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Amazing accutane journey, but another problem came back

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 So I've suffered with really bad acne for a long time, it was bad to the point where you could barely see any clear skin.
I went to a dermatologist and she put me on 30mg accutane everyday for almost 6 months, it did wonders and completely cleared my skin (I still have a lot of scarring and get the smallest zits every now and then, but I'm just grateful most of the acne went way).
 My dermatologist was surprised by how fast the medicine started working on me, the side effects started on my 8th day, and my really oily skin started becoming really dry. By my second month I was doing pretty good, I'd still get around 4 new zits every week, but it was way better compared to the big cystic acne I used to get every single day. When it got to the fourth month I was completely clear, I continued taking accutane for another two months because I was afraid it would come back.
 Before accutane I used to have really bad seborrheic dermatitis on my scalp, it's really itchy, makes your hair oily and your scalp flaky and gross feeling. During my accutane course the seborrheic dermatitis disappeared in like the first 8 days, my hair was never oily. Now that I came off of accutane my skin is still clear but the dermatitis came back, I don't know what to do! I've tried a lot of products before and none of them work (or they do but it comes back really fast). I just wish I could be on accutane forever, I was never afraid of getting pimples or having an annoying itchy scalp while I was on the antibiotics.  I'm constantly afraid that it will spread to my face and bring the acne back!
 It doesn't matter if I wash my hair every single day or only once a week, it is always there, I'm pretty sure it doesn't have to do with any of my hair products cause I'm constantly changing them.
 Can anyone help me? Thanks in advance and I'm sorry for any writing mistakes.


Edited by SunnyLyric

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Borax shampoo may help.  Borax kills both fungal infections (seborrheic dermatitis) and microscopic Demodex skin mites. 

Borax shampoo is an easy DIY mix.  Get a box of 20 Mule Team Borax from the grocery store (look on the laundry aisle).  Shampoo:  Add one tablespoon of Borax per cup of hot water - mix thoroughly and let cool.  Pour into an old shampoo bottle.  This is a "no poo" lather-less shampoo so don't expect suds.  But it works.  Just pour some Borax shampoo on your head and massage just like regular shampoo.  Good to let it stand on your hair while showering.  Then rinse as usual.  You can wash your face with Borax shampoo too.

You can also do a Borax-Epsom Salts body soak for itchy skin if needed.   For a standard 5 foot bath tub, add 1 cup of Borax and 1 cup of Dr. Teal's Epsom Salts with Avocado Oil to a tub of warm (not too hot) water.  Soak for 30 minutes.  Be careful when getting out of the tub as it may be a bit slippery.

Did your doctor test you for Demodex?  Everybody has these skin mites.  They can cause itchy skin, scalp, blackheads/whiteheads, red eyes, and pustules/cysts (when they die).   Demodex Brevis live in the oil glands while Demodex Follcularum live in the hair follicules and pores.  Demodex are active at night and may track bacteria and fungus back down into the pores and hair follicules causing additional secondary infections.

Demodex skin mites eat oil.  Accutane may reduce/control the population of  Demodex by reducing their food source.  But Accutane will not kill all of the mites.

If you do have Demodex, a 2 week oral treatment with Oral Ivermectin and Oral Metronidazole published in the International Journal of Infectious Disease in 2013 was super effective for me.  The article is here: https://www.sciencedirect.com/science/article/pii/S120197121201315X
The oral treatment is effective over your whole body to kill the mites down in the glands not just on the surface of the skin. This oral treatment is effective for the eye lids, where you can't use a topical treatment that might burn or irritate your eyes. Demodex mites can infest any oil gland or hair follicle.  

The combined oral parasite treatment is what worked for me. Oral treatment took 2 weeks. Face and eyes still clear at 3 months after treatment.   

The good thing is that this oral treatment uses 2 old drugs that are available as cheap generics. My insurance copay for both drugs was $13.03 - without insurance full retail price was $52 USD.

The 2 week treatment that worked well for me was:

1. Two doses of oral Ivermectin one week apart. Each weekly dose is 200 micrograms Ivermectin per kilogram of body weight. Worked out to 12 mg per dose for me. Take on an empty stomach with a large glass of water.

2. Oral Metronidazole, 250 mg. three times a day for two weeks. Do not drink alcohol while taking oral Metronidazole and for 72 hours after taking the last tablet.

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