Results 1 to 5 of 5

Thread: Assistance with diagnosis and treatment - Any help is greatly appreciated!

  1. #1
    Junior Member
    Join Date
    Nov 2018
    Posts
    3

    Default Assistance with diagnosis and treatment - Any help is greatly appreciated!

    Good evening all

    Firstly, I would like to introduce myself as a bit of a forum lurker over the past few weeks.

    A bit about me, I'm male, 23 and have started to experience what I believe are SD symptoms over the past 4/5 weeks. Before this point, I had no idea what SD was and my only symptom was some mild dandruff on my scalp on occasions.

    However, during a period of high stress, late nights and overall bad health (not looking after my diet, drinking alcohol etc), I suddenly developed an onset of extremely greasy skin. Now my natural skin is definitely on the oily side, however, I have never in my life had to use blotting paper, wash my face during the day. At this moment in time, I could probably blot 8/9 times in a day and still look greasy/ shiny.

    This sudden onset of greasiness, was met with about 100 tiny papules/ under skin spots on my forehead. As shown in my first picture in my blue jumper. These spots were extremely itchy and during certain points in the day, they would become covered in oil and my forehead would turn a yellowish/red colour.

    I tried all sorts of acne products which only made these worse, until I found that they are likely a type of follucilitis. As a result, I tried Nizoral on these spots for a few days and defintely noticed a reduction however, the Nizoral is extremely drying on my forehead skin and makes it quite irritated.

    Fast forward a few weeks and the rash seems to have spread to my nose and cheek area as shown in my most recent pictures. This rash is often very mild of a morning however, as the day progresses and my oil levels increase, it will often flare up as shown in one of my pictures and become very swollen and red. This is often met with a burning/ stinging type sensation.

    I've no met with two dermatologists privately this week, which has cost me £500 in total, as this condition has become very difficult for me and I've definitely decreased my social contact and developed a certain level of anxiety which I've never had before. The first derm said it was SD and said to use steroid creams (hydrocortisone and Eumovate) and continue the Nizoral. I tried the steroids and to be honest, they really didn't help that much at all.

    The second derm I visited this afternoon, she struggled with a diagnosis as apparently this doesnt look like typical Seb Derm as I dont have much flakiness, just inflamed greasy skin. She said to continue the Nizoral also, and she also prescribed an antibiotic cream in case its bacterial and also Soolantra in case its from Demodex.

    I'll be completely honest, I am at whit's end with this and am even more confused as a result of these visit's. I've figured that the most knowledgable people are on this forum and would appreciate absolutely any input that anyone may have on diagnosis and/or treatment.

    Thank you ever so much.

    Jamie

    IMG_1251.jpg

    IMG_1301.jpg

    IMG_0567 - Copy.jpg

  2. #2
    Senior Member dryad's Avatar
    Join Date
    Aug 2018
    Posts
    233
    Country: Greece

    Default

    Hi Jamie,
    welcome to the forum

    I was first diagnosed with SD myself, and prescribed what is in effect the same as what you were given: I was given a steroid + antifungal combo cream, and you've been given a steroid and also an antifungal (Nizoral). It worked okayish for me for a while, then it stopped working and I was worse than I started. I would not be surprised if many people are incorrectly diagnosed with SD when in fact what they have is the early stages of Something Else. In my case, the Something Else turned out to be demodectic rosacea (a form of rosacea that is caused by a skin-dwelling mite).

    It's very easy when someone suffers from Disease A to assume that another person with similar symptoms also suffers from Disease A, so I don't want to project onto you but demodectic rosacea does look like SD in the early stages (at least close enough that I was misdiagnosed with SD first), does tend to respond reasonably well to antifungals in the early stages (I did well on the antifungal steroid for a while until it was outclassed by the mites), and does tend to produce LOTS of tiny pustules and an oily skin. BUT that doesn't mean you have what I have, it means that I am projecting onto you what I have because it sounds familiar -- still worth reading up on demodectic rosacea on this forum though - just in case. There is treatment (actually several different ones) and I've been very successful as have others.

    One thing I do want to point out though is that prolonged use of steroid creams can actually cause persistent redness (steroid-induced rosacea). I think this forms at least part of the redness I'm currently dealing with, long after my skin texture has become perfected. So -- please exercise caution with steroid creams. Even my dermatologist who gave it to me for SD told me never to use it for more than 2-3 days at a stretch.

  3. #3
    Junior Member
    Join Date
    Nov 2018
    Posts
    3

    Default

    Hi Dryad

    First of all, thank you so much for your reply. I already feel better knowing that people have experienced similar onset of symptoms and successfully treated.

    The derm that I saw today said that there is a possibility that this is a Demodex issue and has prescribed me Solantra as well as an antibiotic cream.

    I will start applying this tonight as per her instruction, am I right in saying that the antibiotic should assist in offsetting the die off symptoms that release bacteria and cause further inflammation?

    I know it sounds defeatist, just I am already struggling with this inflammation and a further increase would really set my confidence back. However, by the sounds of it, Solantra is really something I ought to give a go.

    Thanks again and any further comments are most welcome.

  4. #4
    Senior Member dryad's Avatar
    Join Date
    Aug 2018
    Posts
    233
    Country: Greece

    Default

    Ah hah! your dermatologist agrees with me

    Soolantra is definitely one to try but don't be heartbroken if you don't get the results you want with it - it's not the only option! I haven't used it as it's not sold in my country.

    Having been through the Great Die-Off Experience, I don't think the antibiotics will do much to offset it but IF you get as bad of a die-off as I did (mine was terrible!) then the antibiotics can help protect you from any sort of secondary infection (my die-off was so bad that my skin was left open to infection, so I was on doxycycline, but it didn't do anything about the demodex or the redness. I was actually on a lot of things to try to protect me from secondary infection because of how destroyed my skin was. I had a rough time! Even I healed up great though.)

    I was on probiotics/prebiotics at the same time as the antibiotics (I staggered them about 6 hours apart because antibiotics just kill the expensive probiotics lol) but this was just to keep me from having side effects from the doxycycline, I don't think it helps the redness either.

    A lot of what I did was sort of "supportive care" to "get me through" the die-off in one piece. Don't be scared -- the worse the die-off, the better the results, I think, because it means it's really working.

    I know how it feels to want to minimize as much as possible the die-off symptoms, believe me. I was in shock during my die-off and refused to leave my house. HOWEVER it clears up pretty quickly (days, not weeks) and then it just gets better and better. At least in my case that's how it went. And I had THE WORST die-off. My confidence was in the toilet too but it's such a short period of time honestly... don't do it the night before a first date? other than that, just go for it, it will either work (and suck temporarily) or not work in which case you just try something else. Many people rave about Soolantra but there is also an oral version of the same drug that is out there, there is another similar drug called permethrin which is used for scabies, there are natural die-off-producers like tea tree oil (that's what I used, don't be misled by it being "natural", that sh** is hardcore), there are chemical ones like zinc+sulfur combos.

    I have seen it said before that being diagnosed with demodex is the best thing that can happen to someone with rosacea. Treatment can be rough and you may have to try several things but this is one form of rosacea that has a great prognosis.

  5. #5
    Junior Member
    Join Date
    Nov 2018
    Posts
    3

    Default

    Hi dryad

    Thank you ever so much for your reply.

    To confirm, I woke today and the swelling and redness is slightly reduced, not majorly but maybe 20% or so.

    Last night, I used a combination of Nizoral and E45 shampoo on my face and today woke up to stange peelings of skin coming from my forehead. Has anyone experienced this before?

    I've also noticed I'm quite a bit less greasy today. although it is still early and this usually build of an afternoon/ evening.

    I've emailed my derm today to ask if this is normal or if this is a reaction to the Soolantra/ Antiobiotic cream.

    Still unsure on exactly what this is, but I am still leaning towards a form of Seb Derm, although I'm going to continue with the demodex treatment also.

    Also, I've been considering asking my derm for Elidel, we discussed this yesterday and she said she wanted to keep this in reserve. I'm going away for a long week in 8 days, and would really love to had a reduction in inflammation and redness by then is possible. Anyone have any thoughts on this?

    Again, any helps is much appreciated.

    Best,

    Jamie

Similar Threads

  1. Prescription medication assistance...
    By boyandhisdog in forum Prescription medications
    Replies: 12
    Last Post: 8th April 2017, 12:29 PM
  2. Any opinions on this matter would be greatly appreciated
    By Dg0622 in forum General rosacea questions
    Replies: 4
    Last Post: 1st November 2015, 03:25 PM
  3. Treatment suggestions much appreciated
    By daphexb in forum Photos
    Replies: 1
    Last Post: 21st May 2014, 06:21 PM
  4. Confused about Rosacea, any help would be greatly appreciated! :)
    By SN77 in forum General rosacea questions
    Replies: 1
    Last Post: 14th January 2014, 12:58 AM
  5. Malassezia folliculitis? Rosacea P&Ps? Something else? Any advice greatly appreciated
    By Guitar_George in forum Similar and co-existing conditions
    Replies: 6
    Last Post: 11th December 2013, 03:21 AM

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •