Rosacea/Seb Derm Dilemma
Over a year ago I was told by a dermatologist that I had rosacea. I
saw a different dermatologist this week and he disagreed with the
diagnosis of rosacea. He said that my problem is seborrheic
dermatitis. I told him that I do have symptoms of rosacea such as
broken blood vessels on the bridge of my nose and I flush
occasionally (mostly when under stress or after drinking alcohol).
He said it might be possible that 5% of my problem was rosacea
(don’t
know how he arrived at that conclusion), but the broken blood vessels
were caused by sun damage (even though I told him I stay out of the
sun). It really seemed that he thought I didn’t have rosacea at
all.
He prescribed Aclovate for my face. That’s a topical steriod,
and
I’m concerned that if I have rosacea it will aggravate it. If I
don’t have rosacea I’m afraid it may induce it. (I’ve
read that
steroids can induce rosacea.) He assured me that Aclovate is safe
and a very mild steroid that is used on babies with dermatitis. He
also assured me that Aclovate would not thin my skin. (I have read
that topical steroids do this and this helps induce rosacea.) He
even said that in some cases topical steroids were indicated for
rosacea such as for rosacea dermatitis.
I looked up Aclovate’s potential side-effects and I am concerned
about them. Aclovate is also an expensive medication.
I asked him about non-steroid treatments like anti-fungal
medications. He said they wouldn’t be very effective and
Aclovate is
what I should use. According to him Aclovate could clear up my skin
in a few days. In my case he did not seem to think that Aclovate
would cause rosacea (or adversely affect it if I do actually have it).
I’ve noticed other people posting similar experiences of
dermatologists prescribing topical steroids like Des Owen. Is anyone
else concerned about this? I am confused and concerned about using
topical steroids.
So what am I supposed to do? Does anyone have experience with
Aclovate? Can it really clear up seb derm in a few days? Has it
caused or aggravated anyone’s rosacea? Are there any effective
treatments for seb derm besides topical steroids? What would you do
if you were in my situation?
I’d really appreciate it if anyone would share their experience
or
knowledge in this area. Thanks.
Dave
April 19th, 2003 at 4:02 am
I want to thank everyone who provided input on the use of topical
steroids for the treatment of seb derm and opinions about the
dermatologist I went to prescribing a topical steroid for me.
I’m going to try non-steroid treatments for now and preferably OTC
products so I don’t have to give more of my hard earned money to
dermatologists.
I found an interesting table of seborrheic dermatitis treatments at
For those of you who would like to treat seb derm with OTC non-
steroid products see table 1 at the above URL.
Here are some options: selenium sulfide, pyrithione zinc, coal tar,
ketoconazole shampoos that can be used to wash the face; antifungal
creams - miconazole, clotrimazole, terbinafine. All of these
products are OTC so you don’t need to go see a dermatologist for a
prescription. The table also lists non-steroid products that require
a prescription. Check out the table for more information.
Regarding ketoconazole cream I found the following quote at
"In some patients, 2% ketoconazole cream or other imidazoles twice
daily for 1 to 2 wk induce a remission that lasts for months."
Unfortunately a 2% formulation requires a prescription but you can
get a 1% shampoo solution (Nizoral) OTC.
Could someone out there offer more information about OTC non-steroid
treatments for seb derm?
People also mention Protopic and Elidel. These require a
prescription and have helped some but made others worse. One thing
that concerns me is that these are very new drugs. How do we know
that five years from now we won’t find out that these drugs make
rosacea worse or induce it like topical steroids?
The search goes on for safe and effective treatments. I appreciate
any help you can give me in this search. Thanks for your input.
Dave