You said it's not flaky but it sounds like psoriasis. Google that and see if it looks similar. Your doctor should test it to see what it is.

i guess it has some symptoms similar to it, yes. Although this patch on my face isn't scaley, bumpy, flaky etc. It is literally just flat, and red.

I'll go to the doctors (again, for another pointless consultation) next week to see what they say this time.

Has anyone had this problem, or a similar problem, before? And what did you use to treat it?

You could treat it with Lotromin Ultra (not the AF kind) for two weeks and see if you have any improvement. The problem with doctor-type diagnosing is that nearly all skin conditions look the same -- red bumps of various sizes. By comparison to a doctor-type diagnosis, it's easy to treat it as if it were a fungal problem, using an OTC anti-fungal, and see what happens.

Your location is correct for seb derm induced by malassezia, and the raised red plaque is too, but usually this causes skin flakes too. If you buy the Lotromin Ultra, use it in your eyebrows too, and if you get any flaking there, then you have a correct diagnosis for seb derm induced by malassezia. The manufacturer's website usually has a $2 off coupon, so buy the larger size tube.

Right, okay. Thanks for the info. Im from England so I dunno if that stuff you recommend is easily available to me or not. I'm going to wait to see what the doctor says this time before I waste any more time and money.

Thanks for the reply though.

Any idea what might have caused the problems I described? Or what causes the condition in general?

Turns out it is seb derm. Got some daktacort cream prescribed for it.

Lovely.

It's believed the problem is genetic, because it will recur without constant treatment. The trick is to find a mild everyday solution. Anything with cortisone is not an mild everyday treatment. If it's malassezia you are treating, try Hegor 150, a shampoo with 1.5% climbazole, or any other shampoo with climbazole. There are several available in EU countries.

Hi Tom (Busby)

Sorry to hijack this thread.

What are your thoughts on using zinc pyrithione to cover off any potential fungal involvement? I'm not sure about using a product like Nizoral on my face as while it might help with seb dermatitis it might trigger contact dermatitis...?

Yes, you can use Nizoral cream (2% ketoconazole) or Lotrimin Ultra without contact dermatitis worries, as far as I know. Neither cream is listed as non-comedogenic, but they seem to have a very mild carrier base, and no fragrances. In my experience a shampoo alone is not effective, and a cream is necessary. These are the only two commercial creams that have any effectiveness, in my experience, but there are other creams with piroctone olamine that some people say are effective. For example, Promiseb, or one of the others..

I make my own lotion with 0.065% climbazole but that's a bridge too far for most people. I use MCT oil as a base, because the carbon chain lengths in it, C8 and C10, are not edible to malassezia. So your question about contact dermatitis is near to what I was concerned with in my development of an effective lotion.

Concerning shampoo, in my experience, zinc pyrithione is simply not anti-fungal -- it tends to remove sebum, that's all it does. ZInc pyrithione has been in Head and Shoulders shampoos since 1962 and yet the manufacturer has never been able to show that it actually does anything to malassezia. Successful marketing is the only reason to buy this.

Selsun Blue (selenium disulfide) is one small step up, but still not very effective.

The next best product is Nizoral (1% ketoconazole) shampoo, which has an advantage because you can buy it any drug store .com in the US. (Nizoral is usually not on the shelves though.)

The absolute best shampoo is Hegor 150, or one of the other climbazole shampoos available in the EU, but you might not like the smell of the climbazole shampoo made by Eucerin because it includes piroctone olamaine, which has a very strong smell, like soap on steroids. Hegor 150 smells fine, better than all the other shampoos I've listed here, but it sells only off eBay, and then ships from Bulgaria and takes 3 weeks to arrive in the mail.

You may try pure chimp natural super cream as it may help you out.

It consists of 100% naturals and it's absorbed easily. And it's recommended by pharmacist Gareth Evans.

Cheers for all the suggestions everyone. This daktacort cream seems to have done the trick and it's fading nicely.

But of course, as soon as one problem goes, another pops up instantly. Now I have 2 red itchy patches just down below either corner of my mouth. This shit just never ends.

Hi Tom

Thanks for your reply.

May I ask on what basis are you such an advocate of Hegor 150 shampoo with 1.5% climbazole?

As far as I can tell, it is not mentioned on emedicine.com or any of the other mainstream medical resources? But you are obviously very expert in the area so I'm very curious to learn what you've read about Hegor 150 shampoo with 1.5% climbazole?

Do you have any data on its efficacy?

Cheers

Dave

Hi Tom

Not sure if you're still following this thread but you mentioned something about the lack of evidence for Zinc Pyrithione.

I presume you have read this study http://www.ncbi.nlm.nih.gov/pubmed/21919897 which concludes;

"The molecular basis for the antifungal activity of the commonly used active ZPT has been elucidated, more than 50 years since its introduction, as utilizing a copper toxicity mechanism that targets critical iron-sulphur proteins".

I'm aware it doesn't mention malassezia specifically. What are your thoughts on this study and the mechanism it proposes? And it's relevance to malassezia?

I've also read somewhere that Zinc Pyrithione is a factor of several hundred times more effective at killing S.Aureus than Salicylic Acid, which sounds useful for fungal infections which are often comorbid with bacterial infections?

Thanks

That study was funded by The Proctor and Gamble Company. They make more money selling Head and Shoulders than all the other companies make from selling all the other antidandruff shampoos, so P&G publishes self-serving "research" that continually fails to find any mechanism for zinc pyrithione. I think it has no mechanism at all. Mechanism means a medical explanation of the reason that a drug is successful.

My experience is a 1.5% climbazole shampoo is about 5 times more effective than a 1% ketoconazole shampoo. When Citric Acid at 0.3% is added to the climbazole shampoo it becomes about 10 times more effective.

This forum's "paste" text feature doesn't work anymore for me, so it's impossible for me to cite research articles, but send me a PM with your email address and I'll send you some medical research citations for my statements above.