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Thread: My story and pics. Rosacea? Seb Derm?

  1. #1
    Senior Member dan pacifik's Avatar
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    Default My story and pics. Rosacea? Seb Derm?

    Hey everybody. First all I have big respect for all of you. I know how this can plague your life, if you donít manage to get control of it.

    I started developing my problem about a year ago. It was first noticed when i was trying things out to get rid of my acne. I didn't have a massive problem with it, but every few days did get some pop up here and there. I was prescribed Dalacin T to help with them. I have to admit to probably over using it a little. I was meant to use it 2 times a day and some days i might of used it upto 4 times just because i wanted the spot to go away. I canít think anything specifically which could of contributed to it,, but a couple of times in previous summers I remember getting sunburnt on my head quite badly. I have a shaved head so have very little protection from the sun, and my head actually peeled. Not nice!

    Anyway, i can't remember the exact time, but probably within a few months the creases on the side of my nose started to become red and really itchy. This was also coupled with the skin on my upper lip becoming very flaky and dry. I tried all sorts of moisturisers and creams to stop the flaking but they didn't seem to help. After a second trip to the doctors, my doctor seemed to think it was rosacea so she prescribed me metro cream 0.75%. This seemed to help with the itchiness and calmed down the redness a littleÖÖI think! I pretty much used this for about 8 months. It did progressively get worse over that time. About 2 months ago I started to develop a crazy amount of acne on my forehead. I never really had acne on my forehead. It seemed to happen from nowhere. The spots can be quite painful sometimes, like they donít have puss in them but feel kind of like bruises and can stay there for over a week sometimes. I have had upto 10 on my forehead at one time. I went back to my doctor about this and she said it looked more like acne on my forehead. Itís quite weird though because the spots seem to be localised to my forehead, and side of my temples. They do seem to come and go. My doctor prescribed me with oxytetracycline and finacea to help with the spots. It hasnít seemed to do much for the spots but has settled the redness a little, still real itchy. I've also been to a derm and he said it was rosacea. I wasn't pleased with him though, seemed he was in quite a rush to diagnose me then get me out. Plus his diagnosis was simply by asking me symptoms then ticking a few boxes. Maybe thatís all all they can do these days, but he didnít seem very thorough.

    My condition at the moment isnít too good. My cheeks/nose/upper lip seemed to flare up in a red itchy rash last night and has been really irritating all day. I am however skeptical over my doctors and derms diagnosis. The folds of my nose are very red and sore. Seem to be the most irritated part of my face at the moment. I put moisturizer on them, one called Diprobase, prescribed from the doctor and another called ĎGood Skin All calm mosituriserí. Neither seem to help the dryness. The metro cream seems to make it sting aswell. Also when I gently rub my finger over the area there are little flakes on the tip of my finger. Coupled with the initial symptom of my upper lip flaking, which it also does every now and then, Iíve come to think it could be seb derm or even worse a combination of the 2. I was hoping from the pictures some of you may recognize some symptoms they have.
    I have trouble washing my face, usually use just water but did try ĎPaulaís Choice for Normal to sensitive skiní the other day but it seemed to irritate it.
    I also experience redness and itchiness on my chin every now and then, seems to happen in cycles, thatís with it all. Iíve had the stubble look (not so much at the moment, more beard) for the last few years so donít really see any redness or cant see any redness under it. But when I touch parts of my jawline and neck its sometimes sensitive to the touch however it doesnít really tend burn like my nose/cheeks and upper lip.

    Also to give you an idea of what it may/may not be, I donít tend to flush that often. For me it seems I probably flush like anyone else. Sports/exercise, when I drink alcohol sometimes. Im not too sure on spicy foods cos im not a big fan of them, tend to stay clear. Recently I have been trying to cut down my drinking cos of what people say between the links of drink and rosacea. But on most occasions I havnít noticed a difference to myy face the next morning. Would this be worse in the long run however?

    Sorry for the essay, but I wanted to be as detailed as possible. Iíve got a derm appointment again in a month but am a little impatient so wanted to see If I could get some more opinions first. Iím hoping I can get on low dose accutane for my spots and rosacea (whatever it is). Fingers crossed!

    Thanks

    Dan
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    Hey Dan -

    It is hard to say from the pics but it looks kind of like my Seb. Derm.

    Like you, I have the same redness on the nose and cheeks. I can also see that yours creeps down into your jawline beard just as mine does.Of course your Derm will be able to tell you. I went to 4 and 3 said i had Seb. Derm. My GP thought it was Rosacea so you can see they can be hard to distinguish between. I think with Seb. Derm, if your not super crusty and flakey in your nose creases and eyebrows so Dr.s can see the butterfly pattern and assume it is Rosacea.

    There are other members who can give their opinions as well. All will say get properly diagnosed. Have you tried washing your face with a medicated shampoo a few times a week? I am using Ketoconazole shampoo and just lather it on my head and my face. You can buy a over the counter version called Nizoral I think. If it is Seb. Derm you might see it respond.

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    Hi Dan,

    Have you only been seen by your own Dr so far?

    If you're asking people to guess and the choice is between Rosacea and Seb derm, I would say its Seb - like Clfergus, the look and areas of inflammation are very similar to my symptons when I have a flare.

    I really wouldn't recommend it on a long term basis, but initially at least I found Daktacort cream to be very effective - if you can deal with it just by using anti fungals rather than a steroid, even better.

    I know that its frustrating having to wait, but you need an accurate diagnosis from a derm.

  4. #4
    Senior Member dan pacifik's Avatar
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    There are other members who can give their opinions as well. All will say get properly diagnosed. Have you tried washing your face with a medicated shampoo a few times a week? I am using Ketoconazole shampoo and just lather it on my head and my face. You can buy a over the counter version called Nizoral I think. If it is Seb. Derm you might see it respond.
    Yea i'm definitely going to ask the derm. It just seems to me the symptoms move more towards the seb derm then rosacea. Its weird cos earlier on i had a flaky scalp now and then but nothing ever too much too handle. I was using head and shoulders and havn't had a flakes for about 3 months and thats with just using a 'Simple- Shampoo for sensitive scalps' shampoo. I also have slightly flaky eyebrows but i put this down to the finacea i use on my forehead area drying my skin out! But anyway i shall hold for the derm till i go diagnosing myself.

    @ clfergus- cheers, i'll have a ganders at the nizoral. What does thsi do for you? Help with the dryness? flakiness? redness?

    @ slugger3939- Nah i've been to 2 doctors. The first one retired and he said it was rosacea and also my new one said it was rosacea. I think she was going on the diagnosis from my first doctor though. However my first doctor basically diagnosed through looking at some writing & a few pictures on a computer screen. My new one is quite a new doctor aswell i think. I take it she's not very familiar with whatever i have because shes always reading this little handbook. I also went to derm. At this point i had quite mild symptoms, they gave me a 'how to cope with rosacea' leaflet, some metro gel and antibiotics and sent me on my way. Pretty poor in my opinion!

    What is this Daktacort cream? is it a steroid cream? I hear they're not very good for your skin? Is it an over the counter product?

    Thanks for the feedback guys

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    Hey dan -

    Like slugger said, only a derm can diagnose your properly. From all of the info on the web and on these boards, you will see that both conditions can be diagnosed as one another. Your scenario sounds like mine with the regular doctor making a diagnosis and sending you on your way with a pamphlet.

    You mentioned flaking on the scalp, eyebrows. Do you ever notice flaking behind the ears, center of your chest, or pubic region? How about redness at your hairline onto your scalp?

    These are all things my derm checked me for when diagnosing me. I have it in my eyebrows, scalp (had red spots and flaking) and behind my ears and didnt even know it.

    A good derm should also ask you your history. Mine asked me about the time it showed up, my diet and stress level etc. One interesting note was how mine flared badly after taking antibiotics (doxycycline) for 30 days. Doxy is typically a rosacea helping drug but made me worse.

    What I am trying to say is these conditions aren't easy to figure out. J-Mill is another member who has a wealth of knowledge on Seb. Derm and one of the suggestions he made was for me to find a derm who had many years of practice. My younger derms seemed unsure of the treatments for me. My new derm has 22 years of experience and to me hit my condition right on.

    Also, stress from my experience is the worse. If you are thinking about it as much as I was...it wont go away. My flare was way worse than you look. It was really red and all over my face and forehead. So just relax. You will get it worked out.

    Nizoral, its just a dandruff shampoo but you can apply it to your face and let it sit for 5 minutes in the shower. It might dry your face out so be careful. But for me..it helps reduce the redness and splotchy look of my Seb. Derm.

    I also cut out all alcohol, sweets/sugars, fried foods. I have been eating light and healthy and am seeing the benefits of it.

    But first find out what you have and then we can give you suggestions.

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    Reading from a handbook.....oh dear Not criticising GP's, its impossible for them to be expert in every area.

    If a derm has told you rosacea, I'm not saying that they are wrong, I'm only judging off my own symptons which have been confirmed as seb derm by three dermatologists and yours look inceredibly similar. I don't have any of the p&p's and flushing generally associated with rosacea.

    Daktacort is hydrocortisone with micronazole. It was incredibly effective for me for 18 months or so. I propbably overused it and it ended up thinning the skin in some areas (was given no advice about application or possible long term side effects). That's why I would advise that, if possible, (and if it is seb derm) you try and deal with it using an anti fungal treatment only. Short term use of a steroid wouldn't be a problem and it may help you deal with the inflammation while you try and find alternative treatments, but imo it is not a long term answer.

    Not sure where you are but the Daktacort was given by perscription (GB), for some reason though I have a feeling that it may be available in a small tube otc (don't ask me why a larger tube would be perscription only, I can only think that they contain slightly different ingredients).

    Like you, I used to have seb derm on my scalp (as a teenager), which completely cleared years before it appeared on my face.

    You might want to try washing your face with an anti dandruff shampoo (Nizoral/Head & Shoulders/Te-Gel) which have been shown to be effective for many, though some work better than others for different people, so it's all a bit of trial and error.... My advice would be to dilute the shampoo, use over the face, leave, then wash off 5 mins or so later.

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    Senior Member dan pacifik's Avatar
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    You mentioned flaking on the scalp, eyebrows. Do you ever notice flaking behind the ears, center of your chest, or pubic region? How about redness at your hairline onto your scalp?
    I can't say i have seen any flaking in those areas. You mentioned the doxycycline clfergus, do you think this is the same with all tetracyclines. Im currently on oxytetracycline, and if anything it may of got a little worse then better. It certainly hasn't got better that for sure! At the moment it is hard to tel though because it seems to happen in cycles. One week its not bad then all of a sudden it will flare up

    Yea i've changed my diet in the last 3 weeks but its hard to tell if its worked at the moment. I've cut out all chocolate and have this habit now of checking sugar content of all things i buy/eat. Only thing im struggling on is the alcohol. Im going to call it quits for the next month up until the derm though and see how it goes.

    I read your story a minute ago, glad you found a good dermm and starting to get yours under control Seems quite a long process and hard thing to do nowadays.

    Im gunna go for a bike ride in a bit, usually stops me worrying about it. All i seem to think about is this at the moment, probably wouldn't be so hard if it was so itchy all the time! On this note what can be used for this? i've tryed using an anti-hystamine called zirtek but they don't seem to be doing a lot.

    Reading from a handbook.....oh dear Not criticising GP's, its impossible for them to be expert in every area.
    I know, i guess you've got to start somewhere!

    I don't have any of the p&p's and flushing generally associated with rosacea.
    Thats where i'm confused. I don't really get flushing, only at the expected times sports/exercise/embarrasing situationss etc. I've read about people with rosacea getting flushed very easy for eg. like when bending over just to lift something but i don't get this. I have got acne recently appear on my forehead area though and temples, i'm thinking this may be due to stress though of justt constantly thinking about it!

    Im going to ask the derm about some anti-fungal cream when i go. Think that might be a good place to start to eliminate what it could be.

    Couple more questions: What does the areas that flare feel like when you rub them? Gently rubbing my finger over the side of my nose, it sort of has a bumpy/rough texture like theres small scales there!

    And also is there a moisturiser i can use to help the situation a little more? I ordered a La Roche one which was recommend my j-mill on one thread. Hopefully that should help

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    Senior Member dan pacifik's Avatar
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    Besides an itchy scalp, patients may complain of a burning sensation in facial areas affected by seborrhea. Seborrhea frequently becomes apparent when men grow mustaches or beards and disappears when the facial hair is removed. If left untreated, the scale may become thick, yellow and greasy and, occasionally, secondary bacterial infection may occur.
    Just found this on a site describing seb derm. This statement sounds exactly like what i have. The redness/itchiness seems to appear round my moustache/beard line and if i let my facial grow to long it gets worse, but as soon as i trim it seems much more calm! Weird

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    Quote Originally Posted by dan pacifik View Post
    Just found this on a site describing seb derm. This statement sounds exactly like what i have. The redness/itchiness seems to appear round my moustache/beard line and if i let my facial grow to long it gets worse, but as soon as i trim it seems much more calm! Weird
    Dan,

    It sounds like you may have your diagnosis.....

    Ps you mention the feeling when you rub the inflamed areas, if the skin is dry then it will feel rough (are there flakes there?), pores in the affected areas may well become enlarged as well which could explain the uneven feel. It's a personal choice but I have oily skin and avoid moisturisers.

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    Senior Member dan pacifik's Avatar
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    Hmm i do hope so! This has been plaguing me for too long now, and would just like to get some control over it. I'm not too sure to wait a month for my derm appointment and then ask about an anti-fungal or book a doctors appointment and tell her about my concerns, do you think it would be wise to do so? Don't want it getting worse!

    I just rubbed my finger over the side of my nose again and found to very small flakes on my finger, i guess they could be enlarged pores aswell. I've got some nizoral and am going to give that a shot tonight, if it drys my skin out too much i guess i'll put some sort of moisturiser on. How often would you recommend using it on my face?

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