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Dermatology (Expert Forum)
Diagnosed with Seborrheic Dermatitis... Need help!
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
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Diagnosed with Seborrheic Dermatitis... Need help!
by Dan315, Jun 24, 2004 12:00AM
Hello,
I am a 22 year old male, I am active and in good health. In late January of this year, I noticed what I thought was irritated skin occuring below my bottom lip, between that area and the chin. I continued to wash as normal, and it did not go away. It worsened over time, as I would try to apply soothing lotions after getting out of the shower it would just seem to be dry and flaky within an hour. Over time, it turned from small papular (in my best description) red spots to having slight ***** areas in the middle. I eventually turned to an over the counter hydrocortisone ointment, which helped for a short time, but then ceased to help, and it seemed like the condition just worsened.
In mid April, I went to a general healthcare practicioner at my school, who diagnosed me with folliculitis of the beard area, and she gave me clindamycin pledgets to use for a bacterial infection. This seemed to clear up the ***** stuff (which she said could have been worsened by the ointment), but did nothing for the rash itself. So, I saw a dermatologist in early May. I told her it was localized, which it is, I have had intermittent slight flaking in my eyebrows every once in a while as far back as I can remember (no redness whatsoever and it resolves itself quickly), and I know that this certainly is not the same condition.
She diagnosed me with seborrheic dermatitis, and prescribed me a desonide .05% lotion to apply twice daily. This worked EXTREMELY WELL at first, after two days of twice daily application, it was gone for a full three days. Then, it started to creep back slowly, so it got to the point where I was using it twice daily every day. I tried to scale it back to once daily, but I would begin to see symptoms creep back.
I just a few days ago decided to take a complete break from the corticosteroids to see what would happen. Each day since I stopped I have just used a dandruff shampoo twice daily on my affected facial area, in hopes it would calm things down. Each day it has worsened, and now I believe it is the 3rd or 4th day after I stopped, and the breakout is now as bad as I ever remember being broken out. Under my lip, not on it, and on the top portion of my chin, very red and angry, and some pussiness. I had to start the desonide again this morning, because I couldn't take it anymore.
My question to you is this... I know that if I do have seborrheic derm, that it cannot be cured. However, I know it can be controlled. Why does it seem like mine cannot be controlled using non steroidal methods? Or, do I have something different altogether? I really dont want to apply corticosteroids to my face twice a day for the rest of my life, I'm sure that's not healthy. It's not along my hairline, or along my nose, or ears, or mustache area. I need your expertise, if there is any more information I could give let me know.
Thank you.
I am a 22 year old male, I am active and in good health. In late January of this year, I noticed what I thought was irritated skin occuring below my bottom lip, between that area and the chin. I continued to wash as normal, and it did not go away. It worsened over time, as I would try to apply soothing lotions after getting out of the shower it would just seem to be dry and flaky within an hour. Over time, it turned from small papular (in my best description) red spots to having slight ***** areas in the middle. I eventually turned to an over the counter hydrocortisone ointment, which helped for a short time, but then ceased to help, and it seemed like the condition just worsened.
In mid April, I went to a general healthcare practicioner at my school, who diagnosed me with folliculitis of the beard area, and she gave me clindamycin pledgets to use for a bacterial infection. This seemed to clear up the ***** stuff (which she said could have been worsened by the ointment), but did nothing for the rash itself. So, I saw a dermatologist in early May. I told her it was localized, which it is, I have had intermittent slight flaking in my eyebrows every once in a while as far back as I can remember (no redness whatsoever and it resolves itself quickly), and I know that this certainly is not the same condition.
She diagnosed me with seborrheic dermatitis, and prescribed me a desonide .05% lotion to apply twice daily. This worked EXTREMELY WELL at first, after two days of twice daily application, it was gone for a full three days. Then, it started to creep back slowly, so it got to the point where I was using it twice daily every day. I tried to scale it back to once daily, but I would begin to see symptoms creep back.
I just a few days ago decided to take a complete break from the corticosteroids to see what would happen. Each day since I stopped I have just used a dandruff shampoo twice daily on my affected facial area, in hopes it would calm things down. Each day it has worsened, and now I believe it is the 3rd or 4th day after I stopped, and the breakout is now as bad as I ever remember being broken out. Under my lip, not on it, and on the top portion of my chin, very red and angry, and some pussiness. I had to start the desonide again this morning, because I couldn't take it anymore.
My question to you is this... I know that if I do have seborrheic derm, that it cannot be cured. However, I know it can be controlled. Why does it seem like mine cannot be controlled using non steroidal methods? Or, do I have something different altogether? I really dont want to apply corticosteroids to my face twice a day for the rest of my life, I'm sure that's not healthy. It's not along my hairline, or along my nose, or ears, or mustache area. I need your expertise, if there is any more information I could give let me know.
Thank you.
Doctor's Answer
by Alan Rockoff, MD, Jun 25, 2004 12:00AM
, Jun 25, 2004 12:00AM
My guess is that you have not seborrhea but rather steroid rosacea. Seborrhea is scaly, not pimply. Rosacea gets a little better with a steroid, then rebounds as soon as you stop, just as you describe. Ask your dermatologist to consider a course of oral doxycycline and topical metronidazole. And don't use the desonide for now. This should be completely curable, even if it takes a few more weeks.
Take care.
Dr. Rockoff
Take care.
Dr. Rockoff
Member Comments (1)
by Smiley777, Apr 07, 2008 05:04PM
A related discussion, Seborrheic Dermatitis was started.
