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Thread: Is this Seb Derm? KP? Sebum plugs in skin, eyebrow loss and crepey skin

  1. #1
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    Default Is this Seb Derm? KP? Sebum plugs in skin, eyebrow loss and crepey skin

    I've been getting these hard plugs in the pores of my skin that leave my pores enlarged and they have spread to my eyebrows. The eyebrow hairs that come off are either attached to a sebum plug or if examined closely the pore it came out of has a sebum plug. This seemed to be what happened to the downy hairs on my forehead as well. I'm not sure if its from picking out the plugs (bad, I know, trying to stop), but the skin over the forehead and inner eyebrow area is kinda like dried glue? as in when i make a facial expression you can see a bunch of lines in the top layer of the skin. The skin is also flaky and rough there.

    I don't know if this is KP or maybe just a bunch of clogged pores but the area on my nose including the bridge and under eye is bumpy and if the bump are squeezed a little hard ball comes out for the nose/under eye and softer white paste for then chin. The reason I'm considering KP is because I have patches of it on the back of my arms.

    Help is appreciated if any of you have any idea whats going on!
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  2. #2
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    maybe demodex follicultis?

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    Demodex - it is soo typical with the "pulling out the plugs". Do you get wounds by pulling them out? Does more plugs comes to the surface? Are they elastic, and seem to be stuck "very deep"? Do they bleed alot when you finally get one out? Itching? Dandruffing eyebrows/eyelashes? Itchy, dry eyes? Do they get inflamed like a pimple, but when trying to pop only "oozing"? There are several alternatives here. Whatever you do - DO NOT PUSH OR PULL OUT. It will only make it all worse! There are alot of products you could try for some weeks, and see if it gets better or not - then either continue treatment or discontinued it, then start treating for another possible cause. Check this link http://rosacea-support.org/just-how-...dex-mites.html and there are tons of threads here about it

  4. #4
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    Default This is niether Seb Derm nor Demodex but COMEDONAL DARIERS DISEASE !!!

    Hi Guys,

    Been long since I posted on the forum and thought of giving you an update on my eyebrow condition. There are quite a few posts here reporting very similar condition and who are looking for ways to get a handle of the condition. Been suffering from similar symptoms which generally starts with white plugs and flakes &/ peeling skin in Eyebrow pores leading to Brow loss.

    Comedonal Dariers disease resembles Seb Derm in its initial period and is a very slow spreading but progressive disease In my 9th year now and it has manifested in past two years as more than just plugged pores or flakes. Now the plugs are manifesting like tiny syringoma like growths which medium strength acid like TCA also cannot penetrate. The soft flakes have now turned into skin thickening. Dariers Disease has many types and comedonal is one such type. Unfortunately no satisfactory treatment is known till date. Retinoids, micro dermabrasion and Acid peels can reduce the size of the abnormal growths coming out of the dermis. The growths are comedone like but are not your regular comedones which a scrub of sal acid can treat. Also this disease is typically non-inflammatory so there is no redness unless you over scrub the area. Occasional redness is expected owing to aggressive skin treatments. Itching is transient and fleeting and not daily.
    It is also referred to as Dariers "white" disease implying the conglomeration of the growths/plugs and plaques all together which makes that part of the skin appear whitish.

    So if you have Plugged Pores in the Eyebrows and treatments (anti fungals, immunomodulators, steroids etc) which normally work for those with SEB DERM are NOT working for you its most likely Comedonal Dariers Disease . This is very resistant to treatment and there is no satisfactory treatment so far. Accutane which works for pure Dariers Disease in some of the cases is known not to work in Darier type Comedonal. Dariers has many types and Comedonal is one of them. So when you compare the images online be careful which type you are comparing with as original Dariers is usually intense and full body including scalp. Comedonal is localised to some body parts only not all and most common being the face.

    Mine began 8 years back in the Eyebrows has very slowly spread to the forehead and nose. Prominent follicular involvement and presence of "elongated dermal villi" and "papillary projections", the histopathological appearance of Comedonal Darier's disease differs from that of typical lesions of Darier's disease The mechanism of comedone formation in this disease is unclear, but both follicular involvement and dilatation seem to occur. I also have some hypopigmented spots (in around the eyebrows) which is again typical of comedonal type. Recently found some spots growing on eyelashes too which I was trying to scrub off thinking its simple flake actually turned out that its part of the same disease and I have applied TCA 15% in hopes of dissolving the elongated skin colored growths. Just so you know TCA 15% is considered a low-med strength acid and when applied to normal skin will cause a burn in seconds but since these growths are abnormal and thick and elongated even the acid is struggling to work but for me is the only thing that makes a slight difference other than Retinoids like Tretinoin Gel and Differin 0.1% Gel. Its still a catch 22 guys ..... how does one save the Eyebrows while removing the follicular growth/plugs. Delicate balancing act it is and a tough one for sure !!!

    Anyone who wants to PM me can also email me "sukhwant25@gmail.com" for further questions or concerns or those who wish to simply talk or share your experience around it. I can understand what the suffering is as I have had it close to a decade now and have tried every possible thing OTC, Rx & natural which is generally touted for eczematic skin or healthy skin for that matter.

    Lets be a support for each other since there is no known cure.


    Desperado

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    A follow up to my earlier post from yesterday....
    Yes it is related to KP and Follicular Hyperkeratosis. With Seb Derm there is typically inflammation which makes the skin appear red but not so in comedonal dariers disease which is a much more aggressive and progressive disease compared to regular KP. The skin gets very dry and rough with enlarged pores and lot of elongated villi round the follicles. Several things happen in paralell like the flakey plugs which constantly grow back no matter how hard you try to remove them. With passing years when you get tired of creams and gels and turn to acids you realise that once the plugs are removed the surface beneath still appears bumpy and wonder what the hells going on. This all takes very microscopic observation to realise and one may not be aware of some facts unless clisely observing. You cant miss the plugs but the elongated villi are tiny and I observed them after I had switched to removing the superficial plugs with Lactic and Glycolic acid creams and lotions since nothing else was doing it.
    To my wonder what I found over period of yearrrs is that beneath the superficial plugs the skin was still bumpy until closer observation revealed bumps which resemble tiny milia and some resemble very tiny syringomas but these structures are what they call elongated villi. Its complicated to describe and again can easily go unnoticed unless closely observed under adequate light and clear vision.
    The bumpiness is abnormal ofcors to say the least.
    AHAs should be your first line of defense to get some level of normalcy. Try Ponds Rejuveness cream if you are in your initial 5 years of the disease. It willl soften and clear most if not all plugs. This has mild acid so nothing to fear. Amlactin is very strong and can be used once in 2 weeks after the 7th year opposed to Ponds Rejuveness which can be used daily.
    Initial 5 years brows fall easily worst brow fall in initual 3 years.
    Glycolic acid gel 10% is stronger than ponds rejuveness and is effective in initial 7 years and is safe to use.
    Yes as you clear the plugs you will loose some hair as they are attached to the follicles.
    Good news after 6th year the eyebrows will fall less since the superficial plugs will lessen and the deeper dermal milia like growths will instead rear their heads. Cosmetically the plugs are more of an issue but the milia like comedonal like growths are not easily removable other than electrocautery and professional extraction..needless to say its not the best option for the brow zone. Chemical exfoliation is the best option but you have to be regular.
    Once your brows build resistance to AHAs swotch to Rx Retinoids. Tazorac 0.5% gel works well so does Retin A 0.025% gel. Try both and alternate usage.
    TCA would be the last option guys. Currently am using Retinoids too.
    Hope this info will help some brow loss sufferers who come on the board and for whom Seb Derm solutions have failed.

  6. #6
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    Quote Originally Posted by desperado View Post
    A follow up to my earlier post from yesterday....
    Yes it is related to KP and Follicular Hyperkeratosis. With Seb Derm there is typically inflammation which makes the skin appear red but not so in comedonal dariers disease which is a much more aggressive and progressive disease compared to regular KP. The skin gets very dry and rough with enlarged pores and lot of elongated villi round the follicles. Several things happen in paralell like the flakey plugs which constantly grow back no matter how hard you try to remove them. With passing years when you get tired of creams and gels and turn to acids you realise that once the plugs are removed the surface beneath still appears bumpy and wonder what the hells going on. This all takes very microscopic observation to realise and one may not be aware of some facts unless clisely observing. You cant miss the plugs but the elongated villi are tiny and I observed them after I had switched to removing the superficial plugs with Lactic and Glycolic acid creams and lotions since nothing else was doing it.
    To my wonder what I found over period of yearrrs is that beneath the superficial plugs the skin was still bumpy until closer observation revealed bumps which resemble tiny milia and some resemble very tiny syringomas but these structures are what they call elongated villi. Its complicated to describe and again can easily go unnoticed unless closely observed under adequate light and clear vision.
    The bumpiness is abnormal ofcors to say the least.
    AHAs should be your first line of defense to get some level of normalcy. Try Ponds Rejuveness cream if you are in your initial 5 years of the disease. It willl soften and clear most if not all plugs. This has mild acid so nothing to fear. Amlactin is very strong and can be used once in 2 weeks after the 7th year opposed to Ponds Rejuveness which can be used daily.
    Initial 5 years brows fall easily worst brow fall in initual 3 years.
    Glycolic acid gel 10% is stronger than ponds rejuveness and is effective in initial 7 years and is safe to use.
    Yes as you clear the plugs you will loose some hair as they are attached to the follicles.
    Good news after 6th year the eyebrows will fall less since the superficial plugs will lessen and the deeper dermal milia like growths will instead rear their heads. Cosmetically the plugs are more of an issue but the milia like comedonal like growths are not easily removable other than electrocautery and professional extraction..needless to say its not the best option for the brow zone. Chemical exfoliation is the best option but you have to be regular.
    Once your brows build resistance to AHAs swotch to Rx Retinoids. Tazorac 0.5% gel works well so does Retin A 0.025% gel. Try both and alternate usage.
    TCA would be the last option guys. Currently am using Retinoids too.
    Hope this info will help some brow loss sufferers who come on the board and for whom Seb Derm solutions have failed.

    I have tried ultra low dose Accutane but had to stop because I could not handle the dryness and the bumpiness seemed to get worse owing to dried up skin.
    Salicyclic acid face wash gels and creams can also be used and in gel and cream form at 3% atleast to make a difference.

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    How is one diagnosed with Comedonal Darier's Disease? Are there other accompanying symptoms? Especially if one is in the very early stages of the disease...?
    Last edited by Daners; 10th July 2016 at 05:43 PM.

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    Quote Originally Posted by Daners View Post
    How is one diagnosed with Comedonal Darier's Disease? Are there other accompanying symptoms? Especially if one is in the very early stages of the disease...?
    Good question !

    Truly one could not tell one from the other in the initial stages other than maybe SD has a far greater degree of inflammatory (visible red/pink) and itching component associated to it which would be minimal or close to none in case of classic Comedonal DD.
    None of the Seb Derm common treatments (steroids, anti-fungals creams/shampoos, coal tars, honey, antibiotics etc etc) would make any difference and the plugs keep coming back uncontrolled at the same spots.
    In Comedonal DD the plugs are more often skin colored but can also vary in some people of color and appear brown/black based on melanin content of the skin. Surrounding skin can get hyper-pigmented (slightly darker) or hypo-pigmented (slightly paler) compared to your normal skin and more so in later stages.

    Comedonal DD seems to be common amongst those of us with excessively OILY skin along with a tendency for clogged pores (blackheads/whiteheads). Hence in its early stages will easily go undetected and misdiagnosed as SEB DERM.
    CDDs full manifestation and the villi like tiny projections from pores and conglomeration of the plugs and some plaque is in its later stages. Soft white oily flakes turn more and more dry and plaque like in the later stages while Eyebrow fall reduces over time. It still looks ugly in the mirror on close examination despite less brow loss because by the time one gets to this stage the Eyebrows would be sparser making the abnormal skin growths underneath more visible.

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