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Suggest Treatment For Recurrent Facial Breakouts

Posted on Thu, 12 May 2016

Question: Hello,
For the past 9 months I have had recurring facial breakouts with severe itching. My dermatologist says I have an abundance of yeast in my body. I am on a regimen of Desonide cream 0.05%, Elidel, and Ketoconazole Shampoo 2%. I use them religiously but the moment I stop the breakouts return. Is there something else I should be doing? Perhaps a probiotic? Thanks in advance.

Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Brief Answer:
Upload images, please

Detailed Answer:
Hello and Welcome

I appreciate your concern

If appropriate, Kindly upload some good quality images with high resolution of your face and the areas where the flares occur.

If you want me to answer without the help of an image , kindly let me know to do so.

Wishing you best of health

Thanks

Let me know if you have any query

Please consult your doctor before deciding on any further course of action.

For future follow up / correspondence you may ask me directly at the link given below

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Dr. M.S. Khalil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (44 hours later)

Good evening Dr. XXXXXXX

Sorry but I do not have any images of a breakout to show you at this time. I use the shampoo each day. The Elidel each day and the Ketoconazole on the weekends. When the breakouts disappear I stop using the medications and within a week or two the rashes return. Rashes mostly appear in the T-Zone area, chin, around the nose, behind the ears, and in my hair area in the back of my head. I use the medications wherever there is a breakout. The breakout are not always in the same spots.

Answered by Dr. Dr. Muhammad Sareer Khalil (17 hours later)

Brief Answer:
Explained

Detailed Answer:
Hello again.

From your description it can be excessive fungus in skin leading to sebboric eczema

Desonide topical is used to treat eczema dermatitis allergies and rash
Elidel which is pimecrolimus a immunosuppressant control immune system to slow down growth of atopic dermatitis
Seborric eczema for which exact cause is not known but but excess oil in skin may act as an irritant secondly malassezia a type of fungus found in skin's oil can grow abnormally and increase oil production its long term skin condition that requires continous treatment and very good scalp and skin care
Skin has scaly patches that flake off white or yellow in colour usually called dandruff, scalp can be itchy red oily and greasy hair loss may occur
Risk factors include obesity weak immune system endocrine disease congestive heart failure neurological disease such as Parkinson and depression
The medications your on it is used to treat it
Its a chronic disease patient may have periods of worsening disease and also when its better. Flares should be treated before it worsens makes it manageable
Shampoo having coal tar ketokonazol salicylic acid selenium and zinc pyrithione is helpful
Oral antifungal can also be given
Medication that affect the immune system are also used.
Best results are found when a combination of treatments are used both meds and life style
You have to continuously take care of your scalp it will take time and many repeated treatments before symptoms go away. And it may return so nothing can ve said about it.
Condition similar to it are psoriasis atopic dermartitis and rosacea.

Hope this can help
Thanks

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar