January 2018. Different dermatologist's office.
Not my old one who just kept prescribing steroids.
New guy. Dr. Patterson.
"What do you think causes your winter flaking?" he asks.
"Dry air from heating," I say. "That's why I use moisturizer. But it doesn't help."
He leans back.
"Want to know the real reason?"
I nod.
"A yeast. Malassezia. Lives on everyone's skin. But on you, it's out of control."
Wait. A yeast?
"Yeah. And here's the interesting part: this yeast loves warmth and moisture. Know what happens in winter?"
I think.
"Hats," I say.
"Exactly. Hats. Scarves. Heated rooms. You sweat under your beanie, then walk into a warm bar. For the yeast, that's like a five-star resort."
He shows me a study.
35.3% of all seborrheic dermatitis cases are diagnosed in winter.
Not because skin is too dry.
Because the yeast has perfect conditions.
"But," I say, "I moisturize. I use oils and everything."
Dr. Patterson nods.
"That's exactly the problem."