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Thread: First time anti-fungal user - advice appreciated

  1. #11
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    Quote Originally Posted by sejon View Post
    My sentiments exactly. People resort to athlete's foot creams and doctors are prescribing harsh shampoos for the face -- a testament to how seb derm research and treatments are horrendously lacking as compared to other common skin conditions like acne, rosacea, and eczema.

    Out of the commercially available creams I've tried, I found that the only ones that made a discernible difference were the Ducray Kelual DS and the Bioderma Sensibio DS creams. Using these creams caused my entire face to turn red like a sunburn, which appeared to be a fungal die-off reaction, and then the redness faded over the course of two months with continuous use, and the stubborn seb derm rashes on the sides of my nose and between my eyebrows cleared.

    There are quite a few European, and especially French, brands that have ranges for seb derm, so it seems, to a certain extent, big "cosmeceutical" companies have recently stepped in where pharmaceutical treatments are lacking, having discovered that there's a considerable market for it.
    You feel like you are in the dark ages in the 🇬🇧
    When I said I canít wash my face with shampoo as I have rosacea aswell and dry sensitive skin he just went 🤷🏼*♀️ Put some moisturiser on it then .
    Iíve since changed my doctors

  2. #12
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    I'm currently visiting Lithuania, and out of curiosity went to a cosmetics shop inside a supermarket here in Vilnius, and despite it being such a small store space they even had a section specifically for seb derm, where I identified the following ranges: La Roche-Posay Kerium DS, Bioderma Sensibio DS, Ducray Kelual DS, Noreva Sebodiane DS, and Uriage DS.

    They appeared to have French brands only; however I'm aware of at least a couple Italian products (Biogena Flogan Gel and Eutrosis DS Cream) and a Spanish product (Nutradeica Cream, which is available in the US by prescription-only as Nutraseb Cream).

    Drugstores in the UK don't even have a dedicated seb derm section, much less the ranges mentioned above. Fortunately, a lot of the French ranges can be purchased online fairly easily from sites like cocooncenter and easyparapharmacie, for those who care to try.

  3. #13
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    Sejon, many thanks again for your very helpful input - I'm getting quite the education. If I could just trouble you for your thoughts on a couple of final points...?

    In terms of the ciclopirox olamine: there's a particular Polish brand that appears to be abundantly available via a big auction site but infuriatingly, this variety does include isopropyl myristate. However, it would appear that ciclopirox olamine shampoo is available OTC in the UK, via the Oilatum brand. This seems to be the same concentration as the cream (1% or thereabouts, if I'm interpretting correctly). I know that shampoo-on-face use has already been frowned upon in this thread, but what would be your thoughts on trying this as an alternative? Apart from anything else, it appeals to me on the grounds that I currently have a fairly thick beard covering most of the problem area (ie my chin, though the nasolabial folds are obviously exposed). This was troubling me regarding cream usage, as I'd probably want to shave it off to ensure proper application which would in turn 'expose' the extent of the issue - not something I'm keen to do. The shampoo might get around that problem, but is it a) advisable, and b) likely to be as effective?

    Finally, would you agree that I'm drawing a reasonable enough conclusion in theorising that the issue is fungal, bearing in mind my previous comments and that the issue has worsened in unison with the antibiotic-inspired improvement of my acne symptoms? I know you previously said that fungal treatment might be counterproductive while taking antibiotics - can you elaborate on that thought, and would you agree that waiting until I've finished the antibiotics before attempting fungal treatment might be prudent?

    Sincere thanks again.
    Last edited by davem81; 29th August 2019 at 10:10 AM.

  4. #14
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    All shampoos are formulated differently, so when I advise against using them on the face, it's just because as a general rule they contain harsher surfactants than face washes, and foam up more, which can strip the skin of its natural oils and worsen the problem. If you find a shampoo that's gentle enough to use, then by all means, go ahead. It's a hazy area anyway, because there are gentle shampoos (like baby shampoos) and harsh face washes.

    It's important to bear in mind that dermatitis is ultimately a malfunctioning skin barrier, and doing things that stress the skin barrier even further can do more harm than good. My personal opinion is that calling seb derm a strictly fungal problem is a gross oversimplification, just as much as calling rosacea a strictly demodectic problem, or acne a strictly bacterial problem. There might be a fungal component, and it's worth treating for that, but it shouldn't be at the cost of damaging the skin barrier even more.

    With that in mind, I believe a more reasonable approach than trying any product just because it has ciclopirox olamine is to try products that are less likely to cause problems, even if they don't use the specific active ingredient you want. I understand why using a wash that lathers would make it easier to apply to a beard -- some of the product ranges I've mentioned in earlier posts have creams and face washes for seb derm. It would be worth taking your time and doing more research before making the leap to try anything, so you can try it with confidence.

    Use of antibiotics is very well-known to cause fungal outbreaks, because bacteria and fungi are competitive in your skin's microbiota -- not only that, but bacteria are also competitive with other species of bacteria, and fungi with other species of fungi. Obviously I can't diagnose your specific condition, though.

    Sorry, I didn't mean to say it's counter-productive to treat a fungal condition while taking antibiotics, but rather the inverse -- it's counter-productive to take antibiotics. Your acne will likely return once your antibiotics course has finished, and you're potentially worsening what you suspect is a fungal condition in the process. A lot of risk with little reward, in other words. My opinion is that antibiotics are dangerously over-prescribed. But that's a conversation best to have with your doctor rather than me.

    I don't see any reason in waiting to complete the antibiotics course to start treating a fungal issue -- if anything, the earlier the better.
    Last edited by sejon; 29th August 2019 at 11:18 AM.

  5. #15
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    Thanks again, Sejon.

    I'm actually not completely certain it is seb derm I'm dealing with. Though my GP last week diagnosed at least a portion of my condition as such, this is only the 2nd (possibly 3rd) time a doctor has ever suggested seb derm to me in literally dozens & dozens of consultations. Prior to this recent appointment I'd moved away from suspecting seb derm, based upon the predominance of pustules within the rash. The interest in ciclopirox olamine arose when you shared the story of the excellent results your sister obtained when treating for perioral dermatitis, as this was where my thinking had moved to. A recovery as swift as hers would be most welcome...!

    Thank you also for clarifying over the antibiotic use - I can see now that I had misinterpreted your original comment. The condition around my mouth is actually worsening by the day, so I was in any case beginning to question the wisdom of delaying treatment. I'll get on with things now...

    I had actually previously 'sworn off' antibiotic use, but this latest course was literally a last ditch, desperate attempt to bring my symptoms back under control - I've just had my worst year yet with my skin, which all seemed to be sparked off by my soolantra use last summer, but after discontinuation my symptoms only seemed to settle at a level well above where they'd been previously and if anything, I then exacerbated the issue with my bactroban experiment. Believe me, I wouldn't have turned to antibiotics as anything other than a last resort. I was desperate for some relief.

    As well as clearing my acne symptoms though, they seem to have done me a significant service in highlighting the apparent distinction between the conditions from which I've been suffering (the longer standing acne, which the antibiotics have cleared; and the more recent chin/mouth acne-rash that has only appeared post-soolantra use, and which has worsened significantly since taking the antibiotics). I'd suspected as much previously but this has strengthened my belief, and now allows me to calibrate my treatment attempts as such. Now I come to think of it, even the dandruff that I'd previously got under pretty decent control seems to have roared back over recent days...

    I'll report back with any notable developments.
    Last edited by davem81; 29th August 2019 at 05:45 PM.

  6. #16
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    Quote Originally Posted by davem81 View Post
    Thanks again, Sejon.

    I'm actually not completely certain it is seb derm I'm dealing with. Though my GP last week diagnosed at least a portion of my condition as such, this is only the 2nd (possibly 3rd) time a doctor has ever suggested seb derm to me in literally dozens & dozens of consultations. Prior to this recent appointment I'd moved away from suspecting seb derm, based upon the predominance of pustules within the rash. The interest in ciclopirox olamine arose when you shared the story of the excellent results your sister obtained when treating for perioral dermatitis, as this was where my thinking had moved to. A recovery as swift as hers would be most welcome...!

    Thank you also for clarifying over the antibiotic use - I can see now that I had misinterpreted your original comment. The condition around my mouth is actually worsening by the day, so I was in any case beginning to question the wisdom of delaying treatment. I'll get on with things now...

    I had actually previously 'sworn off' antibiotic use, but this latest course was literally a last ditch, desperate attempt to bring my symptoms back under control - I've just had my worst year yet with my skin, which all seemed to be sparked off by my soolantra use last summer, but after discontinuation my symptoms only seemed to settle at a level well above where they'd been previously and if anything, I then exacerbated the issue with my bactroban experiment. Believe me, I wouldn't have turned to antibiotics as anything other than a last resort. I was desperate for some relief.

    As well as clearing my acne symptoms though, they seem to have done me a significant service in highlighting the apparent distinction between the conditions from which I've been suffering (the longer standing acne, which the antibiotics have cleared; and the more recent chin/mouth acne-rash that has only appeared post-soolantra use, and which has worsened significantly since taking the antibiotics). I'd suspected as much previously but this has strengthened my belief, and now allows me to calibrate my treatment attempts as such. Now I come to think of it, even the dandruff that I'd previously got under pretty decent control seems to have roared back over recent days...

    I'll report back with any notable developments.
    Well the derm I went to I was really impressed with he does online diagnosis aswell
    donít know weíre you are in the UK but PM me if you want his details

  7. #17
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    So I thought I'd post up my experience of the attempted treatment to date;

    I applied clotrimazole cream (minus the hydrocortisone) to my nasolabial folds twice a day for one week. I did this almost as a 'patch test' type experiment - these are/were the only areas of my face not covered by beard that were affected by these symptoms (though when you take the area under the beard into account, they actually make up a fairly minor proportion of the whole affected area).

    I think I can now understand the logic of incorporating hydrocortisone by the way, as the clotrimazole alone did seem to induce moderate itching and redness/irritation - nothing I couldn't handle, but noticeable nonetheless. Aside from this however, results were somewhat puzzling/inconclusive. For the first day or two, the cream appeared to be working well, as the small number of blemishes I had seemed to visibly calm overnight following application of the cream. That was as good as it got however - thereafter, the cream seemed to instead provoke symptoms rather than reduce them, with numerous new blemishes appearing over the following days and a general dry, irritated, angry appearance of the areas to which I was applying the cream.

    One query I have here is, does fungal treatment induce a 'die-off'-type reaction that might cause symptoms to worsen in the first instance, and might explain what I experienced? I think in all honesty I'd be reluctant to replicate this experiment on a wider area of my face, and will probably try the shampoo approach next.
    Last edited by davem81; 8th September 2019 at 03:19 PM.

  8. #18
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    Quote Originally Posted by davem81 View Post
    So I thought I'd post up my experience of the attempted treatment to date;

    I applied clotrimazole cream (minus the hydrocortisone) to my nasolabial folds twice a day for one week. I did this almost as a 'patch test' type experiment - these are/were the only areas of my face not covered by beard that were affected by these symptoms (though when you take the area under the beard into account, they actually make up a fairly minor proportion of the whole affected area).

    I think I can now understand the logic of incorporating hydrocortisone by the way, as the clotrimazole alone did seem to induce moderate itching and redness/irritation - nothing I couldn't handle, but noticeable nonetheless. Aside from this however, results were somewhat puzzling/inconclusive. For the first day or two, the cream appeared to be working well, as the small number of blemishes I had seemed to visibly calm overnight following application of the cream. That was as good as it got however - thereafter, the cream seemed to instead provoke symptoms rather than reduce them, with numerous new blemishes appearing over the following days and a general dry, irritated, angry appearance of the areas to which I was applying the cream.

    One query I have here is, does fungal treatment induce a 'die-off'-type reaction that might cause symptoms to worsen in the first instance, and might explain what I experienced? I think in all honesty I'd be reluctant to replicate this experiment on a wider area of my face, and will probably try the shampoo approach next.
    My derm said with the cream wipe on wash off . Then leave it on a little bit longer the next time .
    But he said no need to leave these creams on. Maximum of 15 mins then wash off . Otherwise it just irritates the skin.

  9. #19
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    Quote Originally Posted by Rubydo1 View Post
    My derm said with the cream wipe on wash off . Then leave it on a little bit longer the next time .
    But he said no need to leave these creams on. Maximum of 15 mins then wash off . Otherwise it just irritates the skin.
    Interesting. That would fit with my experience, as there was definitely some level of irritation caused. Whether it did anything positive for my symptoms, I'm less certain...

    Strangely though, the symptoms on my chin under my beard (which have not been treated in any way) have actually calmed down noticably over the past week or two. Not gone away, but definitely reduced. I wonder if this could be heat/weather related, as it has coincided with a definite cooling in that regard. Might support the fungal theory...who knows
    Last edited by davem81; 9th September 2019 at 02:13 PM.

  10. #20
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    Quote Originally Posted by Rubydo1 View Post
    Well the derm I went to I was really impressed with he does online diagnosis aswell
    donít know weíre you are in the UK but PM me if you want his details
    Hey, sorry to butt in but could you please PM me the derms details when you have a moment? Thanks

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