Hi rachelray,
I certainly sympathize with you ...you must be feeling very
frustrated! While researching your question, I see you fit the pattern
of patient relapse exactly! My research shows that patients who stop
taking Diane 35 do suffer a relapse of seborrheic dermatitis within
months, particularly if their condition is severe. There are some
alternate therapies available, but you will need to speak to your
doctor about most of them.
Let?s address your questions:
1) Are there any pills that will help me clear up my seborrhea dermatitis
on my scalp? I do not want to use shampoos, because i fear of
hairloss.
Some patients have switched from Diane 35 to Yasmine oral
contraceptives. Yasmine, made by Berlex, is said to contain a
different kind of progestin than Diane 35. Only you and your doctor,
who knows your medical history can decide whether switching to another
oral contraceptive will work for you.
http://www.yasmin-us.com/home.html
Accutane(pills) has been used in treatment of seborrheic
dermatitis, but it too has side effects, seen below. ?An occasional
patient with severe seborrhea that is unresponsive to the usual
topical therapy may be a candidate for isotretinoin therapy.
Isotretinoin can induce up to a 90 percent reduction in sebaceous
gland size, with a corresponding reduction in the production of sebum.
Isotretinoin also has anti-inflammatory properties. Treatment with
daily doses of isotretinoin as low as 0.1 to 0.3 mg per kg may result
in improvement in severe seborrhea after four weeks of therapy.
Thereafter, a dose as low as 5 to 10 mg per day may be effective as
maintenance therapy over several years. However, isotretinoin has
potentially serious side effects and few patients with seborrhea are
appropriate candidates for therapy. The most devastating side effect
is teratogenicity, but other serious side effects include
hyperlipidemia, neutropenia, anemia and hepatitis. Mucocutaneous
adverse effects include cheilitis, xerosis, conjunctivitis, urethritis
and hair loss. Long-term use has been associated with the development
of diffuse idiopathic skeletal hyperostosis (DISH). This agent must be
used cautiously and only by physicians who are well versed in all of
its adverse effects.? From the American Academy of Family Physicians.
(?Teratogenicity? means birth defects.)
http://www.aafp.org/afp/20000501/2703.html
http://www.isotretinoin.com/
There is a nice chart found here that outlines all the prescribed
topical treatments for SD. Perhaps you and your doctor can find one
that you have not yet tried.
http://www.aafp.org/afp/20000501/2703.html
This American Academy of Dermatology states:
?People in hospitals or nursing homes and those with immune system
disorders appear to be more prone to this disorder as well.? Are you
eating a healthy diet, with lots of fruits and vegetables that boost
the immune system?
http://www.aad.org/pamphlets/seborrhe.html
The Milton Hershey Medical Center Health Information site says that
?It appears more likely to occur in people with oily skin, those who
don?t wash their hair often, and those undergoing illness, stress, or
hormonal changes? Some researchers believe a fungus (Pityrosporum
ovale, a lipophilic (?lipophilic? means lipid or fat-loving) yeasts of
the Malassezia genus) may be at the root of the problem. (No pun
intended)
http://www.hmc.psu.edu/healthinfo/s/seborrheicdermatitis.htm
http://www.aafp.org/afp/20000501/2703.html
You stated that you have tried the usual gamut of shampoos for this
condition. Are you using them for the recommended time period? Do you
use them daily? According to the American Acadamy of Family
Physicians, this is important, as is maintaining excellent hygiene.
(Please note I am not suggesting that you do not maintain good
hygieine, just giving all the options I find)
http://www.aafp.org/afp/20000501/2703.html
This Hendrick Health site says: ?For more severe problems, the
doctor may prescribe shampoos containing coal tar or scalp creams
containing cortisone. The antiseborrheic shampoo should be left on the
scalp for approximately five minutes before rinsing out.?
http://www.ehendrick.org/healthy/001231.htm#Treatment
Don?t be concerned that using shampoos of any kind will cause hair
loss. Hair loss is a common effect of seborrheic dermatitis, and is
not caused by the shampoos. To the contrary, using the medicated
shampoos recommended by your doctor will help prevent your losing
hair.
http://www.drmhijazy.com/english/chapters/chapter27.htm
You don?t mention whether you have tried this Galderma product. I am
quite pleased with Galderma skin products, and use some of them
myself. ?CAPEX (fluocinolone acetonide) is a shampoo that contains a
drug used to treat seborrheic dermatitis of the scalp.?
http://www.galderma.ca/en/prod_sccapex.htm
An over the counter alternative treatment:
?SkinPlaque Solution? Medicated Spray is among the most effective
forms of treatment for Seborrheic Dermatitis without a prescription.
It sprays on like water to uniformly cover hard-to-reach areas. It's
greaseless, odorless and non-staining. And rest assured, it has no
side-effects and contains no aerosol fumes.?
http://www.aragonproducts.com/theproducts.cfm?master=5544
2) Is diane 35 safe for me to use?
Diane 35, not FDA approved for use in the US, contains estrogen and
progestin, and is used not only for treatment of acne, seborrhea and
hirsutism, but is an effective contraceptive, and carries the usual
risks of any birth control pills. Diane 35 is used to inhibit
production of androgen, a male hormone that can aggravate seborrheic
dermatitis. Smokers and folks with heart disease should not take this
medication. Some of the side effects dysmenorrhea (painful periods),
breakthough bleeding, breast tenderness and hardness, and rarely
headache and nervousness. In patients who are exposed frequently to
the sun, chloasma (a tan-brown discoloration of the facial skin) may
occur.
http://www.getpharma.com/product.asp?productid=170
http://www.emedicine.com/med/topic3489.htm
Patients who take Diane 35, as most all oral contraceptives do run the
risk of venous thromosis (blood clots). Smoking increases the
chances.
?Based on an independent analysis, commissioned by Berlex, of recently
published information1-7, cases of non-fatal VTE ranging in incidence
from 1.2 to 9.9 events per 10,000 women-years have been observed in
users of DIANE®-35. As context, the incidence of VTE in non-users of
any oral contraceptive is estimated to be 0.5 to 1 event per 10,000
women-years, and increases to 4 events per 10,000 women-years in
long-term users of low estrogen content (< 50 :g ethinyl estradiol)
combination oral contraceptives8. These event rates are rare, but
still justify caution in the use of DIANE®-35.? (Note: Berlex is the
maker of Yasmine, a competing oral contraceptive)
http://www.hc-sc.gc.ca/hpfb-dgpsa/tpd-dpt/diane-35_dhpl_e.html
From Skin Therapy?s web site: ?In a prospective, two year follow-up
study in 35 of the 143 patients mentioned above9, hematological,
clinicochemical, and metabolic parameters before and after, suggest
that cyproterone acetate, with or without ethinyl estradiol, is an
effective and safe long term treatment of hirsutism and/or acne in
women.?
It appears that Diane 35 is usually prescribed for 3-6 months, and the
number of patients who relapse when the medication is stopped depends
on the severity of the disorder, and the age of the patient.
Occasionally patients will continue taking this medication for years.
http://www.dermatology.org/skintherapy/stl0404.html
These medications are known to aggravate your condition: auranofin,
aurothioglucose, buspirone, chlorpromazine, cimetidine, ethionamide,
gold, griseofulvin, haloperidol, interferon alpha, lithium,
methoxsalen, methyldopa, phenothiazines, psoralens, stanozolol,
thiothixene, and trioxsalen
http://www.emedicine.com/derm/topic396.htm
From Dr.Mahmoud Hijazy?s dermatology web site: ?Predisposing factors
such as high fat intake, stress and hyperhidrosis (excessive sweating)
may play some role on the pathogenesis of seborrheic dermatitis.
Susceptibility to Candida albicans (yeast) and bacterial infection is
usually common in patients having seborrheic dermatitis?
http://www.drmhijazy.com/english/chapters/chapter27.htm
Well rachelray, I hope this answer will help with your condition. I
wish you the best.
If any part of my answer is unclear, please request an Answer
Clarification before rating. This will allow me to clarify my answer,
and I will respond as soon as possible.
Regards,
crabcakes-ga
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Seborrheic dermatitis
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