Seborrheic Dermatitis Questions - Skin Problems Message Board

Ontarian · 07-15-2006, 10:48 AM

Hi.

I can't get my seborrheic dermatitis to go into remission. When I got it in 2001for the first time, it bothered me for two or three months and, then, it went into a complete (spontaneous) remision fo 5 full years. Amazing, eh? Unfortunately, the SD came back with a vengance in February of 2006 and has been getting worse ever since. Yesterday my right cheek (entire side of the face) was totally inflammed

, it was burning and itching like crazy.

These are the things that I've tried so far: Hydrocortizone cream 1%, T-Gel shampoo (containing tar), Nizoral (ketoconazole 2%), tea tree oil antiseptic cream, and apple cider. My SD seems to be extremely stubborn - nothing helps at all.

Since I am struggling to grapple with this disease, I need some answers from fellow sufferers:

1) Is it normal for SD to affect almost the entire side of the face?

2) Once a particular area of the face/body is affected, does it always remain affected? In other words, is the same area more susceptible to future inflammation after a remission than the area not currently affected by SD? In that sense, could SD be compared to eczema - once a particular area is affected, eczema tends to show up at the same location over and over again.

3) Has anyone with SD gone into a long spontaneous remission? As I said, my last "remission" seems to have been about 5 years long. That seems to be abnormal for SD, right? It seems to me that spontaneous remissions are more likely to help than any sort of shampoo, cream, lotion, etc. treatment. It is July now and I was expecting my skin to get much better. However, it is worse than it ever was, expecially after physical activity, sun exposure, or humid days (funny - all the Internet sites say that sun, physical activity, etc. are supposed to improve the condition).

4) Has anyone tried Accutane for SD? That seems to be the closest thing to a cure. I would be willing to try it if it would give me a shot for a cure, despite the potentially dangerous side effects.

Any thoughts, insights, etc. will be greatly appreciated.

Regards,
Ontarian

Lenin · 08-27-2006, 10:33 AM

Ontarian,

Better late then never. I got frustrated after about 10 years with this stuff (DS of the face) and trying every topical known to man. Many worked but using them 3, 4 or 5 times a week forever was just too much to bear for me. Fungicide + corticosteroid over a long long time has risks.

My conjecture is that the offending organism, either pityosporum ovale or a mallassezia variant gets into the hair roots and remains untouched by any topical, and thus KEEPS reinfecting the skin over and over and over. I became determined to KILL IT!

SO, I begged my doctor for a trial with ORAL ketoconazole (Nizoral.) My first thought was terbinafine but since one of the topicals that was of zero use was Lamisil I judged the oral form might be equally useless, and EXCEEDINGLY expensive.
I've gone a 5 weeks with 200 mg. ketoconazole/day and will probably go 8 weeks before I stop. I've not had even a spot of redness so my fingers are crossed. I am also doing the OTC topical Nizoral shampoo which I am smearing on all my formerly infected areas for 10 minutes twice a week...especially into eyebrows and mustache area, to make sure that nothing migrates to the surface hairs and escapes the drug. No cortisone for a month.

I'll let you know my results at the end of my trial...however long I pursue it. I'd rather not take the ketoconazole TOO long because of it's untoward effects on the liver...AND I take Lipitor and niacin!!!

Fingers Crossed!

Just to keep my progress in context, here was my thinking on the first of April:

Quote:

I keep mine in control a couple ways.
A shower every day is mandatory.
After every shower I apply miconazole 2% cream (OTC) to the affected areas (whether red or not.) For me that means between the eyes,,,and into the eyebrows even, above my lip on both outsides and on both sides of my nose. Clotrimazone, spectinazole, and econozole don't work at all.

Once a week I rub in full strength dandruff shampoo with zinc pyrithione (also OTC) on all the affected areas...leave on 5 minutes and spray it off in a shower...it burns if you get it in your eyes.

WHen it gets red and ugly, hydrocortisone (natch, OTC ) works well but too much cortisone can give you permanent red spidery arterioles in the skin (telangiactasias...forgive the spelling). I use cortisone cream that works well works well but I use it as infrequently as I can...when it's red and ugly.

If I keep to this regimen, I can keep the red rash to a day or two a month.

Never a problem in the Summer when, I presume, the ultra violet kills the fungi/yeast as it emerges with facial hair growth.

I am convinced that the way to eliminate it is to eliminate the yeast/fungi UNDER the skin, on the hairshafts with a systemic agent. I don't think Lamisil oral will do the trick because Lamisil cream doesn't touch the stuff. I used griseoflvin years ago for something else and it don't work on the seborrheic dermatitis either.
Tossing around Sporanox, Nizoral and Nystatin.

What I need is to get my GP interested in doing a culture, but so far he thinks all is well with my treatment plan...but who wants to do something like that FOREVER? Not me...a few years has been enough!

Has anyone tried any oral fungicides for it?

mtlguyca · 10-20-2006, 12:35 AM

Hi Lenin,

How are the Nizoral pills that you were taking?
Did it releive SD?

I need to know something that works...I have flaking on my scalp...