Re: cea/Seb Derm...Metrocream/Plexion...Help!

[Guest guest]

> I would love to hear any opinions or any other information anyone

> has using Plexion with Metrocream or just the Plexion. Does Plexion

> help cea as well as Seb Derm?

Plexion is prescribed for both rosacea and seborrheic dermatitis.

According to the formulary, it contains an antibiotic (a sulfonamide,

a sulfur drug which probably acts as an anti-inflammatory agent) and

elemental sulfur (which helps get rid of the upper layers of skin).

I am not familiar with it personally. Some people love it, some

people hate it -- it sounds like one of those products you may have

to try out on your own skin. Even though it is promoted as very

gentle, irritation is the most common complaint so you might want to

start off once a day, and keep it on your face for just 5-10 seconds

rather than the recommended 20 seconds.

No one here can or should advise you regarding continuing Metrocream

or not starting Hydrocortisone. You should follow your doctor's

advice. You don't need to start or stop everything all at once, of

course, but it would be a happy surprise if Plexion cleanser is all

your face needed; it's usually used in conjunction with some kind of

topical cream, at least for initial control of symptoms.

The hydrocortisone is also for both rosacea and (esp) seborrheic

dermatitis, and while effective is not the safest choice, as many

people in this group will attest. Since you already tolerate

Metrocream you're halfway there; instead of the hydrocortisone you

might ask for a prescription to Nizoral, which is a topical

antifungal that has been shown to work as well as hydrocortisone in

seborrheic dermatitis. Using two topical drugs (Metrocream and

Nizoral) is less elegant and more expensive than just hydrocortisone,

but is a reasonable alternative, especially as your condition is

chronic and your face is not experiencing acute inflammation.

You're not my patient, you're another doctor's patient -- don't

listen to me before your own doctor. I hope offering another option

helps a bit, but your doctor may have excellent reasons not to listen

to an emergency physician when it comes to dermatology.

Good luck, and let us know how your treatment progresses.

Marjorie

Marjorie Lazoff, MD

[Guest guest]

I hit return too quickly -- my suggestion for adding Nizoral to your

Metrocream would be instead of the Plexion Cleanser. Using Plexion

with Metrocream would expose you to two different antibiotics, and

using all three would expose you to three different topical

antimicrobial agents -- intuitively, not a good idea. So either the

Plexion (w/ or w/out hydrocortisone), or the Metrocream and Nizoral,

would be the options that make most sense to me.

Marjorie

Marjorie Lazoff, MD