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Re: cea/Seb Derm Dilemma

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Dave,

The dermatologist you saw sounds EXACTLY like the derm I have been seeing

(And Trust me that is NOT a compliment) I even remember hearing the EXACT

same line (This medicine is so safe, I prescribe it for babies with diaper

rash) etc..In fact, come to think of it, he used the EXACT same line when

trying to get me to try Protopic AND Desowen.. both of which were WAY WAY

too harsh for my skin, and I find it hard to believe my skin is THAT much

more sensitive than a baby's butt...(I wonder if thats just a line they were

taught in Dermatology school or something?) The fact of the matter is,

topical steroids are NOT safe, whether or not you have cea. Now, before

I elaborate any further, allow me to clarify. Using a topical steroid on

your face for a few days, will not have any long-term side effects... and if

you want to try using it for three days or something to see if it will clear

up your problem, then go ahead... Unfortunately, it probably will not clear

things up that fast, and even if it did, your problem would most likely

return the instant you discontinue using it.

Topical steroids are Not safe for your skin. They do not just induce

cea. Long-term topical steroid use will break down the epidermis. This

worsens/induces cea because when the Epidermis is weaker, environmental

insults/rosacea triggers are more able to penetrate the skin and cause

irritation/inflammation (At least this is how I understand it to work). But

even if you do not have cea, long-term steroid use will cause the

epidermis to break down, which can cause a bunch of skin problems, and would

probably even worsen your Seb derm in the long run by causing additional

inflammation. Steroids may help in the short run, but in the long run they

WILL damage your skin. This is true of ALL steroids, even the " mild " ones..

And if your derm is anything like mine, he will tell you ANY steroid he

tries to prescribe is " mild " . For instance, my derm tried to get me to use

Desowen, by giving me the same line your derm gave you, and I found out

later Desowen is NOT all that mild, it is actually relatively potent, even

when compared to other steroids. Even 0.5% hydrocortizone (the absolute

weakest Steroid there is I believe, even available over the counter) will

cause this problem. There is no such thing as a safe steroid (At least not

for long-term use).

Using topical steroids intermittently to control flares is debatable (Some

people may be all for that, and others may be against even this, I'm not

sure where I weigh in...) But depending on a steroid for long-term control

will eventually lead to more problems.

Now, this is all just my uninformed opinion. I am not a doctor, and I could

be wrong. However, my well-respected, award-winning derm told me Desowen

would not thin my skin at all, and I later read in probably half a dozen

different places saying he was wrong. And when I tried to use Desowen, it

DID cause me problems. (Luckily I wasnt on it for that long)

Again, I am not a doctor, and maybe Dr. Lazoff (who has already offered alot

of great insite on the website so far) would be able to give you more

accurate information than me.. But this is all what I understand to be true.

Adam

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> Again, I am not a doctor, and maybe Dr. Lazoff (who has already

> offered alot of great insite on the website so far) would be able

> to give you more accurate information than me..

See, now, if you flatter me, Adam, then I'm going to have to say

something.

Seriously, it's understandable that members of this group are

skittish about topical steroid use, after reading some of the horror

stories here. Still, to put it in perspective, topical steroids are

used by dermatologists for acute exacerbations, even chronic

conditions.

Here's my advice: unless you have more questions (for your doctor,

not us) then you have to decide yourself whether or not to go with

how he diagnoses and wants to treat your condition, at least for a

while. Otherwise, ask him to recommend an alternative treatment that

doesn't carry the risks you're concerned about; you may be more

comfortable with other risks or drawbacks. Don't let your doctor

intimidate you, but if he strikes you as competent don't

underestimate his knowledge and experience. Who are the people most

able to decide what's in your best interest? You and your doctor --

certainly not us, right?

Marjorie

Marjorie Lazoff, MD

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> Again, I am not a doctor, and maybe Dr. Lazoff (who has already

> offered alot of great insite on the website so far) would be able

> to give you more accurate information than me..

See, now, if you flatter me, Adam, then I'm going to have to say

something.

Seriously, it's understandable that members of this group are

skittish about topical steroid use, after reading some of the horror

stories here. Still, to put it in perspective, topical steroids are

used by dermatologists for acute exacerbations, even chronic

conditions.

Here's my advice: unless you have more questions (for your doctor,

not us) then you have to decide yourself whether or not to go with

how he diagnoses and wants to treat your condition, at least for a

while. Otherwise, ask him to recommend an alternative treatment that

doesn't carry the risks you're concerned about; you may be more

comfortable with other risks or drawbacks. Don't let your doctor

intimidate you, but if he strikes you as competent don't

underestimate his knowledge and experience. Who are the people most

able to decide what's in your best interest? You and your doctor --

certainly not us, right?

Marjorie

Marjorie Lazoff, MD

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> Again, I am not a doctor, and maybe Dr. Lazoff (who has already

> offered alot of great insite on the website so far) would be able

> to give you more accurate information than me..

See, now, if you flatter me, Adam, then I'm going to have to say

something.

Seriously, it's understandable that members of this group are

skittish about topical steroid use, after reading some of the horror

stories here. Still, to put it in perspective, topical steroids are

used by dermatologists for acute exacerbations, even chronic

conditions.

Here's my advice: unless you have more questions (for your doctor,

not us) then you have to decide yourself whether or not to go with

how he diagnoses and wants to treat your condition, at least for a

while. Otherwise, ask him to recommend an alternative treatment that

doesn't carry the risks you're concerned about; you may be more

comfortable with other risks or drawbacks. Don't let your doctor

intimidate you, but if he strikes you as competent don't

underestimate his knowledge and experience. Who are the people most

able to decide what's in your best interest? You and your doctor --

certainly not us, right?

Marjorie

Marjorie Lazoff, MD

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Dave,

I have had several people email me about the side

effects of DesOwen as I wasn't sure myself when

prescribed it for my cea. Each of us are

different in reactions. I still applied the DesOwen

Lotion and in 2 days have seen a big difference in the

redness and break outs. Do what you feel is in your

best interest. Do you trust your Doctor? If not, ask

to see someone for a second opinion.

Good Luck!

Dawn

--- d9_2003 d9_2003@...> wrote:

> Over a year ago I was told by a dermatologist that I

> had rosacea. I

> saw a different dermatologist this week and he

> disagreed with the

> diagnosis of rosacea. He said that my problem is

> seborrheic

> dermatitis. I told him that I do have symptoms of

> rosacea such as

> broken blood vessels on the bridge of my nose and I

> flush

> occasionally (mostly when under stress or after

> drinking alcohol).

> He said it might be possible that 5% of my problem

> was rosacea

> (don't know how he arrived at that conclusion), but

> the broken

> blood

> vessels were caused by sun damage (even though I

> told him I stay out

> of the sun). It really seemed that he thought I

> didn't have

> rosacea

> at all.

>

> He prescribed Aclovate for my face. That's a

> topical steriod,

> and I'm concerned that if I have rosacea it will

> aggravate it.

> If I

> don't have rosacea I'm afraid it may induce it.

> (I've

> read that steroids can induce rosacea.) He assured

> me that Aclovate

> is safe and a very mild steroid that is used on

> babies with

> dermatitis. He also assured me that Aclovate would

> not thin my skin.

> (I have read that topical steroids do this and this

> helps induce

> rosacea.) He even said that in some cases topical

> steroids were

> indicated for rosacea such as for rosacea

> dermatitis.

>

> I looked up Aclovate's potential side-effects and I

> am concerned

> about them. Aclovate is also an expensive

> medication.

>

> I asked him about non-steroid treatments like

> anti-fungal

> medications. He said they wouldn't be very

> effective and

> Aclovate is what I should use. According to him

> Aclovate could clear

> up my skin in a few days. In my case he did not

> seem to think that

> Aclovate would cause rosacea (or adversely affect it

> if I do actually

> have it).

>

> I've noticed other people posting similar

> experiences of

> dermatologists prescribing topical steroids like Des

> Owen. Is anyone

> else concerned about this? I am confused and

> concerned about using

> topical steroids.

>

> So what am I supposed to do? Does anyone have

> experience with

> Aclovate? Can it really clear up seb derm in a few

> days? Has it

> caused or aggravated anyone's rosacea? Are there

> any effective

> treatments for seb derm besides topical steroids?

> What would you do

> if you were in my situation?

>

> I'd really appreciate it if anyone would share their

> experience

> or

> knowledge in this area. Thanks.

>

> Dave

>

>

>

>

> --

> Please read the list highlights before posting to

> the whole group (http://rosacea.ii.net/toc.html).

> Your post will be delayed if you don't give a

> meaningful subject or trim your reply text. You must

> change the subject when replying to a digest !

>

> See http://www.drnase.com for info on his recently

> published book.

>

> To leave the list send an email to

> rosacea-support-unsubscribe

>

>

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