Seeking Clarity: Chronic Scaling from Ears to Face..Is it SebDerm, Psoriasis, or Something Else?

Since childhood, I’ve had a very small patch of scaling under my ears that was easy to remove and would completely improve with an ointment that combined cortisone and an antifungal. Sometimes it would disappear for months. It never affected my life until my mother insisted that I see a dermatologist at age 18. Before that, I had used some tar on my ears. He prescribed a mild cortisone for a short period, but I didn’t follow the plan and stopped after a few days.

At that time, I was obsessed with washing my face several times a day with a harsh soap. Scales appeared on my eyebrows and on one side near my nose. My skin became very dry, and so did the skin on my hands. I went back to the dermatologist, who prescribed a stronger cortisone for several months. Because I had read about its side effects, I didn’t complete the treatment and stopped after a month.

At 19, the scaling on my ears came back, and this time it appeared inside them as well. As for my face, there were no clearly visible scales, but I felt dryness or a rough texture when I touched my forehead and cheeks near my nose. Some pimples also appeared in those areas, so I increased the frequency of washing. Then I went back to using a mixed ointment containing cortisone, antifungal, and antibacterial agents. I would improve for a few weeks when applying it once or twice, then stop completely. However, that rough texture continued to spread across my entire face. My family found it strange when I complained because they couldn’t see anything.

Later, I used ketoconazole, and this time the scales appeared soft, white, and easy to remove. I then visited another dermatologist who initially said it was psoriasis, but then changed his opinion and said it might be seborrheic dermatitis. He prescribed a cortisone ointment for my face, ears, and hands, as well as pills, without specifying how long I should use them. He said that if I didn’t improve, I should use Soriatane.

I didn’t follow the treatment plan again because I developed red pimples due to the pills. I only used a moisturizer on my hands, and they returned to normal except for the upper half of the palm of my right hand, which looks somewhat dry and slightly wrinkled, as if I had just taken it out of water.

As for my scalp, it is completely fine. Occasionally, small rings or scales appear in the upper chest area. I once used 1% ketoconazole shampoo and they disappeared, but they sometimes come back, maybe once every six months.

I don’t know what I should do. Should I commit again to the last dermatologist’s plan, see another dermatologist, or what?