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Jones4545

Accutane and Seborrheic Dermatitis

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I posted this on another thread, but I figured its more prescription related so im moving it here.

 

Hello all,

 

I am a 29 year old male. I have Seborrheic dermatitis on my scalp as well as my face, mostly in the hair baring areas. I started getting it on the sides of my nose about 6-7 months ago and I also started getting some pretty bad acne around my nose. Not really multiple pimples, but big pustules and cysts that would take up 3-5 pores at a time. I have tried keto shampoo on the face, but it was very irritating, and the only thing that has really helped was putting hydrocortisone on my nose, which might be making my acne even worse. I have started using a sulfur cleanser the derm gave me a week or so ago. But have broken out since then, and it is really effecting my life.

 

Long story short, my Derm thinks that the next course of action is accutane. Because I have Kaiser, they only have one way of prescribing the tane, and that is a full blown course, 40 mg for the first month and 80mg every month after. I have been on accutane before because I did have very severe cystic acne in my teenage years. I was very hesitant in the beginning because of all the negative side effects of taking the drug. But I have gone and seen 2 other derms and they said they agree with the first derm that because of my resistance to antibiotics and I cannot take Retin-a because of the seb derm on my face, accutane is the best way to go. They said that the accutane will actually help the seborrheic dermatits in the long run because it will reduce my overall oil production. I had my bloodwork done this morning so I expect the prescription will be filled by monday.

 

They also went on to say that they would never prescribe accutane for only seb derm but because I have acne they are able to. I just want to hear others thoughts on this. I know that usually there is a seborrheic flare up when you start and accutane might cause an IB with the acne. What are others experiences with accutane and seborheic dermatitis??

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1 hour ago, Worriedscared1 said:

Better to be cautious. I am sure some have used it.


Thanks for the reply. Im really surprised that there are not more people on here with a similar condition. Acne and Seborrheic Dermatitis are both caused by sebum.

I am on day 8 and my SD is worse than its ever been. I still feel oily but my skin is very flaky. 

If anyone has gone through similar situation, please let me know.
 
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Hey Jones, I am in the same boat here.
My seb derm got so bad after a 4 month course of minocycline that my old jack-ass derm prescribed me. I have a new derm now who is awesome and I started a low dose (10mg every day Claravis) accutane course. I have what I would classify as mild to moderate acne, some days its ok and others it looks pretty bad. My main concern however is the SD, it is so uncomfortable and just plain old looks terrible. I'm really hoping accutane helps as nothing else really has, I've done all the antifungals (even oral tablets) and right now I use plexion sulfur wash and moisturize with dermalogica active moist (one of few moisturizers that doesn't feed malassezia yeast). My skin looks like garbage right now, I think the accutane is flaring the seb derm but I don't really care if it ends up helping in the long run. I'm currently on day 11 of the claravis and will probably bump up to 20mg next month. Please keep me updated on your progress and ile update with mine.
Best of luck to both of us,
lets beat this once and for all.
James

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17 hours ago, Jbleez122 said:

Hey Jones, I am in the same boat here.
My seb derm got so bad after a 4 month course of minocycline that my old jack-ass derm prescribed me. I have a new derm now who is awesome and I started a low dose (10mg every day Claravis) accutane course. I have what I would classify as mild to moderate acne, some days its ok and others it looks pretty bad. My main concern however is the SD, it is so uncomfortable and just plain old looks terrible. I'm really hoping accutane helps as nothing else really has, I've done all the antifungals (even oral tablets) and right now I use plexion sulfur wash and moisturize with dermalogica active moist (one of few moisturizers that doesn't feed malassezia yeast). My skin looks like garbage right now, I think the accutane is flaring the seb derm but I don't really care if it ends up helping in the long run. I'm currently on day 11 of the claravis and will probably bump up to 20mg next month. Please keep me updated on your progress and ile update with mine.
Best of luck to both of us,
lets beat this once and for all.
James


My seb derm has calmed down alot. The real issue I am running into now is the dry skin. My skin is just as flaky now because of the accutane. Its hard to tell if the seb derm is going away or what. I normally get it on my nose so bad that it hurts to move my face at all, that hasnt happened in the past couple of weeks which is really nice. 

I have also read that Cerve PM is a lotion that doesnt feed the yeast. Where did you find out about the dermalogica, and how do you know it doesnt feed the yeast??
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I'm glad to hear your seb derm has calmed down now. How can you tell the difference between seb derm and dry flaky skin? That is pretty much how my seb derm manifests itself. I hear you with the nose thing, its so tight that every time I touch it has this dull pain to it. Yes you are right about cerave pm doing the same thing. I have been reading the forums by Tom Busby on the [removed] forum (he is a goldmine of information) and apparently the only 2 moisturizers that don't contain oils to feed malassezia are the cerave and dermalogica. I tried the cerave but it just didn't sit well on my skin (not saying it wont for others but just for me it was weird) so I ordered the dermalogica for 40 dollars which is steep but it doesn't add to the problem. How is your acne doing? I'm kind of flaring a little bit but not so terrible, probably because of my low dose.

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I flared on day 9-12, I have a whole log with every day posted. I learned about the cerave from Busby as well. Its all theory tho. The stuff ive read on that site is not accepted in the medical field. Keep that in mind. I talked with my Derm about the moisturizer and he said it was BS, he has been a long term sufferer of Seb Derm. Have you used the shampoo with the climbozole that they recommend, I am thinking of ordering it this week. 

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Thats interesting you flared 9-12, pretty much the same for me. I will be following your log, perhaps I should start one of my own as well. So you talked to your derm about the cerave or about the dermalogica? I know the stuff on that forum is not backed by anyone with a phd but user reviews and trial and error is still a good way to find products that might work even if the science to back it isn't provided. I have used the hegor 15 climbazole shampoo and it basically works just as well as nizoral. There is another shampoo I just read about on the forum called sachajuan and contains not only climbazole but piroctone olamine as well plus salicylic acid. It sounds like a good mix of ingredients, I'le paste the link below. What else did your derm say about seb derm, does he think the accutane will be effective? The one thing I will say works pretty well is raw honey masks, I do a couple each week and it really reduces inflammation. Talk soon. 
James


LINK: https://www.amazon.com/Sachajuan-Scalp-Shampoo-8-4-Ounce/dp/B002V7T8BC/

 
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I did ask him about the moisturizer and he said it wasn't medically accepted. I still use the cerave pm though. Just because I think I get less flaky with it. I have been doing a very labor intensive shampoo schedule that includes, zinc, selenium and ketoconozole. It seems to be working well, or its the accutane drying up my flakes. I will say that since I started the accutane, my dandruff has become little tiny balls, where before it would be very flaky. I don't know if this is a good thing or a bad thing. As of right now I don't really have any active acne. My issue with the climbozole is that it is just a steroid and your body will get used to it, I wish there was a way to keep this totally under control.

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That's interesting about the little balls instead of flakes, but I'm glad your acne is subsiding now. Climbazole isn't a steroid but an antifungal similar to ketoconazole. In clinical trials it has a higher efficacy rate than keto but its not FDA approved so must be ordered from the U.K. Does your derm think the accutane will eventually put your seb derm into remission? What does your derm use to keep his in check? It'd be very interesting to know what an actual derm would use on their own face when dealing with the conditions we have. Hope things continue to improve for you.
Best, James

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You're right, for some reason I thought it was a steroid that had anti fungal properties. But none the less a lot of people become immune to its effects. 

My derm told me that he uses the sulfur and sodium soap. It's a prescription I think it's 10%sulfur 5% sodium sulfactimide. Something like that. He says he puts that on his face and let's it rest for 1-2 mins, everyday when he is flaring and 1-2 week when he is not. He then uses aquanil HC hyddrocortizone for on his face. He is bald so I don't thing he worries about the scalp much. 

He said he would not prescribe me accutane for SD. The only reason he gave it to me was because I was getting pustulare and cystic acne that was scaring. Even though I only get 1-3 pimples at a time. He said using accutane for SD is and off label use and it can reduce oil production for a long time which would help manage the SD. But I have Kaiser and they do not prescribe low dose. It's an all or nothing course, so he wants me to take 80 mg a day. I am just taking 40mg every 36 hours. He said they get a lot of patients that transfer from other derms outside of Kaiser that are on a low dose regiment, but they done prescribe it like that. 

*typing on my phone and it's tough to correct errors so sorry if I sound like I'm 12

Edited by Jones4545
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Yeah unfortunately we must rotate antifungals so they can keep being effective. If I don't use keto for a month then go back I find it works really well for the first couple days. I also use the sulfur wash, it is ok but too much dries out my face. I'm surprised your derm only uses that and occasional aquanil, his seb derm must be pretty mild.
Accutane for SD is definitely off label use but I too have pustular acne with the occasional cyst around my chin area mostly. I have done the whole antibiotic rout and it doesn't really respond to them anymore, plus it flares the SD horribly. I have started to get scars so I'm really glad I'm starting the accutane. That's a pain with the insurance situation but on the bright side you will definitely hit your cumulative dose and most likely be acne free for a long time if not forever. If I could just get rid of my acne and focus solely on my seb derm I think things would be much easier. I hope I can shrink my oil glands semi-permanently so I can starve the damn fungi all over my cheeks. I'le be bumping up to 20mg next month then probably on it for another 8 months. I'm putting most of my faith into the accutane right now. 

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This is a good post, i'm starting accutane in a few days and also have seb derm, mostly on my scalp, but also a little between my eyebrows and on the corners of my nose sometimes. Currently I find the best thing to be neutrogenas t-gel with coal tar, but I dont use it on my face as it as way too drying to be of any help to those areas.
I'll be sure to update this reply in a few months so that anyone who views this thread in the future can see if it helped mine!

UPDATE:  Day 84 
Since about day 50 I can go 6 days without washing my hair. Around the one month mark I noticed all of the scaly areas on my scalp disappeared. 90% less itchy. Flakiness reduced by 85%. I experienced no initial flair
:D

Edited by AppleySauce
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Glad that it helps, I will give you a little update of how my pregress is going. I have a couple of active pimples right now. I am on day 50 or so. My dandruff has been really really bad since I started the accutane. It is not large flakes like before I started but now it is little tiny dried out skin, Everything is dry and flaky now. But the red irritation that I would get from the seb derm is completely gone. Now i just have very dry skin and if I touch it will produce flakes, which is a little hard to manage. 

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I'd really love to know how the accutane worked for your seb derm. I'm considering going on it for the first time. I have SD on my scalp and hair loss when I get a flare up. Also have cystic acne on my back and occasionally on my face. I'm just worried Accutane will make me lose more hair. It seems that whenever I sweat my head feels like it's crawling and my hair sheds like crazy.

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On 2/2/2016 at 10:35 AM, Jbleez122 said:

Yeah unfortunately we must rotate antifungals so they can keep being effective. If I don't use keto for a month then go back I find it works really well for the first couple days. I also use the sulfur wash, it is ok but too much dries out my face. I'm surprised your derm only uses that and occasional aquanil, his seb derm must be pretty mild.
Accutane for SD is definitely off label use but I too have pustular acne with the occasional cyst around my chin area mostly. I have done the whole antibiotic rout and it doesn't really respond to them anymore, plus it flares the SD horribly. I have started to get scars so I'm really glad I'm starting the accutane. That's a pain with the insurance situation but on the bright side you will definitely hit your cumulative dose and most likely be acne free for a long time if not forever. If I could just get rid of my acne and focus solely on my seb derm I think things would be much easier. I hope I can shrink my oil glands semi-permanently so I can starve the damn fungi all over my cheeks. I'le be bumping up to 20mg next month then probably on it for another 8 months. I'm putting most of my faith into the accutane right now. 


How did treatment with accutane impact your SD? Update? 
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Can someone please let me know if they actually cleared their Seborrheic Dermatitis with Accutane. I’ve been taking Accutane for the past 12 days. I had very light facial SD that would flair up once in 4-5 months. Severe SD on my scalp and chest and back acne(SO SEVERE that i have dark scars all over my chest and back that would even change to keloids). So now what has started happening is that my facial SD had flaired up so bad that my face has started hurting me when I even touch it. My face has become so dry and the area of SD has become flaky. I am just hoping that this pain is worth it. I’m just taking 20mg per day

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