Just diagnosed - 32 yr male - question about treatment

[pulp]

Hello everybody and welcome to your world. My name is Dom and today I was diagnosed by a rather ratty Dutch doctor.
Apparently I have Rosacea as well as Seborrheic dermatitis - lucky me! Should go nicely with my rapidly balding head:)

So anyways here's the thing. Before I was diagnosed by a proper bona fide dermatologist, my house doctor / gp had a go. They prescribed my some kind of hydrocortisone cream and lotion. The lotion was called Locoid. The topical cream was called Cutivate Zalf - It has Fluticasonpropionaat in it basically. Not sure what it is exactly but my dermatologist said they were both very bad, evil even and have made my Rosacea worse.

Ok so thats the back story. Now he has prescribed me minocycline 100mg tablets for 60 days AND metronidazol actavis 1% cream twice a day.
He's also said I should use Denorex RX coal tar based shampoo for my scalp which is very bad - big yellow patches of greasy scales (guess thats the seb derm?)
and also Ketoconazole gel.

My question is how should I take all this stuff? Last time the hydrocortizone made the Rosacea worse. I dont want to take treatments that conflict and worsen one or other condition.

And do I start taking the pills and cream immediately?

Also do I need to bring down the Rosacea a bit before I start treating the Seb derm?

I also read somewhere that the metronidazole gel is actually good at treating the Seb derm too and could be used as a replacement for the Keoconazole.
Anyone heard the same?

Sorry for all the questions and too much detail right now. And if Ive placed it in the wrong place - please be kind and point me in the right direction.

Right now Im stumbling around in the dark. Up until today Id never even heard of Rosacea!

Thanks for your help

dom

[Artist]

Hi Dom: Welcome to the group!

So sorry you are going through this, but it's good you finally have a proper diagnosis. Yes, your derm is right in that the hydrocortisone is bad for rosacea in the long run. Your derm sounds great, like they know rosacea well. The treatment they have you on now sounds appropriate for rosacea. As far as how to apply or take the treatments, I would do just as the doctor instructed. I would probably also be careful not to allow the hair/head treatments run into my face, since rosacea skin is very sensitive.

The Metronidazole is generally applied to rosacea skin in the morning and at night after washing with something gentle, patting dry, and allowing the skin to rest for a five or ten minutes. After applying the medication, let it soak in and then apply a good moisturizer to counteract the dryness it generally causes. I like Vanicream moisture cream.

Rosacea treatments take a while to work, so mark six weeks from today on your calendar and don't expect results from the prescribed rosacea treatments until then. Once they start helping, though, you will likely notice a big difference. They can really be a huge help. In the meantime, you may want to spend some time figuring out your big triggers (like sun, spicey foods, etc), and a gentle skin care routine.

I like Toleraine Dermo Cleanser to wash with and Vanicream Moisture Cream to moisturize with. I use a hat in the sun since sinscreens tend to irritate. I use a good, soft scarf made of that soft felt-type material to protect my skin from cold winds in the winter.

Let us know how you are doing along the way.

Artist
Not medical advice. Ask your doctor first.

[pulp]

Thanks for the advice artist!
Despite being prescribed things, I am usually slightly wary at first about taking them. I like to know whats in them etc - especially tablets!
Is Minocycline a pretty mild drug? Im supposed to take 100mg a day.
Also Im supposed to use the Metronidazol actavis cream twice a day.
Is it wise to do both at the same time?

The thing is it was a drop in clinic so very fast - a bit like a factory production line:)
So I couldnt really get the detail I was after.

As I said before in my first mail, I also suffer from Seb derm - particularly my scalp.
I say its this but im not sure. Thats what the dermatologist said but again he didnt actually look at my scalp properly, just observed from a distance.
I have this yellow type crust on my scalp - like a soft scab that comes away if you pick at it. Usually along with a few hairs.
Does that sound like seb derm to you?

Im currently using Denorex RX shampoo every other day but thats all.
He advised to use Ketocanazole cream as well.
But I read somewhere that the Metronidazol that was prescribed for my Rosacea works good on seb derm as well.
Does anyone know if thats the case?

Finally - I vaguely remember my dermatologist saying I needed to treat one thing before the other. I think it was the Rosacea.
Does that sound about right?

Thanks everyone for any help u can give me on this!

dom

[Artist]

Hi Dom: I personally would not have a problem taking 100mg Minocycline daily, and consider it to be mild compared to the vast array of other medications for other diseases out there. I think the doctor you saw sounds to really know what they are talking about, which is great for you. Yes, in general, if you improve the rosacea the seb derm should improve as well. The assumption is that the seb derm is there because of the rosacea. The flakes are sometimes also referred to as "rosacea dermatitis". It's just flakey, irritated skin due to the inflammation of rosacea. If that's what you have, then rosacea treatment should improve all of it. It sounds like you have a real case of dandruff (seb derm-same thing) on your scalp, though, so it makes me wonder if that is the primary issue irritating your rosacea or you would just be more prone to have seb derm component to it. You might consider asking this question to the dermatologist next time you go if you don't see improvement with the routine they started you on. I would tend to do exactly what this doctor says and give treatment a good chance since they are the ones who see rosacea and seb derm every day, over and over.

Remember, it takes a good six weeks to see improvement, so be patient!

Ketaconazole kills yeast (it's an antifungal), which is the problem in seb derm (dandruff)
Metronidazole is primarily an antibiotic (kills bacteria), but scientists currently believe it helps due to the inti-inflammatory effects against rosacea, not the anti-bacterial effects.

You have been prescribed both of these, so look forward to eventual relief. Yay!

Artist
Not medical advice. Ask your doctor first.

[Aurelia]

Hi Dom,

Welcome!

Hello everybody and welcome to your world. My name is Dom and today I was diagnosed by a rather ratty Dutch doctor.
Apparently I have Rosacea as well as Seborrheic dermatitis - lucky me! Should go nicely with my rapidly balding head:)

Love your sense of humour. Not everyone can stay cheerful through the trials of rosacea, but humour makes life easier to cope with, imho.

Is Minocycline a pretty mild drug? Im supposed to take 100mg a day. Also Im supposed to use the Metronidazol actavis cream twice a day. Is it wise to do both at the same time?

Minocycline and a metronidazole topical is probably a fairly common combination. As Artist says, Minocycline is generally thought of as mild. However, a tiny number of people report bad side effects with most drugs and Minocycline is no exception, so please read the product insert carefully and perhaps check on one of the internet drug sites?

To put it in proportion, I used Minocycline every day for seven years (for acne) until it eventually stopped working and never had any side effects apart from throat irritation from taking them at bedtime. (Never lie down straight after taking pills, especially if you aren't drinking loads of water with them.)

My GP at the time said that none of his patients had any problems with Mino, and his understanding was that if someone wasn't getting on well with the drug, problems usually showed themselves within days - a week or two at most - and any problems reversed as soon as the drug was withdrawn. (However, I'm no expert and am only passing on his comments.)

Sorry for all the questions and too much detail right now. And if Ive placed it in the wrong place - please be kind and point me in the right direction.

Not at all. The more info you provide, the easier it is for other members to offer suggestions. Also, you posted in exactly the right place. Well done!

Kind regards,

Aurelia

[pulp]

Hi Aurelia,

Thanks very much for your kind words and advice. Sometimes laughing is all you can do

[Aurelia]

Good to hear from you, Dom.

Any progress?

Kind regards,

Aurelia

[pulp]

Hi Aurelia,

Thanks for the mail.
Um no I wouldnt say there has been much progress yet.
But its only been 2 weeks.
My skin is really not in good shape so I guess I cant expect miracles.

But it would be nice to find some products to use for washing and moisturising.

Do you have any ideas? I am presently in Holland so not sure the names will be the same but perhaps I can search for ingredients etc.

Currently after washing with just water I apply Vaseline Paraffine (its a mix between petroelum jelly and paraffin I think)

Do you know if this is ok for my skin or not?

Thanks

btw whats your situation? I'm sure youre always helping others but how are you doing?

[louie147]

hi pulp,
i use stuff from this website and find it very good
and alot cheaper than other creams your derma will try sell you
www.acne-rosacea.co.uk
i find the anti couperose and suncream very good indeed,
also learn what is triggering your condition,
coffee and chocolate seems to do it for me,
oh and red meat
best of luck

[Aurelia]

Hi Dom,

Since skin is supposed to have a turnover rate of at least four weeks, it is wise not to be impatient, although we all hope for miracles and sometimes are lucky enough to receive them.

My skin is okay thanks, and rosacea is the least of my problems these days.

Ideas for washing and moisturising? Currently, I mostly use Cetaphil Gentle Skin Cleanser (the liquid form, although many rosaceans say they do a lot better with the bar form) and Cetaphil Moisturising Lotion ("fragrance free, for dry, sensitive skin"). I don't have dry skin, but this stuff doesn't clog pores and keeping my naturally oily skin lightly moisturised stops it from generating excess oil.

Sorry, I've never heard of "Vaseline Paraffine (its a mix between petroelum jelly and paraffin I think)" so couldn't offer an opinion on it. Hope someone else can.

Kind regards,

Aurelia