speed up vitamin A depletion. I would not touch it though, because all the people I know who take it have turned into nasty egoistical people! Baffling but true, and every time it happened in less that a month so this group effect was very visible. Losing our vA does not make us nasty, on the contrary so it must be something else.
As to liver flushes, we did more than 50 more than 5 years ago. Now they do not produce any stones at all so I don't know if they are a good idea for now.
We did this over 2 or 3 years. It seemed to help until it did not. At the same time we started to eat more and more vA foods. In fact we more than compensated the vA loss with concentrated vA foods. So really I don’t know if the well being from the liver flushes was not in fact a well being from eating more vA.
Anyway now we cannot produce stones at all. The good news is that today we took more niacinamide and don’t feel too bad!
@ourania sorry to hear you’ve had covid too. It’s a real blip on our vA detox journey imo. I’ll be interested to hear how the niacin (nicotinic acid) supplementation goes. After finding the NAD deficiency theory of long covid (by coming to that conclusion myself!) I’ve listened to a lot of Youtube videos by this person.
https://youtu.be/ZFPleh6z7io
It makes a whole lot of sense to me. It connects to the NADPH steal work by Bob Miller. In fact it connects up a lot of stuff. I think that NAD deficiency could be a MAJOR issue for many of us even without covid.
The long covid/NAD deficiency people don’t know about the vA toxicity connection. They don’t know about Anthony Mawson’s work on covid causing a retinoid dump. This would add into the system a lot of vA demanding NAD for ALDH activity and imo would be another factor driving this deficiency (from my observations).