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Thread: Seb Derm is getting to be even more annoying than rosacea...advice?

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    Default Seb Derm is getting to be even more annoying than rosacea...advice?

    Hi all,

    Just looking for a little bit of friendly advice. In the last 6 months my rosacea worsened and then, around the same time, I developed an annoying case of seb derm on my forehead. I'm finding RLT is working quite well to keep my rosacea flushes at bay, and while that condition is still not entirely where I want it to be, I find most days I can cover my rosacea easily with just a thin layer of tinted moisturizer. The seb derm, however, doesn't seem to be getting any better.

    My seb derm is a red, almost scaly looking rash in the center of my forehead (it looks like tiny red bumps up close) along with some redness near my eyebrows. Sometimes it's itchy, though I avoid scratching it because when I do it makes the rash very red and irritated. It's just so annoying. This will sound vain as hell, but I used to pride myself on having a flawless forehead. Now it's like my whole damn face is covered with skin problems. And I'm only 26. What kind of joke is this?

    Anyway, I'm hoping someone on here will be able to give me some insight as to what I can do for my seb derm. I'd really like to see some of these red bumps disappear, and for my skin in that area to be less irritated. The "leave it alone" method doesn't seem to be working for me, so...thoughts, anyone? I've heard some people say that they use anti-dandruff shampoos like Nizoral to wash their face with and that that helps. Is there any merit to this?

    I'm currently using Elidel for it. The Elidel was prescribed to me by my derm--don't worry, he warned me not to use it long-term and to be careful with it--and I apply a VERY thin layer to the affected area only, twice a day, once every 12 hours. I've been doing this for about four days now and don't really see any improvement. About how long does it take for seb derm to start clearing up? Or rather, how long does it take to know if a treatment is working?

    I welcome any thoughts and/or insight on this topic.

    Thank you,
    Katie

  2. #2
    Senior Member Tom Busby's Avatar
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    Hi Katie, using Nizoral 1% shampoo, once daily, for 2 weeks, should show a very small improvement but it will be visible. This is the easiest diagnostic test for seb derm (induced by an allergic reaction to malassezia). If you see no change at all, then malassezia is not the cause, which will be useful to know.

    Nizoral contains ketoconazole, which barely works -- by which I mean, you could use it daily for a year or more and still not have healed. Climbazole is effective, but there isn't an FDA Final Monograph authorizing its use in the US, so you would have to order Hegor 150 from baroness.co, and it will be shipped from Romania, arriving in about 3 weeks.

    With climbazole, I estimate that the number of months to heal, (to where no one else would notice anything wrong, on reasonably close inspection), is calculated by your age in decades, multiplied by 2. For example, if you're 25, it would be 5 months to heal.

    With both of these shampoos, do not wash in the sink -- you need to have the force of a shower to adequately rinse off the surfactant SLS, which is used in both of these shampoos. Rinse off very completely. During the lathering phase of cleaning, turn the shower off for 3-4 minutes, so the active ingredient has some time to work.

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    Quote Originally Posted by Tom Busby View Post
    Hi Katie, using Nizoral 1% shampoo, once daily, for 2 weeks, should show a very small improvement but it will be visible. This is the easiest diagnostic test for seb derm (induced by an allergic reaction to malassezia). If you see no change at all, then malassezia is not the cause, which will be useful to know.

    Nizoral contains ketoconazole, which barely works -- by which I mean, you could use it daily for a year or more and still not have healed. Climbazole is effective, but there isn't an FDA Final Monograph authorizing its use in the US, so you would have to order Hegor 150 from baroness.co, and it will be shipped from Romania, arriving in about 3 weeks.

    With climbazole, I estimate that the number of months to heal, (to where no one else would notice anything wrong, on reasonably close inspection), is calculated by your age in decades, multiplied by 2. For example, if you're 25, it would be 5 months to heal.

    With both of these shampoos, do not wash in the sink -- you need to have the force of a shower to adequately rinse off the surfactant SLS, which is used in both of these shampoos. Rinse off very completely. During the lathering phase of cleaning, turn the shower off for 3-4 minutes, so the active ingredient has some time to work.
    Hello,

    Thank you for your reply. I'm not really comfortable using a drug that is not authorized for use in the U.S. So I will try the Nizoral for a few weeks and see if there are any signs of improvement.

    Thanks again for your advice!

    --Katie

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    Quote Originally Posted by Tom Busby View Post
    Climbazole is effective, but there isn't an FDA Final Monograph authorizing its use in the US, so you would have to order Hegor 150 from baroness.co, and it will be shipped from Romania, arriving in about 3 weeks.
    I don't believe Hegor 150 is available anymore. I've checked several times on eBay, Amazon and Baroness and only Hegor 50 is available.

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    Senior Member Tom Busby's Avatar
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    Thanks Daners for the info -- Hegor 50 is 0.5% climbazole which is more than enough. I make my shampoo and lotion at 0.08% climbazole, which is completely effective.

    The EU authorizes climbazole at up to 2.0% in shampoo, and a face/scalp lotion at 0.5% -- I extrapolated the data to 0.08% for a lotion and make the shampoo at the same percent, because the arithmetic leads to a simpler result that way. The EU requires a 100 to 1 safety ratio for OTC products, so the EUU guidance is clear, safe, and relatively simple, although the assumptions are complex.

    The FDA is simply a tool and by federal law blocks everything that was first sold after 1972, for OTC. Therefore, US laws and regulations require someone or some company to spend about $5 million in fresh research for a post-1972 OTC product -- no one will ever do this because OTC products are very easy to figure out and mimic. That's also why zinc pyrithione (Head and Shoulders, etc.) is legally marketed as effective against seb derm in the US, even it has no demonstrable mechanism against malassezia, never did, and is a complete waste of time and money for consumers.

    In the EU, the government reviews available research and makes a decision. Here in the US, somebody has to spend $5 million to buy a decision.

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    Default Is this a sign that it's working?

    My seb derm, after a few days of using an antifungal shampoo on the affected areas of my face, is more pink than normal. It also feels a lot more sensitive. And I can't be 100 percent sure, but it seems the little bumps are beginning to disappear. Is this a sign that it's working, or is the fact that it feels more sensitive indicate that I'm aggravating it?

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    Quote Originally Posted by Daners View Post
    I don't believe Hegor 150 is available anymore. I've checked several times on eBay, Amazon and Baroness and only Hegor 50 is available.
    I have not been able to find it either. I am now considering Bioderma Node P but it does not appear to be available in Canada?

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