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Biofilm Busting, Xylitol, and Simplicity!--Question for Tom Busby and Other Experts

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  • #16
    Thanks again Tom. Last inquiry and then I'll stop bothering you! I used the Ketoconazole cream on my face for about 5 weeks. During this time, I can't say I have seen much of a reaction at all other than my condition continuing to spread to other parts of my face as it has for the last 3 months and the most affected spots turning slightly more pink and producing isolated tiny white flakes . Would you take this to indicate basically no reaction at all and thus maybe my seb derm (and I'm confident it is seb derm however poorly defined) is not an allergic reaction to malassezia? If not, any thoughts on the most common alternative cause and potentially effective treatment or at least options to try? Or is it possible that the biofilm is preventing much of a reaction given the limited efficacy of Ketoconazole, and the use of the e45 shampoo will be a more definitive test? As another piece of context, like I believe you reported, my skin is very oily to the point where I have sebaceous hyperplasia if that helps with determining cause and potential solutions.

    Thanks again for your time and advice. It's been a struggle to get used to this on type of my rosacea so any light at the end of the tunnel is of enormous benefit.

    -Josh

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    • #17
      You can test for malassezia by buying Nizoral shampoo -- it's sold OTC at Target and other big box stores. Use it daily for at least 2 weeks, and you should get a response. If you have essentially no response, then you can cross off malassezia as a potential troublemaker. If you get a response, use it daily for 10 months or longer, or switch to E45 shampoo.

      Ketoconazole cream is in a mineral oil base, which is an occlusive that doesn't penetrate any part of the stratum corneum, so it doesn't work very well.

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      • #18
        The problem with the anti-fungal creams available to us is that none of them is actually designed for facial skin. They're all meant for other parts of the body, mostly your feet, chest, or crotch. They therefore tend to be very thick and sticky and don't absorb effectively. A lot of them also contain a highly pore-clogging ingredient, isopropyl myristate, which wrought havoc on my acne-prone face when I tried them.

        My guess as to why anti-fungals like ketoconazole have been more successful for treatment of facial SD in scientific trials is that the researchers went through the trouble of formulating their own delivery vehicles for it, optimised for facial skin, rather than just giving the subjects a commercially available cream that's designed for athlete's foot.

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        • #19
          Hi Tom,

          after two weeks of washing it with Nizoral, what would you expect your skin to look like if it was Seb derm caused bu Malassezia?

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