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This. We need way more information to understand what's going on here.
Are you 100% sure you do not have eczema, psoriasis, acne, or atopic dermatitis? If you do one of the standard treatments is phototherapy. Specifically UV phototherapy. The dose and spectrum are carefully controlled, but blocking 100% of UV may not be doing yourself any favors, given you seem to have some sort of condition. Of course UV can also damage your skin and cause skin cancer, so finding a knowledgeable dermatologist is highly recommended over blasting yourself with sun.
If you want to add another random item to your list though, some people report good results with dandruff shampoo. Like regular 2-in-1 classic head and shoulders. Just using it as body and face wash 1-2 times a week. Lather up, let dwell for 30-90 seconds, and rinse.
I have recently started to explore autoimmune issues as a causal mechanism. Reasoning: I had bad eczema on my legs as a kid, have had psoriasis in the past, and my mother has a ton of weird allergy issues (allergic to penicillin and aspirin, was on daily antihistamines for 10+ years, now goes in for monthly antihistamine shots). I went to an allergist for the first time a few weeks ago and confirmed with tests that I'm allergic to cats and tree pollen, plus based on my description to her, I'm certainly allergic to hot showers (make my whole face turn red and swell up). The doctor speculated that I was allergic to dust, but my tests were negative. Next month I'll do a skin test where they put thingys on my back for 4 days and I can't shower.
But I don't think autoimmune is the central cause. My skin looks more like it's been put through the ringer by standard acne, with underlying irritation exacerbating it.
I will look into this. I used to use Head and Shoulders daily, but due to the irritation caused by even lukewarm showering, I have cut back on my showering to once every 3ish days (I work from home, don't interact with people a lot).
What is the proposed mechanism for how it would help facial skin? Antifungal?
Looking at other Urticaria, once you get past antihistimines and phototherapy, I've seen some suggested treatments as biologic omalizumab, steroid medications, or selective serotonin reuptake inhibitors (!?).
I'm not a medical practitioner at all, but the allergy to warm water seems like something that's pretty pertinent in figuring this out. Your skin is hypersensitive and the root cause of that hypersensitivity is possibly linked to your acne.
I had stress related psoriasis once that went away after dealing with the underlying cause. Is there a possibility that the sensitivity is psychosomatic (in other words linked to stress or other mental health issues)?
I told my allergist about my hot shower response and she diagnosed me with cholinergic urticaria, but didn't say much else except recommending Claritin when I shower. On its own, it's annoying, but not a huge deal. Hell, hot water is generally considered bad for facial skin anyway, so it served as a little extra incentive to embrace cooler showers.
However, on the off chance this allergic response is connected to something bigger, I'm going to press my allergist during my next appointment. Maybe it's worth getting one of those mega antihistamine injections just to see what happens to my face. Honestly, HOPE my facial skin problems are related to my allergies, because that's so much easier to solve. Wouldn't it be amazing if the root of my problems was an allergy to some random fucking environmental thing that I can avoid or crush with antihistamines? But that's probably wishful thinking beyond the rosacea.
I won't say a psychosomatic role is impossible, but I tend to be skeptical. Besides, I beat my psoriasis with cortisone (that stuff kicks ass).
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Wait a sec, that seems a lot for a guy who has all these skin problems. I’m sorry for the ‘have you tried turning it off and on again?’ question, but have you tried using mild/no soap?
Yep, I've tried going full caveman mode where I use nothing but a light moisturizer, and I've tried going hardcore "throw everything at my face and see what happens." I'm one of those people who is constantly caught in the see-saw between the two extremes. If I go minimalist, I get back acne; if I go maximalist, my skin gets irritated and worn out. I've never been able to maintain a good balance between the two for more than maybe a 6 month period.
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Yes, the active ingredient, pyrithione zinc, is supposed to be anti-fungal. I think people are pretty sure it works for fungal acne, though I suspect it also helps with random dryness and itchiness. What causes dandruff after all, if not scalp dryness.
Edit: Personally, Head and Shoulders every day is too harsh for me. I also see you did mentioned acne in a different part of the thread. I think the other common remedy people try, not already on your list, is changing your pillow case every night or every other night. Some people use a fresh towel to wrap their pillow every night. If you have acne from oily skin, it's supposed to help keep your skin oils from clogging pores while you sleep. Fortunately I've never needed to try it, so no first hand experience on that one.
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