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Thread: Diagnosed with Rosacea - may also be Seb Derm

  1. #1
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    Default Diagnosed with Rosacea - may also be Seb Derm

    Hi,
    I have started getting really worried about my face. It seems to be getting progressively worse. I first noticed it over a year ago as a redness that appeared on my moustache. It would come and go and I thought it was to do with shaving so wasnt sure. Later on I got a patch on the left side of my nose, around my eyebrows and now (as you can see from the photos) its on both sides of my face.






    I have pretty much always had dandruff, also had asthma as a kid and I think my mum had psoriasis.
    I saw the doctor a few weeks ago. He said it was Rocasea and first I tried Rosex - it didnt help. After going back I am now taking Minocycline, after a week I have not noticed an improvement. If anything over the last couple of months its becoming more noticeable. I think it may be seb derm after reading up and hearing that makes the skin flakey. My moustache and eyebrows were quite flakey today, and it seems to get flakey after a flare up.
    Its really starting to affect my confidence and I dont really want to go outside but I still have to goto work.
    Id love to hear other peoples opinions and possible topical treatment ideas to cover the redness or help getting rid of this. I understand its not curable but I cant have it spreading any more...

    Thanks.

  2. #2
    Senior Member tompkin's Avatar
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    If you have patchy red marks, flaky skin, dandruff, and, most importantly, no unusual flushing response to heat, cold, stress, exercise, alcohol and other common rosacea triggers, it seems much more likely that this is seb derm than rosacea. The eyebrows and cheeks near the nose are classic locations for it, too.

    Check the Other Conditions thread for a lot of discussion of SD treatment. It can be brought under control. Good luck!

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    Gman,
    I'm with Tkin, looks like Seb Derm to me, especially given your history and the distribution- especially between the brows and in the mustache.
    Seb derm is a chronic condition that is difficult to control and no one thing seems to work 100% but you should also consider a second opinion with another derm.
    I, as well as J-mill who is also on this site, have had good luck with 1% hydrocortisone and while a number of people may recommend against it, my derm does rec. it (as well as 2.5% as an occasional defense) and I have had good luck with it.
    Reduces the redness, the flakes, and can help greatly to reduce a flare quickly.
    Like Tkin wrote, in the related section, you will find any number of posts on the subject.
    Yours,
    Rob

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    My vote is seb derm too. To get a flair under control hydrocortisone cream 1% is useful but it is not a good idea for continued long term use.

    I find this quite a useful article to read.

    I have found cutting out sugar and dairy useful for the longterm control of seb derm. It may also be worth looking into products such as Born to be Mild that contain 2% pyrithione zinc.

    Of course I may well be wrong about the seb derm.

    best wishes

    Sarah

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    Senior Member J-Mill's Avatar
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    Default Make that three

    I would bet dimes to dollars that is seb derm. You have all the history for it plus the appearance is nothing like Rosacea, and most importantly the distribution (it is all in the classic seb derm areas, right through the t-zone). The upper lip is also common to seb derm and extremely uncommon to Rosacea (not many capillaries in that area from what I understand). You appear to have very clear cheeks for someone with Rosacea. For a doctor to diagnose this as Rosacea is laughable, he should be ashamed and amonished.

    Bottom line, seb derm is a recalcitrant, reoccurring bugger. I have only been able to control mine using a 1% hydrocortisone lotion. My derm. who specializes in Rosacea along with drug reaction skin conditions says it is safe for longterm use. My other derm who i saw for patch testing who specializes in allergic reaction skin consitions seconds this. I have used it considerably over the last year with no worsening of my Rosacea. I use Emocort, which is 1% hydrocortisone in an emollient base, very soothing and normally knocks the inflammation (and therfore the redness) back in a few days.

    If you are in the US you can 1% hydrocortisone OTC. Other treatments include immunomodulators like Elidel or Protopic (off label use) but prescribed constantly for seb derm. Topical antifungals help some, Loprox lotion/cream or ketoconazole cream - I personally think both are horrible and they caused me to get allergic contact dermatitis - but other shave had good success. Oral antifungals help some, generally not as effective for facial seb derm. Recent studies have found that metrogel can be effective, but the jury is still out on this IMO. Finally topicals containing Sulfacetimide/Sulphur such as Novacet or Sulfacet-R have been helpful for some.

    My advice, get some 1% hydrocortisone and use it 2x/day - a.m. and evening - until you clear (I am fairly certain you will). It will likely take 1-2 weeks. Once clear DO NOT just stop using the hydrocortisone, you will rebound badly. Use it at least another 1 week at 1x/day and then every second day for 1x/day for a week and then stop. This will prevent a sudden reoccurence. Once you stop you may remain clear for a few months but it will come back. You can either figure out a maintenance program for hydroocortisone use (some people apply it once or twice a week even if clear to remain clear). Or one of the other above treatments may help you if used intermittently to remain clear. Some people are lucky enough to remain clear byt aking an oral antifungal 1-2x per month.

    BTW, I researched topical hydrocortisone of no greater strength than 1% for safety thouroughly before using it on my face, which I am quite fond of and couldn't find a single scientific study to back up concerns I heard on some boards (including this one) that using hydrocortisone (again of 1% or weaker strength) could cause everything from Rosacea to mad cow disease.
    "Get busy living or get busy dying."

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    Thanks for the advice. I am seeing the doctor again tommorrow and will try the hydrocortisone 1%.
    Ive also ordered Born to be Mild, along with a couple of other products from the US (when I thought it was Rosacea) one from ZenMed and another called Rosacea Ltd III.
    Will let you know how it goes.

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    Senior Member tompkin's Avatar
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    Rosacea III is a topical application of sulfur, zinc and other minerals. It may help with rosacea acne-like breakouts (pustules and papules), but as sulfur may also help seb derm, it may be useful to you.

    However, if you're going to try hydrocortisone, don't use any other treatment. Do one thing at a time. If you get good results with one med, don't switch to another.

    Rosacea III does offer a 90 day money back guarantee, and they have an excellent track record of honouring that guarantee. I got my money back from them promptly when I found that it didn't work for me.

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    Senior Member J-Mill's Avatar
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    Default Second this

    Quote Originally Posted by tompkin View Post
    Rosacea III is a topical application of sulfur, zinc and other minerals. It may help with rosacea acne-like breakouts (pustules and papules), but as sulfur may also help seb derm, it may be useful to you.

    However, if you're going to try hydrocortisone, don't use any other treatment. Do one thing at a time. If you get good results with one med, don't switch to another.

    Rosacea III does offer a 90 day money back guarantee, and they have an excellent track record of honouring that guarantee. I got my money back from them promptly when I found that it didn't work for me.
    This is excellent advice respecting trying too many things at once. I went through this and it can be very frustrating. Most importantly you may discard one treatment that would be very effective but because you used it in combination with a number of things that didn't work or caused a flare you put it in the "do not use" basket, so to speak.
    "Get busy living or get busy dying."

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    Well the doc stuck to his original diagnosis and almost laughed when i suggested seb derm.
    He didnt prescribe cortisone and said I didnt want to go down that path due to skin thinning and cortisone rash.
    So for now i will stick to the Minocycline, and start using whichever topical treatment arrives first and see how it goes.
    If no improvements over the next couple of weeks I will see a dermatologist for a second opionion.

  10. #10
    Senior Member J-Mill's Avatar
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    Quote Originally Posted by gman View Post
    Well the doc stuck to his original diagnosis and almost laughed when i suggested seb derm.
    He didnt prescribe cortisone and said I didnt want to go down that path due to skin thinning and cortisone rash.
    So for now i will stick to the Minocycline, and start using whichever topical treatment arrives first and see how it goes.
    If no improvements over the next couple of weeks I will see a dermatologist for a second opionion.
    I would just go get the second opinion, is this doctor a dermatologist or just a gneral practinioner incidentally? Granted I am no expert (I have zero medical degrees) but I would be absolutely shocked if that is not seb derm.

    Incidentally, what did the doctor suggest you do besides continue taking minocycline, which you appear to have been doing for at least the last 2 months. After 8 weeks if you are not noticing an improvement and in fact the condition is getting worse I would hazard to say that line of therapy is not providing a substantial benefit. I am curious why a doctor would have someone continue a treatment that is not helping and exposing them to unneeded side effects.
    "Get busy living or get busy dying."

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