At the 2024 Paris Olympics, Simone Biles was doing what she has always done: performing gymnastics at a level no one else in history has reached, in front of a global television audience of millions.
What almost nobody watching knew was that she was also quietly terrified the cameras would catch something else.
“At the Olympics, I was flaking everywhere, so I was afraid that someone would see it on the TV,” Biles told People. “That’s why I finally went.”
For more than two years, the most decorated gymnast in history had been living with an itchy, flaking scalp and irritated patches of skin that she assumed were ordinary dandruff. The reality was two separate chronic inflammatory skin conditions that went undiagnosed while she trained for and competed at the highest level of her sport.
This year, Biles finally received a diagnosis. Now she is talking about it publicly for the first time, and her reason for doing so is straightforward: she does not want other people to wait as long as she did.
What Simone Biles Was Actually Diagnosed With
Biles received a dual diagnosis from a dermatologist in Chicago: seborrheic dermatitis affecting her face and scalp, and eczema affecting her arms.
These are two distinct conditions, though they are related. Both fall under the broader umbrella of eczema, which is not a single disease but a group of chronic inflammatory skin conditions.
The eczema on her arms is atopic dermatitis, the most common form. It damages the skin’s protective barrier and causes dry, inflamed, itchy patches. The seborrheic dermatitis on her face and scalp is a different type, one that targets oily areas of the body and is associated with an overgrowth of Malassezia, a yeast that lives naturally on everyone’s skin.
Having both at the same time is not unusual. According to dermatology sources, a person can have seborrheic dermatitis on the scalp while atopic dermatitis affects the arms or legs, which is precisely the pattern Biles describes.
Simone Biles Details ‘Miserable’ Skin Struggle That Made Her ‘Bleed’ Before Diagnosis (Exclusive) https://t.co/1NIRAYgq3A
— People (@people) September 29, 2026
Understanding the Two Conditions
| Atopic Dermatitis (Eczema) | Seborrheic Dermatitis | |
|---|---|---|
| Where it typically appears | Arms, legs, skin folds, hands | Scalp, face, eyebrows, areas rich in oil glands |
| What it looks like | Dry, inflamed, itchy patches; red on lighter skin, purple or dark brown on deeper skin tones | Flaky, scaly, sometimes greasy patches; can look like dandruff |
| Associated cause | Damaged skin barrier, genetics, immune response | Linked to Malassezia yeast overgrowth, plus genetics and other factors |
| Always itchy? | Yes, itching is a defining feature | Not always, though it frequently is |
| Contagious? | No | No |
| Curable? | No, but manageable with treatment | No, but manageable with treatment |
Crucially, neither condition is an infection and neither is contagious. Dr. Angela Lamb, the dermatologist working alongside Biles on her awareness campaign, has been emphatic on this point, noting that sharing a comb, a bed, or a pillow will not transmit either condition.
That misconception hit close to home for Biles. According to People, her husband, NFL player Jonathan Owens, initially raised contagion as a concern before the couple educated themselves about the condition.
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Years of Misreading the Symptoms as Dandruff
Biles first noticed itchy, flaky red patches on her scalp and skin a little over two years ago, according to her interview with TODAY.
Because the flaking was concentrated around the crown of her head, dandruff was the obvious assumption. It is also the assumption most people make, and it is precisely why seborrheic dermatitis so often goes undiagnosed. Mild seborrheic dermatitis on the scalp is, in clinical terms, what most people call dandruff.
She and her hairstylist tried working through it themselves. Over-the-counter products. Various oils. Nothing resolved it.
“I was kind of in denial, so I did a lot of over-the-counter stuff,” Biles said. She also acknowledged a reason that will sound familiar to many people: “I didn’t go to the dermatologist immediately because I’m so busy.”
The symptoms escalated while she trained for the 2024 Paris Games. In her interview with People, she described how bad it became.
“I was itching and flaking. I would itch so hard and use a comb that I would bleed. I was just like, ‘I can’t live like this. I’m itching. I’m miserable. I feel uncomfortable. I need to see someone who can give me relief.’”
The itching followed her into the gym. “I would definitely be in the gym, finding myself waiting for bars or for beam and just scratching and scratching, and people would be like, ‘Simone, can you stop scratching?’ and I’m like, ‘Oh, yeah, my bad, sorry.’”
Dr. Lamb has noted that the delay carried real risk. Scratching a scalp until it bleeds creates an opening for infection, and she pointed out that Biles was fortunate not to develop one.
The Emotional Weight of an Undiagnosed Skin Condition
One of the more striking parts of Biles’ account is not the physical discomfort but the emotional response to it.
She told TODAY she initially felt “embarrassed and ashamed.” She avoided addressing the visible changes to her skin. During the Olympics, the anxiety was not only about the itching but about being seen, about whether a broadcast camera would capture the flaking in high definition in front of a worldwide audience.
That reaction is extremely common among people with visible chronic skin conditions, and it is one of the main reasons diagnosis gets delayed. Shame keeps people from seeking help, the condition worsens without treatment, and the worsening deepens the shame.
Biles has said that learning what was actually happening rebuilt her confidence. Understanding the condition removed the sense that it was somehow her fault or a hygiene failure.
Why Diagnosis Often Takes Longer for People With Deeper Skin Tones
Biles and Dr. Lamb have both highlighted an aspect of this story that goes beyond one person’s experience.
Dr. Lamb pointed out that data shows delays in diagnosis, and greater severity at the point of diagnosis, are higher among people with more melanated skin. She attributed much of this to people not seeking treatment.
There are additional reasons this happens. Both conditions present differently on deeper skin tones. Atopic dermatitis that appears red on lighter skin may appear purple, dark brown, or ashen on darker skin, which can make it harder to recognize, including for clinicians less experienced with diverse presentations. Seborrheic dermatitis can also cause areas of increased or decreased pigmentation in more pigmented skin.
Standard treatment advice can also miss the mark. The National Eczema Association notes that some medicated shampoos commonly recommended for scalp seborrheic dermatitis are not well suited to people with tightly coiled hair, meaning the default advice may not be practical.
Dr. Lamb described Biles’ visibility as valuable for exactly this reason: a widely recognized Black woman discussing these conditions openly may prompt people who have been quietly managing symptoms to seek professional care.
How Biles Manages the Conditions Now
Biles now uses prescription topical treatments for both conditions, a foam formulation for her face and scalp and a cream for the eczema on her arms. Both are products made by Arcutis Biotherapeutics, the company partnering with her on her awareness campaign.
Outside of the prescription treatments, she has described keeping her routine deliberately simple. She told TODAY she maintains a minimal skincare regimen “in a healthy way,” structured around basic daily steps: wash her face, do her skincare, do her scalp care. She also generally avoids perfume to prevent irritating her skin.
It is worth being transparent about the context here. Biles is a paid partner with Arcutis Biotherapeutics on the Skin to Believe In campaign, and the products she references are that company’s. That does not make her personal account less real, but readers should understand the commercial relationship and should not treat any specific product mention as medical advice for their own situation.
General Flare Triggers to Be Aware Of
| Trigger | Why It Matters |
|---|---|
| Stress | Widely reported to trigger flares in both conditions |
| Extreme weather | Cold, dry conditions and heat can both aggravate symptoms |
| Fragrance and irritants | Perfumes and harsh products can worsen irritation |
| Sweat and friction | Relevant for athletes and anyone training regularly |
| Certain hair and skin products | Some formulations aggravate symptoms, especially on the scalp |
Anyone experiencing persistent symptoms should speak with a dermatologist rather than self-treating, which is the central message Biles has been repeating.
The Skin to Believe In Campaign and Why She Went Public
Biles has partnered with Arcutis Biotherapeutics on a campaign called Skin to Believe In, which encourages people living with inflammatory skin conditions to talk to a doctor about their symptoms rather than continuing to manage alone.
The scale of the issue is substantial. Roughly 31 million Americans live with eczema, and campaign materials cite approximately 36 million Americans living with inflammatory skin conditions including seborrheic dermatitis and eczema. Seborrheic dermatitis alone affects an estimated 3 to 12 percent of the population.
Her framing of the message has been consistent across interviews.
“Once we know that we can’t fix every problem on our own, it’s okay to get help,” she said.
And more bluntly, on the practical barrier that kept her from going for two years: “You just have to make the appointment.”
For an athlete whose public identity has been shaped in recent years by her willingness to speak honestly about mental health, the parallel is hard to miss. In Tokyo in 2021 she prompted a global conversation by prioritizing her wellbeing over competition. This is a smaller story in scale, but the underlying message is recognizably the same one: struggling quietly is not strength, and asking for professional help is not weakness.
Frequently Asked Questions
What skin condition does Simone Biles have?
Simone Biles has been diagnosed with two conditions: seborrheic dermatitis on her face and scalp, and eczema, specifically atopic dermatitis, on her arms. Both are chronic inflammatory skin conditions. She received the diagnosis from a dermatologist in Chicago earlier in 2026.
Is seborrheic dermatitis the same as eczema?
Not exactly. Eczema is an umbrella term for a group of chronic inflammatory skin conditions, and seborrheic dermatitis is one type within that group. The most common type is atopic dermatitis. Seborrheic dermatitis typically affects oil-rich areas like the scalp and face and is linked to Malassezia yeast, while atopic dermatitis typically affects areas like the arms and is associated with a damaged skin barrier. A person can have both at once, as Biles does.
Is eczema contagious?
No. Neither eczema nor seborrheic dermatitis is contagious, and neither is an infection. Dr. Angela Lamb has stressed that sharing combs, bedding, or pillows will not transmit either condition. This is a common misconception, and one that Biles said her own husband initially held.
How did Simone Biles find out she had eczema?
She first noticed itching and flaking a little over two years ago and assumed it was dandruff. After over-the-counter products and oils failed and symptoms worsened during her training for the 2024 Paris Olympics, including scratching her scalp until it bled, she saw a dermatologist in Chicago who diagnosed both conditions.
What triggers eczema flares?
Common triggers include stress, extreme weather conditions such as cold and dry air, fragrances and chemical irritants, sweat, and certain skin or hair products. Triggers vary from person to person, which is one reason a dermatologist’s assessment is useful.
Can eczema and seborrheic dermatitis be cured?
Neither condition currently has a cure. Both are chronic, meaning they are managed rather than eliminated. However, effective treatments exist, and dermatologists can help develop plans to reduce flares and control symptoms long term.
What should someone do if they think they have these symptoms?
Speak with a healthcare provider or dermatologist. The National Eczema Association suggests that if symptoms persist longer than about two weeks, it is worth discussing treatment options with a professional. Delays in diagnosis can allow conditions to worsen and, in cases involving broken skin from scratching, raise the risk of infection.
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Last Updated on September 30, 2026 by 247 News Around The World
