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New; need Seb Derm advice! (Moisturize?)

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  • New; need Seb Derm advice! (Moisturize?)

    Hi everyone!

    I have extremely problematic skin. I have incredible sensitive skin (If I scratch it it will remain red for the day, cold weather makes it red), suffer from acne and also seb derm on the folds of my cheeks/nose.

    I was put on accutane last year for 6 months and it cleared my acne and seb derm, however, with time it started to come back. I was put back on accutane, but this time on an extremely low dosage for a long time as a maintenance. I am currently on 20mg per week.

    However... my skin, although slightly better on some days, is still problematic. My seb derm doesn't seem to budge, and I'm not sure what to do! It seems like anything I put on my seb derm breaks me out. I'm interested in a moisturizer as my skin gets very dry, but when I use cetaphil it seems to make the seb derm areas red and very sore. Aquaphor seems to have a similar reaction. They both also break me out in acne around the seb derm areas. HOWEVER...I have not used either for more than a couple of days in succession as I get scared my acne and seb derm will get worse.

    So my question is... should I moisturize seb derm? Or should I leave it? I've noticed that it seems to get better when I leave it entirely and stay inside for a period of time, but obviously this is not possible with work and socializing. However...when I go out, the wind and cold seems to make my seb derm very irritated, sore and red, and then the next day I seem to break out in acne -- hence why I'm thinking maybe I SHOULD moisturize these areas to protect them from environmental factors?

    Any advice on what the consensus is with moisturizing seb derm, and if anyone has any reccomendations? (Bear in mind I currently live in Japan, so there may or may not be products out here)

  • #2
    Do you have a pic yust of cheak and nose you dont have to send full face


    • #3
      You should read Tom Busby thread, he explains which moisturize you can use which doesn't feed the seb.

      You could try Cerave PM.


      • #4
        I second looking into Tom Busby's thread which is stickied on the top of this forum. It is where most of my knowledge originated on treating seb derm and has been quite useful.

        But as I have tried certain things from it, I can tell you the best thing I have found for moisturizing is MCT Oil mixed with Cerave PM. It keeps my skin moisturized better than anything else I have used, and is supposedly one of the few ways to moisturize without feeding the yeast causing the seb derm. Of course, this is if your seb derm has been properly diagnosed and is actually caused by Malassezia. This would normally be done by a skin scraping done by your dermatologist. Something to ask for if you have not already.

        I don't live in Japan so I don't know what is available to you or not, but this: is the brand I use of MCT Oil and from my research seems to be reliable.
        This: is what I mix with it. It may not even be that necessary as the MCT Oil seems quite moisturizing alone, but it helps to spread it and doesn't seem to hurt.


        • #5
          Hi flurb, adding MCT to Cerave PM is a good idea -- I suspect it has only 4% to 5% MCT oil. MCT oil has the INCI name of "caprylic/capric triglycerides". MCT oil at 15% in a lotion is just right in my opinion.

          In Japan, you could look for a lotion that contains only caprylic/capric triglycerides, and no other oil derived from any plant, fruit, seed, or nut.

          CeraVe PM is the most widely available, reasonably priced lotion that generally fits into this category -- it costs about $15 for 3 ounces. As an alternative, if you have money to burn, Dermatologica's Active Moist Lotion is very very nice, but costs $45 for 50 ml. (An ounce is 30 ml.)

          MCT oil in a lotion won't cure anything, but it will prevent malassezia from having an additional food source in your lotion.

          CeraVe has a lot of other products, so look for the one with "PM" in the name.

          None of the CeraVe products are perfect, but they're widely available and at least ok.

          Here's a nearly complete description of the CeraVe product line, which I stole from someone else's Reddit post, and it may not be current. My comments are in brackets []. In addition, Behentrimonium Methosulfate is undesirable and leaves a slimy residue -- it's often found in hair conditioners to make hair feel slippery, and doesn't belong in a lotion, at all, IMO:

          CeraVe Moisturizing Cream
          Purified Water, Glycerin, Ceteareth-20, Cetearyl Alcohol, Caprylic/Capric Triglyceride, Behentrimonium Methosulfate, Cetearyl Alcohol, Cetyl Alcohol, Ceramide 3, Ceramide 6-II, Ceramide 1, Hyaluronic Acid, Cholesterol, Petrolatum, Dimethicone, Potassium Phosphate, Dipotassium Phosphate, Sodium Lauroyl Lactylate, Disodium EDTA, Phenoxyethanol, Methylparaben[a "bad" preservative], Propylparaben[a "bad" preservative], Phytosphingosine, Carbomer, Xanthan Gum

          CeraVe AM Facial Moisturizing Lotion
          Active Ingredients: Homosalate (12%), Octinoxate (7.5%), Octocrylene (2%), Zinc Oxide (3.5%). Inactive Ingredients: Purified Water, Niacinamide, Behentrimonium Methosulfate and Cetearyl Alcohol, Glycerin, Aluminum Starch Octenylsuccinate and Boron Nitride, Dimethicone, Ceramide 3, Ceramide 6-II, Ceramide 1, Cholesterol, Hyaluronic Acid, Phytosphingosine, Hydroxyethylcellulose, Disodium EDTA, Sodium Lauroyl Lactylate, Methylparaben, Propylparaben, Carbomer, Xanthan Gum. [The sunscreen ingredients are likely to clog pores]

          CeraVe PM Facial Moisturizing Lotion
          Purified Water, Glycerin, Caprylic/Capric Triglycerides, Niacinamide, Behentrimonium Methosulfate, Cetearyl Alcohol, Ceteareth-20, Cetearyl Alcohol, Ceramide 3, Ceramide 6-II, Ceramide 1, Phytosphingosine, Hyaluronic Acid, Cholesterol, Dimethicone, Polyglyceryl-3 Diisostearate, Potassium Phosphate, Dipotassium Phosphate, Sodium Lauroyl Lactylate, Disodium EDTA, Methylparaben[a "bad" preservative], Propylparaben[a "bad" preservative], Carbomer, Xanthan Gum

          CeraVe Renewing SA Lotion
          Purified Water, Glycerin, Mineral Oil, Ammonium Lactate, Salicylic Acid, Trolamine, Glyceryl Stearate SE, Behentrimonium Methosulfate, Cetearyl Alcohol, PEG-100 Stearate, Cetyl Alcohol, Cholecalciferol (Vitamin D3 in Corn Oil), Ceramide 3, Ceramide 6-II, Ceramide 1, Cholesterol, Phytosphingosine, Dimethicone 360, Methylparaben[a "bad" preservative], Disodium EDTA, Propylparaben[a "bad" preservative], Hyaluronic Acid, Sodium Lauroyl Lactylate, Carbomer, Xanthan Gum

          CeraVe Renewing SA Cream
          Purified Water, Glycerin, Behentrimonium Methosulfate, Cetearyl Alcohol, Mineral Oil, Glyceryl Stearate SE, Ammonium Lactate, Salicylic Acid, Triethanolamine, Cetyl Alcohol, Niacinamide, PEG-100 Stearate, Cholecalciferol (Vitamin D3 in Corn Oil [so skip this one]), Ceramide 3, Ceramide 6-II, Ceramide 1, Cholesterol, Phytosphingosine, Hyaluronic Acid, Phenoxyethanol, Dimethicone, Methylparaben [a "bad" preservative], Edetate Disodium, Propylparaben[a "bad" preservative], Sodium Lauroyl Lactylate, Carbomer, Xanthan Gum

          CeraVe Skin Renewing Night Cream
          Purified Water, Glycerin, Biosaccharide Gum-1, Caprylic/Capric Triglyceride, Butyrospermum Parkii (Shea Butter), Dimethicone/Vinyl Dimethicone Crosspolymer, Glyceryl stearate SE, Stearic Acid, Cyclopentasiloxane, Cetyl Alcohol, Dimethicone, Saccharide Isomerate, Glycine Soja (Soybean) Sterols, Ceramide 6 II, Ceramide 3, Ceramide 1, Niacinamide, Hyaluronic Acid, Caprooyl Tetrapeptide-3, Tripeptide-1, Cholesterol, Phenoxyethanol [an ok presvative], Cetearyl Alcohol, Carbomer, Behentrimonium Methosulphate, Sodium Hydroxide, Tocopherol, Allantoin, Ethylhexylglycerin, Butylene Glycol, Sodium Lauroyl Lactylate, Phytosphingosine, Dextran, Xanthan Gum

          CeraVe Baby Moisturizing Lotion [no preservative listed -- this list in not complete]
          Purified Water, Caprylic/Capric Triglyceride, Cetostearyl Alcohol, Cetyl Alcohol, Emulsifying Wax, Niacinamide, Ceramide 3, Ceramide 6-II, Ceramide 1, Hyaluronic Acid, Allantoin, Tocopheryl Acetate, Lauric Acid, Zinc Citrate, Polyglyceryl-3 Diisostearate, Behentrimonium Methosulfate, Sodium Lauroyl Lactylate, Arginine PCA, Potassium Phosphate, Dipotassium Phosphate, EDTA, Sodium PCA, Phytosphingosine, Cholesterol, Xanthan Gum, Carbomer

          CeraVe Baby Moisturizing Cream
          Purified Water, Glycerin, Cetearyl Alcohol, Caprylic/Capric Triglycerides, Cetyl Alcohol, Ceteareth-20, Petrolatum, Ceramide 3, Ceramide 6-II, Ceramide 1, Hyaluronic Acid, Cholesterol, Phenoxyethanol, Behentrimonium Methosulphate, Potassium Phosphate, Dipotassium Phosphate, Ethylhexylglycerin, Sodium Lauroyl Lactylate, Disodium EDTA, Phytosphingosine, Carbomer, Xanthan Gum, Sodium Hydroxide


          • #6
            Thank you all so much for the hasty responses - I honestly wasn't expecting to hear anything back. You all seem so knowledgeable on this, so it's good to know there are resources out there!

            Interesting about cerave PM... I haven't actually used that, so I may have to look into it. I have extremely acne prone skin, so it's always scary to apply anything to my skin in fears of breaking out i acne, or aggravating my seb derm.

            Tom, out of interest, what is your opinion on aquaphor/vaseline? I've heard that as it technically isn't a moisturizer, it actually suffocates the seb derm whilst treating the redness and flakes?

            It's hard because my derm did diagnose me with seb derm, but took no test or samples and didn't particularly look close. My skin isn't oily at ALL (due to accutane), and is very dry, however in the past my skin was oily and that was when this all devloped. It may be possible that perhaps this is just dry skin now as opposed to seb derm? But maybe that's lucky I said, moisturizers tend to make it very red, raw and sore. I do, however, seem to have yellowy flakes in this area, and very enlarged pores? I'll try to find a picture to upload..I don't really like taking them anymore as they severely depress me when I see my face, haha..

            But yes... will aquaphor help at all or hinder?


            • #7
              Hi Oswald, Aquaphor and Vaseline will not feed malassezia, because they are C-22 and longer, but they're not at all water soluble, which means they're almost impossible to wash off. As a result, they're much too sticky -- so you could use them on your feet without doing any noticeable harm because your feet are, so what anyway -- but on your face, you'd be wearing an accumulation of grease even with daily washing.

              MCT oil and Aquaphor/Vaseline don't suffocate malassezia, they merely don't provide an additional food source. MCT oil is light and even edible. It's still shiny and oily if you use it at 100%. Perhaps if you put a small amount on your hands, and add some water, you might be able to have a useable product without the hassle of making an actual lotion. You'd be aiming for 15% MCT oil, and 85% water. That's the percentage/ratio I like. Oil and water don't really mix, but your natural sebum has a few natural emulsifiers, and perhaps you'd find some work-around by experimenting.

              Try MCT oil and compare it to Aquaphor/Vaseline, and you'll see what I mean -- just test all of them on your hands, forearms, and elbows so it's easy to wash, and inspect. I suspect you'll see the stickiness-problem with Aquaphor/Vaseline.


              • #8
                Hi this poust is usefull to me to but i have a big question the person in the 2nd coment told to be shore that the funges is a problem and not somthing what can be other couses of sd and how would you treat those sd? Pls somone replay if they have time and know the answer tnx guys and hear you later


                • #9
                  Thanks a lot, Tom! It's relieving to hear that Aquaphor will not hurt the seb derm. I had to dab on a bit today as it was really burning. Unfortunately I wear heavy makeup for work, and it flares up my seb derm very was awful. I had to put some on to relieve the tightness. I'll look into ordering the cerave pm instead as that seems like it will help the most in regards to relieving the redness and flakes. Hopefully tomorrow will be a better day... it's emotionally exhausting dealing with acne as well as this.

                  My routine right now is just cetaphil face wash in the eve and cetaphil moisturizer (I only apply the moisturizer to the non seb derm areas), I'll try to implement cerave pm. Is it recommended to moisturize the seb derm every day and after every wash?


                  • #10
                    Ok now I am confused. I use cetaphil moisturizer daily on my entire face including seb derm areas. Is this bad? My derm has been telling me to do it


                    • #11
                      Hi Frogman, Cetaphil lotion has these ingredients:
                      Water, glycerin, hydrogenated polyisobutene, cetearyl alcohol, ceteareth-20, Macadamia integrifolia seed oil (macadamia nut oil), dimethicone, tocopheryl acetate, stearoxytrimethylsilane, stearyl alcohol, panthenol, farnesol, benzyl alcohol, phenoxyethanol, acrylates/C10-30 alkyl acrylate crosspolymer, sodium hydroxide, citric acid.

                      The ingredients in bold are bad for seb derm induced by malassezia. Polyisobutene is similar to carpet adhesive and probably becomes a component-part of a biofilm, and macadamia nut oil definitely feeds malassezia.

                      The same company that makes CeraVe makes Cetaphil -- CeraVe is made with more modern concepts for general skin health. Cetaphil is fine by standards from 10 years ago.


                      • #12
                        So the aquaphor from yesterday has definately broken me out in clogged pores and just made my face seem generally sore..

                        I hate my skin..

                        It seems like really the only thing that works is to just leave my skin to dry and not moisturize at all, but then that means it's very sensitive to the cold and show makeup I have to wear... Imagine having to stick a prosthetic nose on with very strong spirit gum right ontop of your seb derm for 7 hours, and then taking it off with a weak spirit gum remover - so weak you're basically ripping it off... that's what I'm having to deal with. It was burning yesterday so I thought aquaphor would calm it, but nope... just as red raw and ugly, but now with acne around it too... sigh...

                        Have not stopped crying today. I'm just so crushed by this that I don't know where to turn. I suffer from such bad acne and seb derm that I'm just at a complete loss.. it seems my skin responds best when it's left alone, but that's impossible with my job and the current cold weather.

                        I've been suicidal in the past because of my skin, and the depression is just hitting me again... I just want to enjoy my life like everyone else... sorry for the rant..


                        • #13
                          Thank you tom. I will pick up some cerave today and get rid of the cetaphil. I've actually been switching every time I run out but I'll stick to cerave from now on. To the above poster , I've been there too. Just remember that the skin is able to improve over time so don't give up hope. Mine was sooooo bad 4 years ago and is by no means perfect today but it has drastically improved and I continue to seek out ways to continue to fight seb derm. Don't give up, your skin will improve with time.


                          • #14
                            Hi Oswald, have you tried any basic, lightweight moisturisers with minimal ingredients? I have also suffered from acne and SD, and have very oily skin, and find lightweight moisturisers (in gel or even liquid form) are the best solution for me. A couple examples are La Roche-Posay Toleraine Fluid and Sebamed Clear Face Gel, but I'm sure there are many other options out there.

                            I tried using Aquaphor as a moisturiser once, but found it far too greasy and difficult to wash off. I still use it as a lip balm in the wintertime, though, as it's far more moisturising and long-lasting than any chapstick I've tried.

                            Also, to treat SD, you could consider dumping climbazole powder into whatever moisturiser you choose. Climbazole has been the critical ingredient to treat my case, and it has apparently helped many others here. But it takes time -- several months of treatment -- before symptoms reduce significantly.


                            • #15
                              I'm a little confused. So aquaphor isn't suppose to feed Malassezia but it has lanolin in it. Doesn't lanolin alcohol contain fatty acids that Malassezia can feed on? Sorry if this is a dumb question.
                              Last edited by Fernycall_; 20 May 2016, 07:07 AM.