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Suggest treatment for symptoms of seborrheic dermatitis and rosacea

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Posted on Fri, 22 May 2015
Question: I have a skin ailment that I want solved.
Case History :
Year 2004 : Start of very scaly non-itchy dandruff on scalp. A small red non-scaly round spot on forehead.
Went through extreme stress in job , doctor diagnosed as sebarrhoic dermatitis.

Years 2005-2009 : Dandruff persisted , sometimes more , sometimes less. Some minor rashed behind ears and in forehead and on the sides of ears. Tried home remedies and was under control
Went to al allopathic doctor who prescriber alifast 500 , alaspan , diprovate plus , and salicyl shampoo.

Years 2010-2013 : Tried two homoeopathic doctors , and one reiki expert , it worsened the situation. More spots on neck ,shoulders , total of 15-20 red non-scaly spots overall.

Year 2014-Mar 2015 : situation under control , dandruff still persisted. 2-3 spots of redness used to appear whenever stress levels shot up.

Now - Moved to XXXXXXX on April 2015. Face flared up. Redness in between eyebrows , side of temple , nose , side of nose , below eyes and behind ears.

Never done an allergy test. I was allergic to prawns , crabs in childhood and never touched then afterwards.
My observation is that it gets worse in air conditioned atmosphere and when stress increases.
I have always worked in high stress IT jobs.

I have not used diprovate on my face since 2010.
I use occassional low intensity steroids like cutisoft and flutivate - 2-3 times a year , it gives occassional relief.

Questions :
1) What is it that I suffer from ? what's the diagnosis ?
2) What change do I need in my diet and lifestyle to avoid this ?
3) What medicines to you recommend to solve this , temporarily and permanently ?
doctor
Answered by Dr. Rahul Kumar (1 hour later)
Brief Answer:
Rosacea

Detailed Answer:
Hello
Thanks for the query and photograph.
You have given a detailed history.
Your history and symptoms are suggestive of Seborrheic dermatitis and rosacea.
I treat such cases with a mild steroid shampoo like flucinolone and a mild steroids ointment like mometasone and metronidazole for face .
Capsule doxycycline is also useful in severe cases.
You can discuss regarding these with your doctor.
Wash your scalp daily and face thrice daily.
Avoid oily food.
It cannot be permanently treated but definitely can be controlled.
Let me know if you have any other doubts.
Thank you.

Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Rahul Kumar (32 hours later)
Thank you for the diagnosis.

Please could you tell me the following :
1) Can you please suggest me a non-steroid shampoo , something that I can use as an alternative to Shampoos like Nizoral / Salicyl / Sebowash etc ?
2) Can you suggest me an oral anti-fungal that I can use instead of azifast 500 that my previous doctor prescribed ?


doctor
Answered by Dr. Rahul Kumar (13 hours later)
Brief Answer:
Ketoconazole and Fluconazole

Detailed Answer:
Hello
Thanks for the follow up.
You can use plain ketoconazole shampoo.
It comes in varoius trade names like fungicide, fungitop, ketocip etc.
You can buy any of these.
Tablet Fluconazole once a week would be the ideal antifungal for you.
Let me know if you have any other doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rahul Kumar (27 minutes later)
Thank you Dr. XXXXXXX

One last question - can you please suggest a few non-steroid cream/ointments that I can safely use for occasional skin flare-ups ?

doctor
Answered by Dr. Rahul Kumar (12 hours later)
Brief Answer:
Clotrimazole cream

Detailed Answer:
Hello
You can use clotrimazole cream for occasional flare up.
If it's severe you can use cortisone cream.
Thank you.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
Answered by
Dr.
Dr. Rahul Kumar

Dermatologist

Practicing since :2010

Answered : 6318 Questions

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Suggest treatment for symptoms of seborrheic dermatitis and rosacea

Brief Answer: Rosacea Detailed Answer: Hello Thanks for the query and photograph. You have given a detailed history. Your history and symptoms are suggestive of Seborrheic dermatitis and rosacea. I treat such cases with a mild steroid shampoo like flucinolone and a mild steroids ointment like mometasone and metronidazole for face . Capsule doxycycline is also useful in severe cases. You can discuss regarding these with your doctor. Wash your scalp daily and face thrice daily. Avoid oily food. It cannot be permanently treated but definitely can be controlled. Let me know if you have any other doubts. Thank you.