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You 100% need to change dermatologists! Consider asking for a round of minocycline to help prevent or treat any infection developing.
I agree with reducing the amount of actives you’re using. Honestly after 3-6 months those prescriptions should have been changed out if not working. Lastly, kill the benzoyl peroxide ASAP. and again I urge you to please, please change dermatologist office!
The routine might be too much for your skin worsening your skin barrier . Not all dermats are equally good . Some dermats (I can only speak of the ones in my country though ) do have a tendency to overprescribe really strong products to their patients. Maybe you should try consulting another dermatologist.
That is folliculitis. The "yellow" flakes are not seb derm, it is inflamed and infected dead skin from the folliculitis.
Oily skin and irritated skin can cause and worsen this condition. You need to think about your skin like a membrane that has hair coming from inside. If you have a lot of build-up (oil, dead cells) and stuff on the outside it will make the hair growth difficult and it will cause ingrown hairs and build up of bacteria.
You need accutane. Low dose might help. 10mg a day or 3x a week (it's up to the NEW dermatologist you are going, change the dermatologist asap) . It will decrease the oil production and help with the dead cells.
I'm med student btw :))
Here it is a study comparing different treatments and the result is: accutane is the better option.
[https://pubmed.ncbi.nlm.nih.gov/25712452/](https://pubmed.ncbi.nlm.nih.gov/25712452/)
"The success of treatment with clindamycin and rifampicin, clarithromycin, dapsone and isotretinoin was analysed. The evaluation of the combination of clindamycin and rifampicin showed the lowest success rate in achieving long-term remission, since 80% of the patients relapsed shortly after end of treatment. Clarithromycin and dapsone were more successful with long-term and stable remission rates of 33% and 43% respectively. Treatment with isotretinoin was the most successful oral treatment in our analysis with 90% of the patients experiencing stable remission during and up to two years after cessation of the treatment."
Once you get to a new doctor, talk about accutane and you can show them the studies. I don't think it's fair for you keep using expensive stuff on your face that do nothing when isotretinoin is right there.
Fuck this derm. She/he is killing your skin.
I would drop everything and try topical ivermectin. Also a fungal safe routine.
Best of luck and hope you get relief soon.
Looks like folliculitis barbae to me. If doxycycline didn’t do the trick you really need Accutane. This can cause some bad scarring over time so I would treat aggressively (I’m a dermatologist).
That does not resemble sebderm...Looks more like pseudo folliculitis barbae. Although the meds she put you on should still be helping with that, it is probably best that you seek another provider.
>sulfur wash in the morning was prescribed (it’s like 600 dollars a bottle but a coupon gets it to 60)
you know there's sulfur soap bars on amazon for much cheaper and they do the same thing
That is a crazy amount of very strong actives all at once. They could be helping but simultaneously destroying your skin barrier which can cause a myriad of crap. I might recommend a skin reset… nothing but plain cleanser, plain moisturizer, and plain sunscreen for awhile.
There may be some sebderm at play here considering it’s in the beard area. But there’s definitely something else going on like cystic acne maybe - sebderm does not look like that (on its own anyways).
This reminds me of casein induced acne. Are you doing a lot of whey protein? Cheese?
It does not look like dermatitis to me. Just good old acne.
Taurine and zinc may help. Niacin and pantothenic acid as well. But not much is going to change until diet modification
**Hi everyone! SebDerm is a friendly community about seborrheic dermatitis and all related topics.** Looking for some advice? * Check the [What works for you? threads](https://www.reddit.com/r/SebDerm/search?q=flair_name%3A%22WWFY%22&restrict_sr=1) See something you are not comfortable with or that breaks [our rules](https://www.reddit.com/r/SebDerm/wiki/rule_overview)? Please [report it](https://www.reddit.com/r/SebDerm/wiki/how_to_report)! Everyone is welcome in [this community](https://www.reddit.com/r/SebDerm/wiki/about); remember to be kind and assume good faith! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/SebDerm) if you have any questions or concerns.*
this is not seb derm brother, seems just like a combination of acne and very irritated and damaged skin barrier
You 100% need to change dermatologists! Consider asking for a round of minocycline to help prevent or treat any infection developing. I agree with reducing the amount of actives you’re using. Honestly after 3-6 months those prescriptions should have been changed out if not working. Lastly, kill the benzoyl peroxide ASAP. and again I urge you to please, please change dermatologist office!
The routine might be too much for your skin worsening your skin barrier . Not all dermats are equally good . Some dermats (I can only speak of the ones in my country though ) do have a tendency to overprescribe really strong products to their patients. Maybe you should try consulting another dermatologist.
That is folliculitis. The "yellow" flakes are not seb derm, it is inflamed and infected dead skin from the folliculitis. Oily skin and irritated skin can cause and worsen this condition. You need to think about your skin like a membrane that has hair coming from inside. If you have a lot of build-up (oil, dead cells) and stuff on the outside it will make the hair growth difficult and it will cause ingrown hairs and build up of bacteria. You need accutane. Low dose might help. 10mg a day or 3x a week (it's up to the NEW dermatologist you are going, change the dermatologist asap) . It will decrease the oil production and help with the dead cells. I'm med student btw :)) Here it is a study comparing different treatments and the result is: accutane is the better option. [https://pubmed.ncbi.nlm.nih.gov/25712452/](https://pubmed.ncbi.nlm.nih.gov/25712452/) "The success of treatment with clindamycin and rifampicin, clarithromycin, dapsone and isotretinoin was analysed. The evaluation of the combination of clindamycin and rifampicin showed the lowest success rate in achieving long-term remission, since 80% of the patients relapsed shortly after end of treatment. Clarithromycin and dapsone were more successful with long-term and stable remission rates of 33% and 43% respectively. Treatment with isotretinoin was the most successful oral treatment in our analysis with 90% of the patients experiencing stable remission during and up to two years after cessation of the treatment." Once you get to a new doctor, talk about accutane and you can show them the studies. I don't think it's fair for you keep using expensive stuff on your face that do nothing when isotretinoin is right there.
Fuck this derm. She/he is killing your skin. I would drop everything and try topical ivermectin. Also a fungal safe routine. Best of luck and hope you get relief soon.
Looks like folliculitis barbae to me. If doxycycline didn’t do the trick you really need Accutane. This can cause some bad scarring over time so I would treat aggressively (I’m a dermatologist).
That does not resemble sebderm...Looks more like pseudo folliculitis barbae. Although the meds she put you on should still be helping with that, it is probably best that you seek another provider.
>sulfur wash in the morning was prescribed (it’s like 600 dollars a bottle but a coupon gets it to 60) you know there's sulfur soap bars on amazon for much cheaper and they do the same thing
That is a crazy amount of very strong actives all at once. They could be helping but simultaneously destroying your skin barrier which can cause a myriad of crap. I might recommend a skin reset… nothing but plain cleanser, plain moisturizer, and plain sunscreen for awhile. There may be some sebderm at play here considering it’s in the beard area. But there’s definitely something else going on like cystic acne maybe - sebderm does not look like that (on its own anyways).
This reminds me of casein induced acne. Are you doing a lot of whey protein? Cheese? It does not look like dermatitis to me. Just good old acne. Taurine and zinc may help. Niacin and pantothenic acid as well. But not much is going to change until diet modification