Derm Dispatch: What 'Free to Be Me' Means to Tori Spelling and Stella McDermott

A recent Derm Dispatch episode hosted by Renata Block, DMSc, MMS, PA-C, featured an in-depth discussion with Adam Friedman, MD, FAAD, alongside actress Tori Spelling and her daughter, Stella McDermott. Their dialogue illuminated both the clinical complexity and the profound psychosocial impact of atopic dermatitis (AD) and seborrheic dermatitis (SD), conditions affecting more than 26 million and 10 million Americans, respectively.

Spelling’s account reflects a pattern familiar to clinicians: delayed recognition and underestimation of disease severity. She shared, “Eczema is the one thing I have not shared publicly… I really believe it's because I felt shame behind it.” Her symptoms emerged in adulthood during a period of significant stress, consistent with known exacerbating factors. Stress-triggered flares, pruritus preceding visible skin changes, and the evolution from subtle itching to overt lesions align with the diagnostic variability Friedman emphasized during the episode.

Dermatitis diagnoses remain clinical, requiring careful attention to disease morphology, distribution, chronicity, and patient narrative. As Friedman noted, “It captures so many huge clinical nuggets… because remember, this is a clinical diagnosis.” He highlighted the appearance of eczema—varying by age, location, and skin tone—underscoring the need for clinicians to actively solicit patient histories rather than rely solely on visual presentation.

Stella’s experience adds a pediatric and adolescent perspective. Early childhood onset, significant pruritus, and treatment fatigue from rotating topical corticosteroids reflect long-standing challenges in managing chronic disease with limited therapeutic diversity. Her comment about years spent concealing her condition—“My whole life I tried to hide it and not talk about it, when it does [exist]”—reinforces the psychosocial burden clinicians must consider, particularly in younger patients.

The conversation also touched on evolving treatment paradigms. While the family described positive experiences with a newer steroid-free topical therapy, their story primarily underscores a broader clinical shift: an expanding armamentarium that enables individualized, long-term management beyond chronic corticosteroid use. Friedman contextualized this evolution, emphasizing that while topical steroids retain a role in acute care, modern disease-specific topical and systemic options now support sustained control with improved safety profiles.

For clinicians, this interview serves as a reminder of the importance of validating patient experiences, probing for functional impacts, and offering an updated evidence-based roadmap for disease management. Beyond visible inflammation, AD and SD influence self-esteem, daily activities, and quality of life—dimensions that must remain central to comprehensive dermatologic care.