I guess that goes to show that sometimes you have to start digging around the internet for solutions when your own dermatologist can’t do his job! I’ve read countless times that the prolonged application of hydrocortisone is a bad idea, so that doesn’t give me a whole lot of faith in your dermatologist, I’m afraid. Tell him that it doesn’t work and that you want an alternative.
I’m happy to hear that the sea water treatment is working out for you. It’s such a relief to make some progress. I also recommend going to Palawan to get the full-on sun & saltwater treatment! That cured me while I was there
I haven’t hear about DermaZinc but it sounds like something that might work. I guess it has zinc pyrithione like my shampoo and head&shoulders. Generally, I’ve heard good things about that, but for me it didn’t change my face, and my scalp wasn’t really cured until I started using nystatin on my face: Only then did I get rid of the whole thing - it’s sort of weird actually.
I never tried exfoliants, so I’m not sure about it, but I had bad experiences trying to cleanse my way out of the flare-ups. It might just give the Malassezia yeast more room or better conditions, I’m not sure - but it probably wont kill it like your aiming for. Unfortunately.
But if both things are over the counter you might as well try them out. I had to go through a lot of trial and error, but it seems that a lot of people find different solutions, so DermaZinc or BHA might be it for you. I just recommend nystatin, since that worked for me. Other anti-fungals might work to the same extent, so if you cant find nystatin specifically, it might be worth giving something like sertaconazole or miconazole a shot. But now we’re getting to that part again, where I’m passing medical advice like I’m a doctor - which I’m not. I haven’t had experience with sertaconazole or miconazole, but desperate times calls for desperate measures. At least they’re some alternatives that you can discuss with your dermatologist.