Sunday, December 13, 2009

What This Hideous Rash on my Face Taught Me

This October I developed seborrheic dermatitis on my face. I’ve had it before, to varying degrees, and each time it returns I feel a renewed sense of dejection. It’s angry and red and it spreads, like spilled ink, from the corner of my nose. Sometimes it spills down my chin. Once, for a brief time, I had it on my entire face. Hemingway had something like it; this is how his buddy, the novelist and journalist José Luis Castillo-Puche, described it:

“The angry red streak running from his nose to his cheek, the rash of little whitish pustules that sloughed off like dandruff…the bright red patch, extending from the bridge of his nose almost down to his mouth and up to his eyes.”


I developed seborrheic dermatitis for the first time as an adult when I returned home from my honeymoon in Barcelona, freshly diagnosed with type-1 diabetes. It was a rough time. The dermatitis seemed to know this; it stuck around for the better part of two years, a glaring symbol of my new life with illness. I tried everything: Elidel, steroid lotions, EFT. It just got worse.

When the dermatitis finally spread to my face, I went into Whole Foods and spent nearly $100 on a natural skincare regime from MyChelle Dermacueticals. It cleared, finally. When I met the founder and creator of MyChelle, Myra Michelle Eby, a year later at a Natural Products Expo in D.C., I burst into tears.

"Thank you,"  I said, embracing her.

(I still think MyChelle is the best skincare line in the world, although, as you will see, my seborrheic dermatitis cure promotes a hands-off approach).

Unfortunately, in my experience, seborrheic dermatitis shares a distinctive feature of many autoimmune illnesses: It comes and goes, sometimes independent of treatment; and often each relapse requires a new, novel form of treatment.

The rash returned last winter. I was in Asheville at the time, at my residency session for my MFA program. I was living in a dorm. I was especially sensitive to my appearance at the time because James Franco had just enrolled in the program. I remember walking into the reception the very first night of the residency. I had taken a Percocet (the beginning of residency was always an especially anxious time). I saw James. Jesus, I thought, that guy is handsome. Later I walked into the bathroom and looked in the mirror. Jesus, I thought, investigating my dermatitis, I'm ugly.

One night we had a long face to face discussion. We talked about Emily Dickinson, kissing Sean Penn, and my skin problems. James, a perfect gentleman, stopped the conversation twice to say, “Dude, I don’t even notice it.”

Equating my dermatitis with Harry Osborn’s horribly burnt face in Spiderman III, I asked James what it was like for a handsome man to appear so disfigured on screen.

“Dude,” he said. “It was Spiderman.”

Last winter's outbreak was minor. I came home from Asheville and took hydrocortisone (a steroid cream). The dermatitis cleared up in a week.


This recent outbreak was different. When I first noticed it, in early October, I again tried the hydrocortisone. It worked, at first, but then it seemed to start spreading.

I looked in the mirror and felt ugly. I thought: It will never go away. I complained, unfairly, to my wife (who herself suffers psoriasis).

Days and weeks lapsed without my consent. I started to lose my optimism; my integrity eroded. I ignored my reliable faith in natural healing. Instead, I sought pharmaceuticals: Desonide, a steroid cream. The cream worked, at first, but then my dermatitis got WAY worse. Hemingway bad.

Apparently, if steroids are used too long, you develop additional skin problems. I learned the hard way.

Throughout this time, in the immemorial fashion of frantic sick people, I searched the internet for a “cure.” The internet is a terrible place to look for a “cure.” Balanced perspectives on skin problems are shockingly rare. Message boards are crammed with pessimistic complaints. Thousands of sites suggest miracle cures that simply do not work. Worse, drug companies pay massively for advertising.

Still, inspired by my internet findings, I washed my face with Selsun Blue. That helped a bit. I actually tried tanning! (In an electronic ballast tanning booth; finding the booth was an incredible hassle.) That helped a bit until I developed a secondary rash on my stomach.

I visited my family doctor. He said, "Quit the steroid lotion. Problem solved."

"Really?" I asked.

I urged him to prescribe another pharmaceutical treatment, one that I had assiduously researched: Nizoral foam.

Nizoral is a potent anti-fungal. When ingested, it has been associated with hepatic toxicity, including some deaths. The foam worked, a bit. Then, once again, my dermatitis got worse.


In his life-changing, soul-changing book, Re-Visioning Psychology, James Hillman writes, “We owe our symptoms an immense debt. The soul can exist without its therapists, but not without its afflictions.”

I’m reminded of this quote when I suffer illness. I’m reminded of my sulking; my complaints. And I’m shocked, almost appalled, by my behavior. Sometimes, in the midst of illness, I actually do realize that my suffering can be a good thing, for my growth and maturity and anti-narcissism. But still, illness bums me out. I mean I wake up after a restless night of sleep (I never, ever sleep well and typically I wake six-ten times a night to pee), check my blood sugar (the first test of ten or twelve tests for the day), and look in the mirror, only to discover I’m much uglier than my dreams had led me to believe!

This is the moment I lose my integrity.

I think: You know what, I have a fucking lot of illness for a 33-year-old guy; every person, every fucking single person in the world, sometimes hits the point where enough is enough, and, well, I’m entitled to say, “Enough is fucking enough,” because of my illnesses, because I’ve been through so much illness, so early, and no one, exactly no one, I know, understands what it’s like to be a 33-year-old guy living with type-1 diabetes, ulcerative colitis, Raynaud’s disease, and some fucking skin rash, not to mention I’m allergic to shellfish and have never even known the pleasure of slurping a fresh oyster!

It's funny, though. Standing in front of the mirror, I drive myself to this point—this point of extreme dejection—and then something small happens.

In my complaining, I catch a glimpse of myself as a child, a child throwing a tantrum. My behavior is laughable, really. So I smile, in spite of myself. Then I smile, again, just to see what I look like. I start making faces: ugly faces, happy faces, stupid faces. The dermatitis is still there, of course. But, suddenly, instead of complaining, I'm making fun or myself. And I suppose this is when my heart starts floating, just a bit; it sort of just bounces up, and I’m aware, however briefly, of the possibility of change.


Change. In terms of my recent battle with seborrheic dermatitis, change means relaxing; it means re-finding my integrity. It means taking a deep breath and considering the blindingly obvious.

I’ve successfully treated seborrheic dermatitis on my scalp for ten years. I’ve performed the same routine, two times a week, every week, for ten years. What I do is simple: I wash my hair. I apply about 1 tablespoon of extra virgin coconut oil. I leave it on for a few hours. I wash it out. Why not try it on my face? Seborrheic dermatitis often affects both the face and scalp and both areas manifest the same disease process.

Friday night, I rubbed a little extra virgin coconut oil on my face. Saturday, I woke up and my skin had improved. Last night, Saturday night, I repeated the routine. This morning I woke up my skin had essentially cleared. After weeks of suffering, after weeks of complaints and internet research, weeks of steroids and antifungals weeks of just feeling ugly—my skin had improved with two applications of extra virgin coconut oil.

(Update: I now believe that a permanent natural seborrheic dermatitis cure exists: yogurt masks. I have used nothing but water and yogurt masks on my face for over four years and my skin has remained remarkably clear. Please see my recipe on my post "Seth's Beauty Secrets Revealed").

The simplicity of it is absurd. Albeit, not as absurd as my behavior.

Illness is worthless unless you learn from it. My lesson, of course, has nothing to do with extra virgin coconut oil. More likely, it has something to do with maturity, how I might grow into that complicated, half-ugly, half-beautiful human being I'm meant to be. Probably, the goal is just a sort of unity. Obviously, I own a lot of ugliness, inside and out. But in my ugliness, I learn things. I learn about fighting. I learn about hope. Life handed me illness; it also gave me the capacity to fight. Life taught me the comeback. Moving on, I'll try to remember this.