Battling seborrheic dermatitis/chelitis, hugs needed!
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free skin care · Mon Apr 30, 2012 2:52 pm

Hi everyone, I posted on here a little while ago and got some great advice from everyone as I tried to understand what was happening to my skin (it is seborrheic dermatitis). I am a 30 year old male in the UK and I have struggled with my skin for a long time, acne as a teen which led to roaccutane at 21 which caused dryout and seb derm has gradually appeared as flaky/red areas on my forehead, nose, scalp. It has also manifested itself on the inside of my lips which I always find myself licking when I get nervous (doesn't help!). I have struggled with the psychological side of this condition and felt very ugly and worthless for a long time. I help to look after my Mum who has Parkinson's disease and, to cut a long story short (!), life hasn't been fun for quite a few years now.

I really lost my faith in doctors and derms who I blamed for putting me on a drug I really didn't need to take. This put me off going to the doctor for a long time but I now realise that I need an anti fungal in order to break the cycle. The problem is that I don't know anything about this area (to be fair the doctor I spoke to today didn't seem to be particularly well informed about it either!) and I am really stressed out and scared of making the wrong choice and inflicting further damage upon my skin. I am very alone and isolated at the moment and I appreciate any help that you can give me as I try to put my life together again.

The doctor I spoke to today recommended a cream with a steroid in it but I know that this is unnecessary and potentially harmful. I have been researching this problem myself online and I came across a forum where one of the members recommended a shampoo called Stieprox and a cream with miconazole in it. I mentioned this to the doctor who said that she could prescribe the miconazole but had never heard of Stieprox. I have googled it and it is available in the US (of course!) and other parts of Europe but seemingly not in the UK. It has been described as effective on a daily basis and it sounds ideal in that respect (also seems to have no reported sides when I looked up it's main ingredient (Ciclopirox). Should I ship it in from Europe or should I continue to look for an alternative from the UK? I have read so many desperate messages from others who have been prescribed endless steroids and antifungals for SD to no avail so it is a crying shame if Ciclopirox is effective but unavailable to UK SD sufferers.

After extensive research I also came across the Obagi sun shield SPF 50 Zinc Oxide which I hope will also be compatible with the SD regime that I am planning. I hope it will keep my skin safe in the sun while it recovers from the SD trauma. Predictably the UK doesn't have Obagi so I will need to ship that in too!

Any advice or encouragement is very appreciated and I hope to report back positive results very soon which may just help other SD or cheilitis sufferers. I would love it if I was able to help other people get their skin back too!

Thank you everybody!

free skin care · Mon Apr 30, 2012 3:40 pm

I'm sorry that I don't have any advice for you since I am unfamiliar with what you are going through. But I wanted to say that you've found a great forum here with lots of knowledgeable people who can steer you in the right direction.

And bless you for taking good care of your mother. That is not an easy job, and I'm sure she appreciates it more than you know.

free skin care · Mon Apr 30, 2012 3:45 pm

While I cannot offer advice, I can give you a big hug, you have really been thru it!

I am sure taking care of your mom is, to say the least, stressful, and that is not very helpful for your skin. There are tons of lovely Ladies here that I am sure will chime in, in the meantime, big hugs again.

free skin care · Mon Apr 30, 2012 4:58 pm

So sorry to read how this is affecting your mental wellbeing. (((hugs))) I live in the UK and trained in pharmacy many moons ago, tho I admit to being a tad rusty!

Why did you feel your GP wasn't well informed, because of the Stieprox or more than that? You can ask to see a different GP within the same practice, you also have the right to switch to another local GP practice. What is first and second line treatment locally for SD may well be somewhere on the net, NHS are trying to be more transparent about these things. You will need to find that on your local Primary Care Trust website.

Option 2 is consult with a young community pharmacist, preferably at a time when the pharmacy is quiet enough for them to sit with you in a private room. They will know exactly what is available to purchase over the counter, what is available on NHS prescription in the UK and what is 'first line' treatment locally. Even if Stieprox were licensed in the UK it would not be prescribed before miconazole and ketoconazole unless a substantial improvement in efficacy were demonstrated. They should know far more than your GP about risks and side effects, they can even photocopy pages out of the BNF (pharmacy bible) if you get a sympathetic pharmacist. Take a list of questions and write notes so you have something to take to the doctor.

My experience of working in UK healthcare over twenty plus years is that too often the NHS fails to communicate the importance of self care to patients, and that too often patients expect their doctors to cure them whilst still carrying on an unhealthy lifestyle. Clearly you are researching your own condition, but it is not clear to me whether you have tried the basics (all at the same time)
- low glycaemic index, anti-inflammatory diet
- stop using known topical irritants especially sulphate surfactants and alkaline soaps
- start using ketoconazole and/ or miconazole, with a corticosteroid if necessary.

The biggest problem you will likely have is finding an effective anti-fungal shampoo that is not based on sulphate surfactants, products seem to be lagging behind the research here. That is definitely one to take to the pharmacist because they will have most/ all of the products on hand. Google suggests Nizoral, Capasal, Alphosyl, Dermax, Psoriderm, Selsun, T-Gel and Stieprox are all based on sulphates. Not sure about Ceanel Concentrate, various generic ketoconazoles. Speaking for myself just shampoo bubbles running down my arm flares my atopic dermatitis, my mother is also sulphate sensitive and her mild SD has reduced by ~50% without any steroid or anti-fungal, just losing the sulphates. I would note that ONLY eliminating sulphates may worsen moderate to severe cases of SD because they are efficient degreasers so the combi approach is usually required.

Topical corticosteroids are not harmful when the correct strength, frequency, dosing and for short courses. They can be just as valuable as anti-fungals in breaking the cycle, depending how severe your case is you may get the best result from a combination initially then switch to just an anti-fungal for maintenance. The Obagi Sun Shield contains both zinc oxide and a chemical sunscreen agent. Given that your skin barrier is likely to be damaged and your skin irritated/ inflamed, you would be better choosing a product based only on zinc oxide or on zinc plus titanium dioxide. The few times I have Googled Obagi products they seem to contain a vast array of chemical nasties.

free skin care · Tue May 01, 2012 4:23 am

Thank you to everyone for your encouragement and advice (and hugs!). Thank you Firefox for your information which I have followed up by contacting NHS Oxfordshire and speaking to a pharmacist in the medicines management team. She confirmed that Stieprox (and its key ingredient Ciclopirox) are currently unavailable in the UK. She did not justify this on the basis of efficacy. She described them as being new and "cutting edge" (just not "over here"!) and, while recommending that I tried ketoconazole (Nizoral), did not have a problem with me shipping in Stieprox. My sister is going to Majorca next week so I may have to butter her up! I asked her if she could find me a list of approved first and second line medications and she has agreed to do this and email me the findings. I am also expecting a call from my parents' doctor this morning so I will have her input as well.

The pharmacist advised me to call my local hospital (Oxford University) and speak to a dermatologist so I am going to do that as well. I am on another forum (called "the rosacea forum" which has information about similar conditions inc SD) where a search for "stieprox" will bring up posts by a member Shantelle in NZ who has used Stieprox on a daily basis and had SD relief. She emphasises that she had used other products before which had been too harsh and made her skin worse but Stieprox was fine for daily use on her sensitive skin. You mentioned it may have sulphates but it may be that I only have to use this occasionally in order to see results and/or the application of a good moisturiser may counteract the effect of the sulphates. Is it unreasonable to think that a short course of miconazole and stieprox (for example) might actually cure the SD and then I can just use my natural products again (Salcura and Essential Care)?

In relation to dietary issues I follow a healthy diet, very little wheat or dairy and supplement vitamins, zinc, fish oil. I do have too much stress and I need to work on that side of things (my doctor is liaising with the cogntive therapy service on my behalf). I wonder whether I might have any dietary allergies which are flaring the SD, I will mention this to the doc when she calls.

I avoid all sulphates and nasties in my skincare routine atm. I use Salcura facewash and shampoo and essential care shampoo. I use green people toothpaste.

Re the Obagi I have spent hours (blood, sweat, and tears!) trying to find a sunscreen that is well reviewed in terms of effectiveness in it's primary function while not being difficult to remove, uncomfortable to wear, or leaving an unsightly appearance. You recommended the Devita but that got very mixed reviews on Makeupalley. Some members reported burning while using it. My conclusion (from my own limited experience) is that some degree of chemical constituent is necessary to make a sunscreen truly effective in blocking the sun. What I am seeking is a "block" in the truest sense of the word in order to avoid unnecessary skin ageing. I can get my Vitamin D through a relatively small amount of unprotected sun exposure every week but the rest of the time I want my skin to be totally protected when I am out and about. If one isn't seeking a tan and has no Vitamin D deficit then it is surely logical (if possible) to simply block out all of the suns rays. The logic being that any sun which does reach the skin will only have the effect of ageing the skin without providing any additional health benefits. Within the next ten years there will be a sunscreen tablet which gives the skin total protection, and vitamin d will be supplemented. I am trying to mimic this with what is available here and now and natural sunscreens without chemicals just don't seem to cut it when tested by fire (literally!).

When you mention steroids of any type or strength I immediately think skin thinning, which to me means skin ageing, skin damaging, skin barrier breaking down, bacterial heaven (!), skin even worse than before. Am I wrong?

Thanks again Firefox, I still want to gift you some stuff in return, I usually buy Yankee candles for women but I don't know whether you're a yankee fan!

Best wishes

Chris

free skin care · Tue May 01, 2012 8:25 am

So pleased your local NHS has been so helpful and you have made so much progress in one day! I hope that helps you trust medical professionals again. Very Happy

Stieprox will only be licensed here when the manufacturer applies (many do not) and proves that it is both safe and efficaceous. UK/ EU/ NHS regs are more stringent than some countries, which can be frustrating but IMO keeps us safe. The licensing is a separate issue to whether the NHS agrees to put the drug on formulary, so in some cases a new drug could get licensed but ONLY available on private prescription. Equally I have known of newly licensed drugs jumping right into being first line treatment despite the budget-busting cost, because they have proven to be substantially more effective that their predecessors.

SD is not considered curable although you can get to a point where you are asymptomatic. Traditionally with SD you would use ketoconazole/ miconazole intensively for two weeks, then once or twice a week thereafter to control it, using regular products in between. You *may* be able to control it with certain regular cosmetic type products thereafter but that is very individual. IMO head to Wilkinsons and purchase a box of disposable/ reusable gloves, then wash your hair bending over the bath/ shower wearing gloves with you wrists sealed with hair elastics. Basically don't get any sulphate surfactants on any part of you except your scalp; if you are sensitive even rinsing will not stop the irritation at the cellular level neither will moisturiser. A study published in 2010 calls into question earlier research suggesting sulphates are only irritant from 2% (commercial shampoo are ~20%, eek!)
"volunteers who do not have eczema applied aqueous cream to their arm twice a day, leaving it on for 10 minutes, for 4 weeks ... Overall the areas that had been ‘treated’ were 12% thinner than the untreated areas. There was also an average 20% increase in water loss through the thinner ‘treated’ areas ... Prof. Guy has confirmed to us: ‘Aqueous cream contains 1% sodium lauryl sulphate (SLS) and this is the ingredient, we believe, that causes damage to the skin barrier." http://www.eczema.org/aqueous_cream.html
The ONLY sulphate-free anti-fungal I know of is Regenepure, which contains ketoconazole but not sure if it is 1% or 2% and is not the cheapest. Not saying you should use this, just to keep it is the back of your mind as you see how your scalp responds to the Stieprox.

Which Devita are you talking about? They have at least three sunscreens, all of which contain enough zinc oxide to be effective when used properly. However people tend not to apply enough or not reapply frequently then complain. The two SPF30 (Body Block/ Solar Protective face) are quite dewy or rich. The Rx Ultrasolar SPF50 is very light and very easy to remove - it is based on zinc and titanium. There are a number of issues with chemical sunscreens: firstly they must have direct contact with the skin to be absorbed so you cannot layer them over another product. Secondly the UV light passes into the skin before being 'deactivated', thirdly some break down in the presence of UV light and produce damaging free radicals! Physical sunscreens are a more effective block because they act to 'reflect' UVA and UVB rays before they contact the skin. I have a hunch you will not be comparing like with like when you look at reviews for Obagi Sun Shield and reviews for other sunscreens. Obagi is likely most often used by those on or after the full Obagi programme, so they may well have redness, dryness and irritation and will have been advised to totally avoid the sun. Not your average sunscreen user.

AFAIK skin thinning with corticosteroids does not occur with proper use, it only happens with regular use of higher strengths and/ or layering too thick and/ or over an extended period of time. You should not need to do this if you are using a good anti-fungal and the other measures I mention. I am not aware of any evidence of skin thinning with short courses occasionally, IMO corticosteroids are very valuable in breaking the cycle of inflammation, because irritated skin may produce more sebum which is the last thing you want! Please do check this with the dermatologist and let us know if my information is out of date.

free skin care · Tue May 01, 2012 10:28 am

Hi Firefox, why can't more GP's be like you? You're always so informative and non judgemental and your information really helps me. I spoke to the GP and the Local Care Trust and was recommended ketoconazole (Nizoral?) for scalp and miconazole for face/lips (cheilitis). I don't know how effective cream will be on the lips (rub off might be a problem). I have read mixed reviews of Nizoral, the Amazon reviews (the bad ones!) suggest that the formulation has changed and that it really wasn't helpful for SD, but that it was okay for dandruff (which is obviously a different thing). I tried to speak to a derm but I was told (predictably!) that they don't do telephone appointments and I would have to wait 2-3 months for a face to face appointment.

My research on SD confused me a little, the malassezia yeast is perfectly normal and everyone has it but is SD caused by a weakened skin barrier (caused by dry skin) which allows a normal level of yeast to penetrate the skin barrier, or is SD a result of an increased amount of yeast which then penetrates the skin by sheer weight of numbers? The point to my question is that the second cause would suggest that the solution to this problem is to kill the excess yeast whereas the first cause would suggest that the answer is not to kill the yeast (the levels of yeast being normal) but to strengthen the skin barrier (which I assume would be most effectively achieved through good dietary practices and gentle, natural cleansing).

I am also making the assumption that SD and cheilitis are one and the same (so the solution should be the same). My research suggests that the yeast feeds on sebum and oils mimic sebum so this would suggest to avoid products with oils in them which will feed the yeast. This would seem to recommend foaming cleansers rather than creams or lotions which would have a higher oil fraction, and to make it difficult to find a sunscreen or a moisturiser (they absorb and could therefore imbalance the skin barrier). I am still a little confused about this condition and how it works, and this is blinding me to the most effective solution. Maybe I should just go without a moisturiser/lip balm (LB's have not healed my cheilitis)?

I thought Obagi was going to be my sunscreen but I don't know now, the sunscreen search has almost driven me to tears. I'm searching for something which is SD and sensitive skin compatible, completely blocks the sun, doesn't have oils which feed the yeast (?), and doesn't make you look ghostly white. I'm so confused and upset that all my man hours spent poring over reviews have proved fruitless. The closest I seem to have got to a unanimously well reviewed "block" are Shiseido Anessa and Obagi. Devita has oil and MUA has put me off it. God, I'm a nightmare aren't I! At least you stick by me Firefox. I'm a bit like this when I buy clothes (everything has to be perfect!) and I have driven a few shop assistants to distraction (I can't help it, I'm just made that way!).

I think that another sensible course of action is a food allergy test to make sure there are no obvious allergens. Before Christmas for 3 months I went wheat, gluten, and dairy free but the condition got worse rather than better. Even so, I think it may be worth the effort to find out.

My current course of action (pending more analysis as always!) is to ship in some Stieprox from Belgium and try this for face/scalp/possibly even my lips? I will be eating healthily and meditating to reduce stress. Hopefully this will work well and I will then just continue with Stieprox when needed, going back to my Salcura face wash and shampoo as my regular. I will find a sunscreen (it's going to happen!) and will wear that daily. If this doesn't work then I think the next step is Miconazole cream for face and lips and a Selenium/Zinc/or other antifungal shampoo. It may be that the Stieprox might work well for my scalp but not face/lips, suggesting a combination of the two might be effective. I will need to develop a a schedule for using these medicated items and then taper off to weekly/biweekly as needed. What do you think of that (how long's a piece of string?)? Thank you Firefox, I don't know you but I love you!

Best wishes

Chris

p.s. you didn't tell me whether you like Yankee candles, mmm Be Thankful (as Homer would say if he had tried that fragrance!).

free skin care · Tue May 01, 2012 12:39 pm

Thanks but I am forever getting into trouble online being too direct with my questions and opinions! I love candles but my curtain-scaling kitty would likely set the apartment on fire – please just chuck your spare change in a charity collection box of your choice.

Dandruff really just describes a flaking scalp but the most common cause is SD. Other rarer causes include psoriasis, atopic eczema and xerosis (dry skin). I am not going to pretend I understand the minutiae of how SD gets going and I don’t think the medical community yet understand 100%. I believe it is thought to be chicken-and-egg: a damaged skin barrier is more vulnerable to infiltration of both microbes and chemicals (eg sulphate surfactants), and some skins respond to dehydration and/ or irritation by over-producing sebum. This then feeds the yeast assisting it to proliferate. The yeast’s waste products causes additional irritation so the skin pumps out sebum to protect itself …. Why some people and not others? Likely a combination of a genetically vulnerable skin barrier and lifestyle issues (eg. nutrition, stress) causing the composition of sebum to favour growth of the yeast and no doubt other factors. Interestingly there is a great deal of overlap between inflammatory conditions such as acne and dermatitis.
Haven’t read it but looks interesting
http://books.google.co.uk/books?id=WSKEPJNe_UEC&pg=PA#v=onepage&q&f=false
Also tons of the latest research on PubMed, you can often learn enough from just reading abstracts
http://www.ncbi.nlm.nih.gov/pubmed?term=seborrheic%20dermatitis

I would be surprised if Nizoral has watered down its formulation because it is still available on prescription AFAIK. However there is resistance building up in yeasts to certain anti-fungals, much as there is with bacteria and antibiotics, so that might explain the negative reviews. If you pay for your prescriptions just get a generic ketoconazole shampoo at the pharmacy.

I strongly advise you do not put any shampoo containing sulphate surfactants on the thin skin in and around the mouth. In fact if you use commercial toothpaste switch to a sulphate free one such as Aloe Dent (aloe vera has positive research in dentistry). An idea that I haven’t tried myself: apply your miconazole cream, leave to absorb or dry without licking/ drinking/ eating/ brushing teeth for as long as you can stand, then apply a layer of medical grade lanolin such as Lansinoh (don’t freak out that it’s marketed as a nipple cream, just proves it is edible!) or an own brand petroleum jelly. You may find lipids in the lanolin feed the yeast, but it does have more staying power and personally I’d prefer to eat it! There are also anti-fungal oral rinses such as nystatin which might be appropriate if that system doesn’t work out, and are used four times a day.

Totally understand about the perfectionist thing! It might be worth trying to accept that what your initial solution is will not be the same as your long term maintenance plan so no one regime will be perfect. So maybe products based on silicone, petroleum jelly or mineral oil initially then revert to products containing small amounts of natural lipids longer term. Once you have broken the cycle and have strengthened the skin barrier, the conditions on your skin should not favour the yeast.

Lastly nutrition: What carbohydrates were you eating instead of wheat? What source of calcium did you choose instead of dairy? Did you cut out all sugars, alcohol and white carbs? Were you combining fat or protein with carbs at every meal and snack? Do bear in mind you are as likely to be sensitive to dust mite doings, pollen or your laundry products as you are to a foodstuff.

ETA: Google suggests some with cheilitis get relief using medical grade lanolin, others do not. Didn't note anyone claiming it worsened their condition.

free skin care · Tue May 01, 2012 1:47 pm

What's your cats' name? I used to have cats, 2 black male ones called mickey and sam, and 3 females of different colours called tiffy, tiggy and amber. They're all gone now but I miss them and I would love to have an animal again when the right moment comes along. I miss the unconditional affection (as long as you are holding a can of Whiskas!) and the sort of eskimo kiss thing they do where they come up and sort of headbutt/nuzzle you! Someday soon I will be a catman again!

I did read up on Lanolin which you recommended from before, and shea butter. I ended up going with the shea butter and used that for my lips which helped to break the drying/cracking cycle to some degree but did not really heal the lips. I now understand that there needs to be some antifungal intervention before this healing can occur and I read you 100% on not putting the Stieprox on my lips. Miconazole and Lansinoh (or Lanolips?) sounds like a way to go.

I also understand what you mean about going for a generic keto shampoo. As I understand it not all products are made equally and 1 keto shampoo could be significantly more effective than another based on the 99% of ingredients in it which are not keto (sulphates etc. vs natural ingredients). It seems to be a missed opportunity in the market for someone to make a very natural product which contains 1% keto or selenium sulfide etc. Natural ingredients would be so much better for sufferers whose skin barrier is weakened and susceptible.

I use green people toothpaste (propolis) and I think this is okay (sulphate free). I do get a bit of white gunk on my tongue so the oral rinse sounds interesting and i have been oil pulling with coconut which seems to help my sensitive teeth. I also have some tongue fissures which I have been treating with acidophilous powder (just opening a capsule on the tongue for 20 secs or so) and that seems to be working okay at healing the cracks. The mouth rinse should help even more and I am thinking of flossing to make sure I cover all bases.

Nutrition: At the stage i was everything free (!) I went quinoa crazy! Quinoa for brek, lunch and dinner (I kid you not!), with milled seeds at brek, with salmon at lunch and with salad and lentils at dinner (god those 3 months were fun!). I guess I didnt ge too much calcium, no alcohol at all, only sugar from apples and a little dried fruit in the morning, snacked on nuts, no white carbs. I washed my laundry with soap nuts, although I use surcare laundry granules now.

As of now I eat a mix of quinoa, barley, jumbo oats (thanks!), and buckwheat flakes with milled hemp, flax, pumpkin seed plus goji berries and dried apricots for breakfast. I have an avocado salad pitta for lunch and then things get a bit hazy at dinner (burger and chips tonight, not good!). I think the example above shows how committed I can be to a diet though when I put my mind to it! I will do what is necessary to be well and make the best of myself (god, that breakfast sounds really pretentious doesn't it? Get me going all Gwyneth Paltrow!).

You're still simply the best (I'm going all Tina Turner now!). I hope you don't think my diet is too hollywood!

free skin care · Tue May 01, 2012 5:49 pm

You should have a cat again, they are wonderful for stress management. You might foster if you can't commit to one long term, don't have outside space or money is tight. Many rescues are full to bursting, I have known long term fosterers have a cat occupy their bathroom in an emergency!

Lanolips Lemonaid is just amazing, but it does contain lemon oil which you might find uncomfortable with active cheilitis. Lanolin has far more staying power and a nicer texture than unrefined shea butter - which I like very much for other purposes - when it comes to the lip area.

It is likely that the generic and branded ketoconazole shampoos are much of a muchness, because it is easy (read: cheap) to get a license if your drug mimics another already on the market. Agree that there is a gap in the market for a gentle sulphate-free anti-fungal shampoo that is effective on SD. I get the scalp hygiene argument but most anti-fungal shampoos need to sit on the scalp for five plus minutes anyway. There is a link between oral thrush (candidiasis) and cheilitis I believe so it would be worth getting diagnosed - both the white tongue and fissures might indicate thrush. AFAIK nystatin oral rinse remains the treatment of choice. Are you an asthmatic using inhalers by any chance?

Your diet sounds like it includes healthy foods and is on the right track. Are you getting complete protein early in the day? Nine portions of fruit and veggies and three portions of dairy a day? Overall the example day sounds quite carb heavy, not that carbs are 'bad' (can be great sources of fibre and minerals) but they are better eaten little and often to avoid blood sugar peaks and troughs. Switching out the fries for baked beans or sweet potato wedges would give you a low glycaemic index meal, plus some extra vegetables. If you don't have a lot of time/ energy in the evenings, mixed bean and coconut curry or a massive spicy chicken stir fry are quick, tasty and pack in loads of veggies. Use canned beans for the curry and freeze/ microwave steamed brown basmati rice for the stir fry.

free skin care · Wed May 02, 2012 6:53 am

Thanks Firefox, spicy chicken stir fry sounds good! From looking at pictures of oral candida I don't believe that to be my own condition. I think it was the light I was looking with that made the tongue look white, it looks a healthy colour today and the red bumps I did a google search and I believe they are just papillae but were perhaps a little inflamed for some reason when I looked at my tongue the other day. It's a bit embarassing discussing tongues anyway so I'm glad to have that one seemingly under control! Have you ever heard of using acidophilous to heal fissured tongue? It does (tentatively) seem to be closing the cracks which is encouraging. I will continue oil pulling as it seems to work for me and I will tongue brush and floss to eliminate excess bacteria. Read quite a few reviews pf Lansinoh and Lanolips on MUA which reported irritation and a worsened condition. Maybe I should cover the miconazole with a thick layer of shea butter instead (I get on famously with SB). I was interested to find out what you think shea works best for, it is possibly a little rich for my face (did break me out) and my upper body (root of my teenage acne problem) but it works great everywhere else.

I spoke to Glaxo Ireland who manufacture the Stieprox shampoo and they are going to source a supplier who will ship to the UK for me (I hope!). I am waiting for their email. I will ask for the miconazole cream tomorrow and use this for face, lip, and shins (i get it there too, must be the result of trouser chafing, damn you jeans!).

I am trying to sort out my diet, I am slso trying to help my dad who is at least 4 stone over where he should be. I told him I would find out what I could for him and he seems genuinely determined so I had better do my research! I think what you said about gi of foods will be important for both of us and working out his total calorie requirement for weight loss gives us a starting point. I am planning to use myfitnesspal for him to track his cals.

Best wishes

Chris

free skin care · Wed May 02, 2012 10:15 pm

Why is everyone so down on corticosteroids??? They completely saved my face. They don't cause skin thinning when used properly. I suffered from awful dermatitis, these drugs are prescribed for a reason, they work!

free skin care · Wed May 09, 2012 6:01 am

I have found out that Stieprox shampoo contains 70% SLS, and I don't think this is a good thing! I realise that I need a natural alternative because the #1 thing for me is to avoid further damage to the skin barrier. I have read good things about manuka and neem and I am searching for another shampoo. I actually went ahead and used my Essential Care Shampoo with Tea Tree on my face at the weekend and it was very drying. My cleanser (Salcura) does not irritate my skin but it is not antifungal so is not breaking the cycle (it does reduce the flaking but doesn't remove it).

When I looked at the ingredients for the miconazole cream that had liquid paraffin which if i am not mistaken is the same as mineral oil and can cause a phototoxic reaction. Looks like I can't get any prescription medication for this problem then which makes my task even harder.

free skin care · Wed May 09, 2012 7:44 am

Craven IMO get some help for your phobias, I am all for you not wanting to use sulphate surfactants but if you are not able to use mineral oil/ petroleum jelly then you are never going to find a solution. At present your skin barrier is not functioning correctly, but that can be massively improved with just two weeks use of an anti fungal cream. It is not sunny here in the UK, you already know to stay out of the sun in the middle of the day, and wear sunscreen. Petroleum jelly or mineral oil are in numerous sunscreens, moisturisers and cosmetics and we are not seeing an epidemic of negative reactions in females (on average use these products more than males).

free skin care · Wed May 09, 2012 9:28 am

Will mineral oil as a component of the miconazole, if i wore it and then was exposed to sunlight, have the potential to cause a phototoxic reaction or is it safe within the overall formulation of the cream? I know 100% that if i put a thick layer of mineral oil on my face and then sat in hot sun i would be risking a severe phototoxic reaction. I do not know where the line is drawn, however, so, when i see petrolatum/paraffinum etc in a formulation, i panic. this is largely because no one has explained to me a convincing reason why i shouldn't. in my mind if mineral oil can be phototoxic in significant quanitity then it might be phototoxic to some extent in any quantity. surely not every antifungal has to contain a mineral oil derivative does it?

I'm on a tight schedule now because I am planning a move in a couple of weeks. I need to be out and about because I am going to be looking at places to live. I have to get this sorted now but the reality is that I am scared beyond comprehension at the thought of getting pigmentation on my face (I cover everything else up), so much so that the very thought of it makes me feel suicidal. Yes I need help but right now I need something to break the cycle and I am in dialogue with the local GP. If I could find a natural, non phototoxic antifungal cream/shampoo I would go ahead and use it 100%. If I could find a sunscreen which I felt safe was going to protect me from any pigmentation (I mean any, even the tiniest amount), without having to go round looking deathly white all, then i would use it. Unfortunately due to a lack of availability and living in the UK my search continues and my life continues to wait for me to live it. I do appreciate your help and support Firefox and it has been particularly helpful when I can't really get much info from the local health service. I have to own up and admit that (including the last few months) I havent been out of the house so the only contact I have had is either telephone or internet (my speed typing has really improved though!).

I was very keen on getting an antifungal shampoo until i reread your post about SLS thinning the skin. That killed it for me, I will never use an SLS product again because my fear of sun damage rules over my whole life, every single day i live in fear.

free skin care · Thu May 10, 2012 9:55 am

Just to update I am looking at the anti candida diet to try and solve this problem. I have been stuck in a lot and I do feel that more time outside (protected) would do me the world of good, plus lots of vegetables and lean proteins. I am also planning to do more exercise. I do feel I can overcome this the natural way, the SLS issue really blew the antifungal shampoos out of the water for me so I must stick with my current Salcura/Essential Care, or maybe look for a Neem/Manuka formulation. I think that going out more and allowing some sun and fresh air to my scalp will help along with better diet and stress reduction. I was going to use an antifungal cream but I know that mineral oil is a big no-no so I will just use a little shea overnight and then hopefullly find a good moisturizing zinc oxide based sunscreen/moisturiser with SPF for the day! I'm moving down to Chichester/looking for a new home in a couple of weeks so I have to get my finger out! Thanks Firefox and everyone who has made suggestions for me. I am going to get in touch with the mental health services there to work on my self image issue and I am also in touch with a healer in the same area who I am going to work with! I will let you know what transpires!

Wed May 16, 2012 10:40 am

craven20 wrote:

Hi Firefox,

I have read very thoroughly through all the posts that you made in response to my SD queries. I have changed my diet to an anti inflammatory, low GI approach with as many multicoloured vegetables as possible. I am, however, struggling to find the right skincare items. We had a discussion about SLS and its dangers and as a result of that I went hammer and tongs trying to find an SLS free antifungal shampoo. I have pored through websites at home and abroad (and looked for the powdered version of zinc you also suggested I add to my existing shampoo, no joy I'm afraid) and found nothing with medicated antifungals and no SLS apart from your suggestion Regenepure but it is unavailable in this country and contains sun sensitising ingredients (lemon oil). I am getting desperate here and every day is the same sat indoors searching for sulphate free antifungals and other "safe" products (including the search for a sunscreen which has lasted at least 2 months now). What should I do?

Many thanks

Chris

free skin care · Wed May 16, 2012 5:38 pm

Craven, hi from another cat fan (I have 7). Please consider the p73 extra strength version of oil of oregano. I also have a yeast problem, and this has made a HUGE difference for me. This is the only brand I will use, as others are far weaker.

Btw, do not yet the pills because they will only help fungus in your intestines. You could actually add the oil of oregano when oil pulling, and it will be absorbed via the blood vessels under your tongue, and help to kill the fungus in your mouth.

Be careful though...it is very strong and must be diluted or it will burn your lips. I personally just put a syringe full into a shot glass of water, and just gulp it down. Nasty but very effective, plus my doctor approves of it and says it is an amazing anti fungal.

http://www.iherb.com/m/North-American-Herb-Spice-Co-Oreganol-P73-Super-Strength-1-fl-oz-30-ml/8582?at=0

free skin care · Thu May 17, 2012 4:01 am

Hi Bethany, thanks for the information, 7 cats wow! Are they all different ages? Hopefully they treat each other nice! I had 3 girls and 1 boy and he was totally disdainful of all of them!

Oregano Oil sounds interesting, did your yeast problem show up on face and scalp like mine? Has taking this oil internally really improved your condition? I tried going without shampoo the last couple of days and my scalp was terribly itchy yesterday and full of flakes. I have been "planning" rather than implementing the dietary changes that Firefox suggested and the last week or so I have eaten a very poor diet, partly from convenience and partly from a sense of depression (comfort eating). Before this week my diet was cleaner although far from perfect and I was shampooing every day with an SLS free (not an antifungal unfortunately, although tea tree does have a mild af effect I think?). Taking my eye off the ball for a week and not using the tt shampoo has made a huge difference so i tted again this morning!

I would be happy to use the oregano oil but I really need to address the scalp and facial SD (maybe I could add some to my shampoo?). I tried to find powdered zinc to add to my shampoo but I did not find any online. I feel like I am in the twilight zone at the moment, I am living the same day over and over stuck between medicated solutions which could actually make the problem worse over time (SLS et al), and natural options which are not powerful enough (don't contain potent antifungals). Thanks for coming back to me Bethany.

free skin care · Thu May 17, 2012 7:45 am

My yeast problem primarily impacts my skin in the form of a rash.

Taking the OoO internally will help all of your issues systemically, plus you can indeed add it to your shampoo, etc.

You can see pics of my cats on the EDS Lounge in these 2 threads...I have 1 Himilayan, 1 Persian, and 5 Exotics (short haired Persians). They all get along fairly well (5 males, 2 females).

http://www.essentialdayspa.com/forum/viewthread.php?tid=35702

http://www.essentialdayspa.com/forum/viewthread.php?tid=39596

free skin care · Thu May 17, 2012 9:25 am

Hi again Bethany, your cats are beautiful! I had a cat called Tiffy exactly the same colour as bacardi and amber (as you could probably guess) was quite similar to marmalade in colouring (and enjoyed her food!). I have a good friend who has had several Persian cats, she has one at the moment called Susie who is very timid (and very old!). When she calms down she will sit next to me and likes to rub me (and my bag) and to dribble on my clothes (lovely image!). My parents had a cat called Harry who was a rescue cat, he was left abandoned with his tail under a boulder (leaves you speechless doesnt it). They had him for two years but he developed a brain tumour and had to be put to sleep. I love all the cats I've had. I'm sure that all of yours give you great joy. They are the ultimate pet really!

Thanks for the OOO information. I read some posts by SD sufferers who had gained benefits from using it which has heartened me. I am in the UK which is a bit of a deserted outpost in terms of decent suppliers for this sort of thing but I think I've found a UK supplier and they have the normal and extra strength. Funny that the pills would help the fungus but taking the oil in water helps to remove the fungus? I was considering getting evening primrose oil capsules and I take fish oil capsules but maybe i would do better with these in pure oil rather than capsule form (I remember Udo's being reccomended to me somewhen in the past! Flax is also meant to be good so maybe a mix of these three oils would be better than just swallowing pill after pill). I have a juicer so I am thinking of dusting that off and getting 2 of my 5 a day from that!

I have also had a rash (on my shins) from this accompanied by flaky skin. It's a shame they don't make this in a cream because I would apply it to my face and shins as well as using it in my shampoo.

Just as a little aside I spoke to the doctor today (who is described as the resident expert on skin problems) and she suggested aqueous cream for the areas of dry skin (despite the fact there is an article on the NHS choices website about AC being skin thinning and irritating), vaseline for my lips (which again has been proven to exacerbate rather than solve flaking lips), a shampoo which has SLS (I asked her directly about SLS and she stated that none of her patients had ever had a problem with it and that the internet was full of misinformation!) and a hydrocortisone cream (even though there is a milder alternative called Daktarin which doesnt have steroid content). When quizzed she didn't even know that the Daktarin line contained miconazole (she thought they were all based on ketoconazole). If this experience is not a warning to others to do their own research and come to their own conclusions I don't know what is!

free skin care · Thu May 17, 2012 10:57 am

Sorry to hear you have been down, Craven20. Sadly I am not surprised the GP was so out of date - in January a pharmacist sold my eczematous mother aqueous cream for a rash I had told her was induced by sulphate surfactants. Not impressed with their CPD nor patient assessment skills. Mad

Fish oil in capsule form is more stable than liquid form because there is less exposure to the air. Flax contains short chain omega-3s which are converted to the useable long chain format at a rate as low as 10% - you would need to drink the stuff to get enough O-3s. Oil blends which contain omega-6s will make the balance in a Western diet worse, most omega-6s are pro-inflammatory. Evening primrose is not as good a source of GLA as borage oil, and research on supplementing is conflicting, research on topical application is good. Spend your money wisely IMO. Juice only counts as one of your nine a day regardless of how much you consume, various nutrients are lost in the pulp and the inflammatory sugar is concentrated so the glycaemic index increases.

As regards anti-fungals I don't know what you want me to say. IMO by far the most effective approach is actives such as miconazole and ketoconazole. Two weeks intensive course could well be followed by a more natural regimen to maintain the results. If you go outside in the meantime wear a hat or bandana made of material with a UV rating plus a physical sunblock if you wish. You are highly unlikely to find pharmaceuticals without the large number of ingredients you refuse to use, manufacturers will not 'reinvent the wheel' for a few customers because it is hugely expensive to reformulate then seek official approval for the new formula in each country. Mineral oil and petrolatum do not react negatively with the actives and do not cause allergic reactions and are cheap as chips, so I suspect they will continue to be the base of pharmacy creams and ointments for many years. I don't use them in my everyday products but I absolutely would if I needed a prescription because I would weigh up the potential negative effect of one ingredient with the negative effects (physically and mentally) of the skin complaint. However I would not use sulphates because the negative effects are not potential they are visible.

free skin care · Thu May 17, 2012 2:33 pm

Thanks Firefox, 9 a day is a lot of salad! I do like stir fries but this will take a lot of discipline when I am working and cheating becomes an easy and attractive option. I am used to making salads in bulk so that will be a good base for lunch and I can add some beans and egg or lean meat. I try to get my healthy fats from nuts, seeds (flax, pumpkin and hemp) and avocado. Milled seeds don't present the most attractive eating option though! I have tended to put them into a muesli mix which does become a bit gruelling to eat!

I have found 2 creams from a UK company called Abbey Essentials, one is evening primrose, the other borage. I thought that I could use this for my face and body and combo with shea butter for my lips (the SB does work well for my lips). The ingredients are:

Aqua, Almond Oil (prunus dulcis), Glycerin, Coconut oil (Cocos nucifera), Evening Primrose Extract, Cetearyl Alcohol, Shea Butter, Aloe Vera (Aloe Barbadensis), Cetyl Alcohol, Vitamin E Oil, Phenoxyethanol.

The antifungal search has been a difficult one, are you familiar with Oregano Oil? I am hoping (praying!) that it will be a scalp solution for me because otherwise I am stuck between a rock and SLS!

I hope that good diet, plenty of water, fresh air and exercise will be a natural way to manage my condition. I will use the Oregano Oil internally and on the scalp and minimise the amount of water going on my face during washing. Shea does help my lips very much but is too much alone for my face so I hope that the Abbey cream will be a good ally in healing my skin.

Thanks again FF, I have learned a lot!

free skin care · Mon May 21, 2012 2:45 pm

Hi everyone, I have a little update and a question about supplementation. For the last few days I have been following your diet advice firefox:

breakfast - quinoa flakes, buckwheat flakes, goats milk yogurt, goji berries, dried blueberries and apricots, milled flax/hemp/pumpkin seeds

snacks - apple and nuts inc walnuts almonds cashew

Lunch - large salad with egg or avocado

Dinner - large salad with salmon and or beans
should i eat oily fish every day or just 2-3 times per week? i love it so I would be happy to eat every day finance allowing!

Supplement - multivit and mineral blend, probiotic, fish oils, digestive enzymes, green tea, glucosamine

I am wondering whether I should add a prebiotic supplement? I have found one through the Lamberts brand called Eliminex.

I am also wondering whether to use the oregano oil capsules (more convenient!), the pure oil in water, or to get a blend which includes oregano (I found a product I am considering by lamberts called candaway which has oregano, olive leaf and cinnamon bark in a tablet)

I cut my supps significantly on Firefox advice by getting a multivit and mineral so I didnt want to dash into getting 3 or 4 new supplements without asking advice beforehand! Thanks again for your help!

free skin care · Mon May 21, 2012 3:55 pm

Nine a day is indeed a lot of salad, it can get very expensive, and I wonder if you will struggle to include nine different fruits and veggies? Hence I generally suggest stir fries, tomato and bean curries (canned), frozen berries, vegetable soups (frozen). You can steam a pack of stir fry veggies in the microwave in minutes and chuck in some protein. Lunch should always contain some protein, plus either healthy fats or carbs to get sufficient overall calories - was that just a typo that you had either protein or fat? If you can afford oily fish daily go for it, canned salmon or pilchards can be economical.

The Abbey cream is based on almond oil which is primarily oleic acid, if you want to apply GLA topically you would need straight borage or borage as the main ingredient. Glycerin is used at 2-5% so everything after that is present in very small quantities.

I am not familiar with oregano oil's properties so would not want to give you incorrect information on that. Prebiotics are basically soluble fibre, if you eat enough fruit, veggies and pulses you will get plenty.

HTH! Wink

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